News & Analysis as of

Healthcare Reform Accountable Care Organizations Health Care Providers

Holland & Knight LLP

CMMI Signals New Strategy and Terminates 4 Value-Based Care Models

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The Center for Medicare and Medicaid Innovation (CMMI) has released a statement on plans to unveil a new strategy focused on "improving the health of Americans through disease prevention via evidence-based practices,...more

McDermott+

ACO REACH: What Recent Performance Results Could Mean for the Model’s Future

McDermott+ on

Decisions, decisions, decisions. The Centers for Medicare & Medicaid Services (CMS) under the Trump Administration will have its hands full making decisions about Center for Medicare and Medicaid Innovation (CMMI) models...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

Bass, Berry & Sims PLC

HHS Proposes Rule to Establish Disincentives for Healthcare Providers That Engage in Information Blocking

Bass, Berry & Sims PLC on

In 2020, when the U.S. Department of Health and Human Services (HHS) published its Final Rule to implement the information blocking prohibitions of the 21st Century Cures Act, HHS left healthcare providers wondering what...more

Nelson Mullins Riley & Scarborough LLP

The Importance of Carefully Drafted ACO REACH Agreements

The Centers for Medicare & Medicaid Services (“CMS”) recently announced that 124 applicants have been provisionally approved to participate in the new Accountable Care Organization Realizing Equity, Access, and Community...more

Nelson Mullins Riley & Scarborough LLP

REACHing for More - Benefit Enhancements in the ACO REACH Model

The new, value-based ACO REACH Model reflects the Biden-Harris Administration’s mission in promoting health equity, with a strong focus on improving access to healthcare for individuals in underserved communities. Payments to...more

Nelson Mullins Riley & Scarborough LLP

Using the New Value-Based Rules to Enhance Your ACO

In November 2020, the Centers for Medicare & Medicaid Services (CMS) finalized value-based exceptions under the Stark law, and the Office of Inspector General (OIG) finalized value-based safe harbors under the Anti-Kickback...more

Nelson Mullins Riley & Scarborough LLP

ACO REACH – a Good Opportunity?

On February 24, CMS announced that effective January 1, 2023, the Direct Contracting, or DCE, Model would cease to exist. It is replacing DCE with a new form of ACO, the Realizing Equity, Access, and Community Health (REACH)...more

Akerman LLP - Health Law Rx

A Glossary of Commonly Used Acronyms in Florida Managed Care

Anyone who interacts with third party payors encounter acronyms on a regular basis. While acronyms are intended to facilitate efficient communication, their use often instead leads to confusion. This blog is intended to...more

Downs Rachlin Martin PLLC

Vermont Health Care Update 01-20-20 - An analysis from DRM's Health Law Team

Rural Health Task Force presents report to health committee - The Rural Health Services Task Force presented its report to the House Health Care Committee on Tuesday. Green Mountain Care Board member and Task Force Chair...more

Seyfarth Shaw LLP

New Safe Harbors In A Storm of Risk and Regulations: A Review of the OIG’s Proposed Changes to the Federal Anti-Kickback Laws

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In an effort to modernize and clarify a statute that looms large in the minds of health care providers across the nation, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) recently...more

Polsinelli

Unique Opportunity to Influence Anti-Kickback Statute Rules

Polsinelli on

Starting today, the industry has 75 days to provide input on the proposed rules published in the Federal Register regarding the future enforcement of the Anti-Kickback Statute (AKS). ...more

Ballard Spahr LLP

CMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed Rules

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring the Physician Self-Referral...more

Jones Day

Jones Day Talks Health Care: The Eliminating Kickbacks in Recovery Act

Jones Day on

With the passage of the Eliminating Kickbacks and Recovery Act in October 2018, Congress took aim at the ongoing opioid crisis threatening communities across the U.S. This new criminal statute targets healthcare providers...more

Robinson+Cole Health Law Diagnosis

CMS Finalizes Overhaul of the Medicare Shared Savings Program in “Pathways to Success” Final Rule

On December 31, 2018, the Centers for Medicare and Medicaid Services (CMS) published a final rule (Final Rule) establishing the “Pathways to Success” program that overhauls the Medicare Shared Savings Program (MSSP). ...more

Mintz

Massachusetts Senators Hold Healthcare Roundtable Discussions

Mintz on

This past August, the Massachusetts Senate and the Millbank Memorial Fund Healthcare Working Group held three roundtable discussions geared towards finding solutions to rising healthcare costs and providing patients with more...more

Bradley Arant Boult Cummings LLP

2016 – Health Law Year in Review

We are pleased to present our annual review of developments in the field of health law. The year was marked by key changes in False Claims Act jurisprudence and Medicare payment policy. 2016 also brought with it focused...more

Foley & Lardner LLP

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

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Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more

Polsinelli

Health Reform + Related Health Policy News - January 2015, Issue 1

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In This Issue: - Health Proposals - Department of Health & Human Services - Medicare - For More Information - Excerpt from Health Proposals: Department of Health & Human Services - ...more

Katten Muchin Rosenman LLP

Impact of Health Care Reform on Provider Liability

In this presentation: - The Changing Healthcare Landscape - Key Features of an ACO/CIN - ACO Standards and Quality Metrics - Examples of Quality Standards - Impact on Board and Corporate...more

Brownstein Hyatt Farber Schreck

The Reformed Health Care Industry: Creative Structures and Alliances Can Yield Great Benefits, but Also Great Risks

Since the Affordable Care Act (the “ACA”) was enacted in 2010, the health care industry has been on the edge of its proverbial seat waiting to see which care delivery models are best suited to sustain all the changes: to...more

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