AGG Talks: Home Health & Hospice Podcast - Episode 9: The Impact of AI and Prior Authorizations on Home Health and Hospice
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Business Better Podcast Episode: 2024 Advance Notice: Proposed Changes to the Medicare Advantage Risk Adjustment Model
Video: Record-Shattering Year for FCA Recoveries in Health Care - Thought Leaders in Health Law
Hooper, Kearney and Macklin on Cutting Edge Topics in the False Claims Act
Hospice Audit Series: The Latest Developments and Strategies for Success in the Ever-changing Audit Landscape
Podcast: IP(DC): Drug Prices, Political Pressures & Patents
Last week, the Government Accountability Office (GAO) published a report determining that there is a nontrivial risk that prior authorization requirements, together with internal coverage criteria, may undermine the Medicare...more
The U.S. Department of Justice (DOJ) announced last Wednesday that settlements and judgments under the False Claims Act (FCA) exceeded $2.9 billion in fiscal year 2024—up approximately 5% from last year. DOJ’s announcement...more
House Energy & Commerce Health Subcommittee Holds Hearing on Cybersecurity. During the hearing, there was bipartisan concern about UnitedHealth Group’s response to the Change Healthcare cyberattack and consensus around the...more
On January 25, 2024, CMS released a Request for Information (RFI) seeking public input on how it can enhance and increase transparency of Medicare Advantage (MA) data. CMS says that the RFI “builds on our existing MA data...more
This Week in Washington: Still No Speaker in the House; NIH Director Nominee has Hearing; FDA Seeking Feedback on Innovative Drug Clinical Trial Design....more
The House and Senate were both in session this week, with significant healthcare activity at the committee level. The House Ways & Means Committee met to discuss healthcare price transparency, and the Ways & Means Health...more
This Week in Washington: Debt Ceiling Continues to Loom Over the Capitol; DEA Extends COVID-19 Controlled Medications Prescribing Telehealth Flexibilities...more
This Week in Washington: Debt Limit fight continues; Disagreements arise during Senate HELP Committee mark-up of PBM and Generic Drug Competition Bills...more
This Week in Washington: Congress returns to complete appropriations and year-end legislation....more
This Week in Washington: Senate HELP Committee Chair Patty Murray and Ranking Member Richard Burr Release Discussion Draft of Bipartisan Pandemic and Public Health Response Bill....more
This week in Washington: CMS develops additional code for coronavirus lab tests, announces actions to address spread of coronavirus; House passes bill to ban e-cigarette flavors; Grassley says updated Senate Finance drug...more
Upcoming Hearings/Markups - Wednesday, February 26, 2020 - House Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies: “Department of Health and Human Services...more
This week in Washington: The House and Senate will be in recess the week of Feb. 17 in observation of Presidents Day....more
This week in Washington: The House of Representatives passes legislation on fentanyl analogues; Senate continues impeachment trial....more
The Centers for Medicare and Medicaid Services (CMS) recently released several significant Medicare Advantage (MA) and Part D guidance documents outlining new Center for Medicare and Medicaid Innovation (CMMI) programs and...more
Coming Week’s Highlights: State of the Union scheduled for Feb. 5; House committees continue discussion on pre-existing conditions....more
On September 10, 2018, the United States Government Accountability Office (GAO) published a report titled “Medicare Advantage: Benefits and Challenges of Payment Adjustments Based on Beneficiaries’ Ability to Perform Daily...more
Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we...more
The OIG added six items to its Work Plan with the December 2017 update, as listed in the chart below. Interestingly, three of the new items relate to Medicaid, and two relate to the opioid abuse problem. Medicare Advantage...more
Recently, the Centers for Medicare & Medicaid Services (CMS) released its draft 2019 Medicare Advantage application. Health plans seeking to participate in the Medicare Advantage (MA) program for the first time or expanding...more
I. REGULATIONS, NOTICES, & GUIDANCE - On May 6, 2016, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule entitled, “Patient Protection and Affordable Care Act; Amendments to Special...more
On September 28, 2015, the Government Accountability Office (GAO) released a report regarding CMS controls of provider adequacy in Medicare Advantage Organization (MAO) networks. The GAO pursued its review because many MAOs...more
This Week: CMS Releases Guidance on Fast Track Process for 1115 Waivers for Medicaid and CHIP... Healthcare.gov CEO Sends Letter to State Insurance Commissioners Concerning 2016 Premium Decisions... Medicare Board of Trustees...more
This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more
CMS Issues Final Rule on Certifying National Accrediting Organizations – CMS recently issued a final rule related to national accrediting organizations responsible for evaluating Medicare provider compliance with program...more