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Smith Anderson

OBBB Act Brings Major Medicaid Changes: What North Carolina Providers Need to Know

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The One Big Beautiful Bill Act (P.L.119-21) (the “OBBB”) passed by slim margins in the U.S. Senate (51-50) and U.S. House (218-214) and was signed into law by President Trump on July 4, 2025....more

Husch Blackwell LLP

New Mexico Rules That Anesthesia Services Can Be Purchased Exempt for Resale

Husch Blackwell LLP on

New Mexico’s gross receipts tax (what the state calls its sales tax) is generally imposed on receipts derived by the seller from performing services in the state; however, a resale of the services is not generally taxable if...more

Foley & Lardner LLP

Six Key Investment and Strategic Themes from Payer-Provider Convergence Deals

Foley & Lardner LLP on

At the 11th Annual Investment and M&A Opportunities in Healthcare conference in Nashville on June 6th, 2018, a panel session moderated by Chris Donovan, partner in Foley’s Health Care Practice Group, addressed the topic of...more

Sheppard Mullin Richter & Hampton LLP

‘Twas the Season to Contract? A Year-End Review of Network Negotiations and Billing Disputes

Sheppard Mullin Richter & Hampton LLP on

As 2017 drew to a close, some health plans and healthcare providers across the country were still busy trying to finalize contracts for in-network services for 2018 and beyond. A number of negotiations made the headlines in...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Morgan Lewis

Passage of the Bipartisan Budget Act: What You Should Not Do Now

Morgan Lewis on

Tips on preserving the provider-based status for existing clinics. The Bipartisan Budget Act of 2015 (H.R. 1314) was signed into law on Monday, November 2. Notwithstanding significant concerns raised by the hospital...more

K&L Gates LLP

Pennsylvania Hospitals Successfully Challenge Sequestration Reductions

K&L Gates LLP on

In a case of first impression, a Pennsylvania court recently ruled in favor of 12 independent community hospitals (the “Hospitals”) that sued health insurer Highmark Inc. (“Highmark”) for passing on its 2 percent Medicare...more

King & Spalding

CMS Issues FY 2016 IPPS and LTCH Proposed Rule

King & Spalding on

On April 17, 2015, CMS released a proposed rule (Proposed Rule) to update the fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital...more

Akin Gump Strauss Hauer & Feld LLP

Software Glitch Sparks FCA Suit Against Hospitals for Late Repayment of Medicaid Reimbursements

Akin Gump Strauss Hauer & Feld LLP on

On June 27, the New York Attorney General’s Office and the U. S. Attorney’s Office for the Southern District of New York intervened in a qui tam suit against Continuum Health Partners, Inc., Beth Israel Medical Center and St....more

Faegre Drinker Biddle & Reath LLP

Medicare Patients Caught In Two-Midnight Rule Crossfire

Faegre Drinker Biddle & Reath LLP on

Hospitals have been complaining about the two-midnight rule since it was first announced. But mounting evidence indicates that Medicare patients themselves are suffering badly from the effects of the rule....more

Baker Donelson

CMS Publishes Inpatient Prospective Payment System (IPPS) FY 2015 Proposed Rule

Baker Donelson on

On April 30, 2014, CMS posted its proposed changes and updates to the Medicare IPPS [PDF] that would apply beginning in fiscal year (FY) 2015. Comments are due by June 30, 2014. Below is a summary of the major changes to the...more

Polsinelli

Polsinelli Podcast - Health Care Payment Changes: From Service to Value

Polsinelli on

Healthcare is changing for consumers and providers under the Affordable Care Act. Less publicized is the way providers are now being paid and the way they will work together. In this week's Polsinelli "Inside Law," podcast,...more

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