News & Analysis as of

Health Care Providers Medicare Patients

McDermott Will & Schulte

New EO Targets Prescription Drug Costs – and Drug Manufacturers, Hospitals, and Health Centers

On April 15, 2025, President Trump signed an executive order (EO) aimed at addressing the cost of prescription drugs. This EO, titled “Lowering Drug Prices by Once Again Putting Americans First,” outlines specific directives...more

McGuireWoods LLP

OIG Recommends Increased RPM Oversight

McGuireWoods LLP on

On September 24, 2024, the Department of Health and Human Services Office of Inspector General (“OIG”) published a report (the “Report), reviewing and recommending increased oversight of remote patient monitoring (“RPM”)...more

Jones Day

Health Care Provider Bankruptcy Update: Patient Care Ombudsman Not Necessary in Every Health Care Business Bankruptcy Case

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Recent headlines have starkly illuminated the headwinds facing health care providers struggling to recover from a host of financial pressures. Many providers have resorted to filing for bankruptcy protection as a way, among...more

Quarles & Brady LLP

HRSA Notice Provides Clarity on 340B Child Site Registration Requirements

Quarles & Brady LLP on

After months of relative uncertainty, the Health Resources and Services Administration (HRSA) published a Notice confirming the end to a COVID-19 pandemic-era flexibility that allowed unregistered child sites to utilize 340B...more

Roetzel & Andress

Opting Out of Medicare: When and How to Do It

Roetzel & Andress on

On the #HealthLawHotSpot this week, host Ericka Adler is joined by fellow Roetzel attorney Christina Kuta to answer some commonly asked questions regarding opting out of Medicare. Ericka and Christina discuss the situations...more

McDermott Will & Schulte

This Week in 340B: September 2023 #3

This weekly series provides brief summaries to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

Health Care Compliance Association (HCCA)

Enforcement actions relating to a lack of medical necessity

In a climate of shrinking margins, diminishing reimbursement, and frequent denials, healthcare organizations may make efforts to increase the volume of services they provide, especially those that are more profitable. Of...more

Pullman & Comley - Connecticut Health Law

Significant 2022 Connecticut Health Law Cases

Significant health care cases of 2022 included a surprise billing unfair trade practices case, a class action recognizing a patient’s constitutionally protected interest in their inpatient classification and a ruling...more

Sheppard Mullin Richter & Hampton LLP

Day 1 Notes from the 41st Annual J.P. Morgan Healthcare Conference

I was struck on the first day of the 41st Annual J.P. Morgan Healthcare Conference by Sanjay Doddamani (CEO of UpStream Healthcare) saying that “Health is a state of independence.” A simple statement, but a very profound and...more

Sheppard Mullin Richter & Hampton LLP

Finding Our Way Out of the Pandemic Haze: What Telehealth Tools Are Medicare Providers Allowed to Keep, and Which Must They Leave...

During the COVID-19 pandemic, Medicare coverage expanded to include a vast arsenal of tools that help patients access medical services while keeping patients and practitioners safe. Many of these tools involve telehealth...more

Troutman Pepper Locke

Centers for Medicare and Medicaid ‎Innovation Announce New ‎‎“ACO REACH” Model to ‎Replace ‎Medicare Direct

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On February 24, 2022, the Centers for Medicare & Medicaid Services (CMS) announced that it had redesigned the Global and Professional Direct Contracting Model for 2023. The Center for Medicare and Medicaid Innovation...more

McDermott Will & Schulte

CMS Announces Request for Applications for Participation In the ACO REACH Model

On February 24, 2022, the Centers for Medicare and Medicaid Services (CMS) Innovation Center announced a Request for Applications (RFA) for the Accountable Care Organization (ACO) Realizing Equity, Access, and Community...more

Sheppard Mullin Richter & Hampton LLP

“REACHing” For Health Equity: CMS Revamps The Professional Direct Contracting Model

On February 24, 2022, the Centers for Medicare & Medicaid Services (CMS) announced its redesign of the Global and Professional Direct Contracting Model (GPDC), which now will be called the Accountable Care Organization (ACO)...more

Mintz - Health Care Viewpoints

Telehealth Update: New Bill Could Provide Much Needed Certainty to Providers and Patients

On Monday, February 7, 2022, U.S. Senators Catherine Cortez Masto, D-Nevada, and Todd Young, R-Indiana, introduced the Telehealth Extension and Evaluation Act, which if passed, would extend several of the telehealth waivers...more

Sheppard Mullin Richter & Hampton LLP

The Permanency for Audio-Only Telehealth Act: A Matter of Healthcare Equity?

In our December 7, 2020 Blog Post, “Permanent Expansion of Medicare Telehealth Services,” we discussed the 2021 Medicare Physician Fee Schedule Final Rule (the “Final Rule”) and the regulatory changes made therein by the...more

Sheppard Mullin Richter & Hampton LLP

Permanent Expansion of Medicare Telehealth Services

On December 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released the annual Physician Fee Schedule final rule (“Final Rule”) which, among other things, aimed to further President Trump’s October 3, 2019...more

Chambliss, Bahner & Stophel, P.C.

Tennessee General Assembly Significantly Expands Telehealth Flexibility and Payment Parity

Yesterday (August 13), while in special session ordered by Gov. Bill Lee, the Tennessee General Assembly overwhelmingly passed an amended version of HB8002, which significantly enhances telehealth flexibility and payment...more

Mitchell, Williams, Selig, Gates & Woodyard,...

Liability and Patient Standards of Care in Response to COVID-19

Patient standards of care have always been a moving target, dependent on specialty, circumstances, and resources. Add in a global pandemic and this standard for the treatment of COVID-19 is in a constant state of flux. Novel...more

Pullman & Comley, LLC

Health Law From the Courts: Review of 2019 Connecticut Case Law

Pullman & Comley, LLC on

Our annual survey of health law cases for 2019 includes a number of notable decisions affecting the practice of medicine and the delivery of other health care services in Connecticut.  These include the Connecticut Supreme...more

Sheppard Mullin Richter & Hampton LLP

Day 1 Notes at the 2020 J.P. Morgan Healthcare Conference

If I printed a tee shirt for the 2020 J.P. Morgan Healthcare Conference, what would it say? In past years, it would have been “Big Data,” Analytics, Artificial Intelligence, ACA, Risk, Medicare Advantage or Quality. This...more

Bricker Graydon LLP

CMS announces reduced psychiatric hospital burden with new survey process

Bricker Graydon LLP on

On January 13, 2020, the Centers for Medicare & Medicaid Services (CMS) announced a new streamlined survey and certification process for psychiatric hospitals as part of the agency’s “Patients over Paperwork” initiative. ...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes New Home Health Agency Rule Including Potential Changes to Reimbursement, Coverage, Quality, and More: CMS Accepting...

On July 11, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced a proposed rule for home health agency Medicare reimbursement that would increase payments by an aggregate 1.3% for 2020, amounting to $250...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes To Shift Hospice Funding From Routine To Enhanced Care Days

With the FY 2020 proposed hospice rule, CMS proposes two material changes for hospice providers: • CMS proposes to shift approximately $500 million of hospice funding (2.7% of payments) from routine care to enhanced care...more

Bass, Berry & Sims PLC

Modernizing Medicare: CMS Expands Reimbursement for Virtual Care and Telehealth

Bass, Berry & Sims PLC on

As part of the 2019 Medicare Physician Fee Schedule Final Rule (Final Rule) published on November 23, 2018, the Centers for Medicare & Medicaid Services (CMS) took significant steps toward modernizing Medicare to expand...more

Holland & Knight LLP

Healthcare Law Update: September 2018

Holland & Knight LLP on

Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

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