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Competition Centers for Medicare & Medicaid Services (CMS)

King & Spalding

HHS Issues Report on Consolidation and Private Equity in Health Care Markets

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On January 15, 2025, HHS released a report highlighting negative sentiments from commenters toward consolidation, private equity, and private insurers in health care markets. The comments were received in response to a joint...more

Sheppard Mullin Richter & Hampton LLP

Increased Scrutiny into Agents & Brokers in the Medicare Advantage Space

Most Medicare Advantage (“MA”) beneficiaries rely on agents and brokers to help them navigate the complex process of selecting a health plan that will meet their needs. In exchange, brokers and agents received certain fixed...more

Sheppard Mullin Richter & Hampton LLP

CMS Issues CY2025 Medicare Advantage and Part D Final Rule

On April 4, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued the contract year 2025 (CY2025) Medicare Advantage and Part D final rule (the “Final Rule”). In addition to finalizing its CY2025 proposed rule,...more

Foley & Lardner LLP

Biden Administration Announces New Efforts to Promote Competition in Health Care

Foley & Lardner LLP on

On December 7, 2023, the Biden Administration announced several new initiatives intended to “promote competition” in the health care sector. These initiatives reflect a broad range of concerns about rising costs in health...more

Foley & Lardner LLP

Medicare Advantage Agent and Broker Compensation: Commissions, Administrative Payments, and Referral Fees under 42 C.F.R. §...

Foley & Lardner LLP on

A common question in the context of Medicare Advantage (“MA”) distribution and compensation is how agents and brokers may be compensated for commissions and administrative payments and whether, and to what extent, referral...more

McDermott+

Healthcare Preview for the Week of: April 24, 2023

McDermott+ on

A Busy Week in Congress - This week will be very busy on Capitol Hill. Six hearings will focus specifically on healthcare. The House Energy and Commerce Committee will hold a legislative hearing to review 17 pieces of...more

Hogan Lovells

A Survey of President Biden’s Executive Order on Promoting Competition in the American Economy

Hogan Lovells on

It has been one year since President Biden signed a far-reaching, industry-spanning Executive Order on Promoting Competition in the American Economy.  The Executive Order outlines a “whole-of-government” approach to...more

Husch Blackwell LLP

CMS Releases CY 2023 OPPS and ASC Proposed Rule

Husch Blackwell LLP on

The Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule on July 15, 2022. The Proposed...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | May 2022 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights notable enforcement activity between April 21 and May 20, 2022, including a telemedicine case involving $64 million in false and fraudulent claims. We also...more

McDermott Will & Emery

Biden Administration Takes Action to Improve Competition, Transparency and Quality for Hospitals and Nursing Homes

McDermott Will & Emery on

The Centers for Medicare & Medicaid Services (CMS) recently published detailed databases summarizing changes of ownership of Medicare-enrolled hospitals and skilled nursing facilities (SNFs). The databases currently include...more

Akin Gump Strauss Hauer & Feld LLP

President Biden’s ‘Promoting Competition’ Executive Order: Key Health Care Actions to Follow

As has been widely reported, earlier this summer, President Biden issued Executive Order (EO) 14036, “Promoting Competition in the American Economy.” The EO provides insight into how the Biden-Harris administration plans to...more

Sheppard Mullin Richter & Hampton LLP

Executive Order on Promoting Competition in the American Economy: The Biden Administration Considers Drug Pricing Strategies While...

On August 10, 2021, the Centers for Medicare and Medicaid (“CMS”) published a proposed rule (“Proposed Rule”) to rescind the Most Favored Nation Model (“MFN Model”) interim final rule that was published on November 26, 2020...more

Goodwin

President Biden Issues Executive Order Including Provisions To Promote Generic Drug and Biosimilar Competition in the American...

Goodwin on

On July 9, President Biden issued an Executive Order regarding competition in various sectors of the United States economy, including the healthcare market. Among the 72 initiatives set forth in the Order are instructions...more

MoFo Life Sciences

Biden Administration Executive Order On Promoting Competition In The American Economy: Drug Pricing And Healthcare Industry...

MoFo Life Sciences on

On July 9, 2021, President Biden enacted a sweeping executive order creating a “whole‑of-government competition policy.” Morrison & Foerster outlined the administration’s policy in a recent client alert that provides a...more

Cozen O'Connor

41-State Data Breach Settlement | Additional CCPA Regulations | Suit Over Patient Discharge Notice

Cozen O'Connor on

Antitrust- Attorneys General Testify in House Hearing on Big Tech and Competition- •On March 18, 2021, Colorado AG Phil Weiser and Nebraska AG Doug Peterson testified before the Subcommittee on Antitrust, Commercial,...more

Mintz - Health Care Viewpoints

CMS Seeks to Lower Costs and Increase Competition with Step Therapy for Medicare Part B Drugs

As a continuation of the recent drug pricing developments tied the Trump Administration’s American Patients First Blueprint, beginning January 1, 2019, Medicare Advantage plans will be able to apply step therapy for...more

Pierce Atwood LLP

Aetna-Humana Merger Blocked

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The District of Columbia federal court recently ruled that a proposed $37 billion merger between health insurance giants Aetna and Humana cannot proceed, granting the US Department of Justice’s bid to block the combination on...more

McGuireWoods LLP

Washington Healthcare Update

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This Week: House Energy and Commerce Subcommittee Holds Hearing on Legislation to Strengthen Medicaid Program Integrity and Fraud Controls... Bipartisan Senate Bill Introduced to Stop Anti-Competitive “Pay-For-Delay”...more

Epstein Becker & Green

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

Epstein Becker & Green on

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

BakerHostetler

Antitrust Law Encourages Accountable Care Organizations (“ACOs”) Formation

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Once again, the staff of the Federal Trade Commission (“FTC”) has rebutted claims by physician groups that state legislation is needed to allow independent physicians to collaborate....more

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