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McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | September 2024 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for September 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged violations under the False...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 6, October 2024

Welcome to our sixth issue of The Health Record - our healthcare law insights e-newsletter. In this edition, we take a look at the impact of AI when it comes to diverse health data, the FDA and AI medical devices, Virginia's...more

Manatt, Phelps & Phillips, LLP

CMS Proposed 2026 Notice of Benefit and Payment Parameters Rule Focuses on Marketplace Oversight

On October 4, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) for plan year 2026. This proposal begins the annual rulemaking cycle for the Marketplaces...more

McDermott+

Regs Coming Through the End of the Year: Expect the Expected and the Unexpected

McDermott+ on

There could be an all-you-can-eat buffet of regs (and eggs) from now until the end of the year! As you may recall, a July 2024 Regs & Eggs blog post highlighted the spring 2024 “unified agenda” that listed all the regs...more

McDermott Will & Emery

Trending in Telehealth: September 17 – 30, 2024

McDermott Will & Emery on

Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and facilitate...more

Ballard Spahr LLP

Practical Pointers for Compliance With New MHPAEA Regulations

Ballard Spahr LLP on

The Departments of the Treasury, Labor, and Health and Human Services have published final regulations under the Mental Health Parity and Addiction Equity Act that prohibit group health plans and health insurers from imposing...more

Brownstein Hyatt Farber Schreck

Health Care Policy Positions: Expectations for a Harris or Trump White House

With less than one month until the presidential election, health care policy issues are at the forefront of voters’ minds, including issues around drug pricing, federal research funding and reproductive rights....more

Epstein Becker & Green

Application of New Mental Health Parity Rules to Provider Network Composition and Reimbursement: Perspective and Analysis

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On September 23, 2024, the U.S. Departments of Labor, the Treasury, and Health and Human Services (collectively, the “Departments”) released final rules (the “Final Rules”) that implement requirements under the Mental Health...more

McDermott+

CMS Issues Guidance to States on Children’s Access to Medicaid Coverage

McDermott+ on

Last week, the Center for Medicaid and CHIP Services within the Centers for Medicare & Medicaid Services (CMS) released what it calls “historic” guidance to states on best practices for adherence to early and periodic...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 5, September 2024

Welcome to our fourth issue of The Health Record - our healthcare law insights e-newsletter. In this edition, we take a look at the Biden administration's proposed insurance rule regarding mental health and substance use...more

Nelson Mullins Riley & Scarborough LLP

Biden Administration Finalizes Stronger Rules On Mental Health Coverage Parity

Summary: Under a final rule released by the Biden administration on Sept. 9, 2024, health insurers will be required to cover mental health care and addiction services on par with other medical conditions. This rule is part of...more

Troutman Pepper

White House Finalizes New Mental Health Parity Rule

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The White House has finalized the new Mental Health Parity rule, which focuses on increasing access to mental health/substance use disorder treatment through nonquantitative treatment limitations (NQTL) data and reporting,...more

Mintz - Health Care Viewpoints

2024 Pre-Election Analysis: Health Care Issues

In recent elections, health care has been one of the most hot-button issues with consequences for millions of Americans, and this election is no exception. The next administration and the 119th Congress have the potential to...more

Manatt, Phelps & Phillips, LLP

Maryland PDAB Releases Draft Upper Payment Limit Action Plan

On August 9, Maryland’s Prescription Drug Affordability Board (PDAB) released its draft action plan for establishing upper payment limits (UPLs) for drugs identified as causing or likely to cause affordability challenges. The...more

Sheppard Mullin Richter & Hampton LLP

Attention Maryland Providers: Are You Availing Yourselves of Regulatory Flexibilities under the TCOC Model?

An April 2024 independent report (“Report”) analyzed the results of the first four years following implementation of the Maryland Total Cost of Care Model (the “TCOC Model”), finding that between 2019 and 2022 (the “TCOC...more

Harris Beach PLLC

Court Rejects IDR Rules in No Surprises Act Case

Harris Beach PLLC on

Out-of-network health providers recently won a huge legal victory when the Fifth Circuit Court ruled that federal guidelines regarding Independent Dispute Resolution (“IDR”) proceedings were unlawfully slanted in favor of...more

Nelson Mullins Riley & Scarborough LLP

FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS)...

On August 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to increase Medicare inpatient prospective payment system rates for certain acute care hospitals by a net 2.9% in fiscal year 2025, compared...more

ArentFox Schiff

The Accelerating Kids’ Access to Care Act: Breaking Barriers for Pediatric Patients Across State Lines

ArentFox Schiff on

In July 2023, US Senators Michael Bennet (D-CO) and Chuck Grassley (R-IA), along with US Representatives Lori Trahan (D-MA) and Mariannette Miller-Meeks (R-IA), introduced legislation to improve access to critical care for...more

McDermott Will & Emery

Trending in Telehealth: July 9 – 15, 2024

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Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate...more

McDermott Will & Emery

Trending in Telehealth: July 2 – 8, 2024

McDermott Will & Emery on

Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

McDermott+ on

We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

Manatt, Phelps & Phillips, LLP

Patient Impact of the Inflation Reduction Act - Administrative Options to Address Changed Incentives for Formulary and Utilization...

Executive Summary- The Inflation Reduction Act (IRA) makes significant changes to the Medicare Part D prescription drug benefit and also directs the Centers for Medicare and Medicaid Services (CMS) to enforce...more

Manatt, Phelps & Phillips, LLP

2024 Medicaid in Montana - How Medicaid Impacts Montana’s State Budget, Economy, and Health

Montana Medicaid provides health care coverage to nearly 300,000 Montanans, including low-income children, pregnant women, people with disabilities, and adults. We produce the Medicaid in Montana annual report to help...more

Nelson Mullins Riley & Scarborough LLP

Using A Value-Based Enterprise to Integrate Specialists and Primary Care: Taking Value-Based Care to the Next Level

Meaningful progress has been made in value-based care, but the documented advances in reducing costs and improving patient outcomes have taken place predominately in the primary care sector. Significantly less headway has...more

BakerHostetler

OHCA Proposes Material Updates to CMIR Regulations

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California’s Office of Health Care Affordability (OHCA) released a set of proposed revisions to its sweeping Cost & Market Impact Review (CMIR) regulations yesterday afternoon. ...more

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