News & Analysis as of

Medicare Price Transparency

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - March 2024 #1

News Briefs - Massive Cyberattack Could Spur Movement in Healthcare Industry - As the disruption caused by the cyberattack at Change Healthcare stretches beyond its tenth day, cybersecurity experts say the incident could spur...more

Saul Ewing LLP

2024 Health Care Predictions

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Happy 2024!  The entire Saul Ewing Health Law Practice Group wishes you and yours a healthy and prosperous new year and successful (and compliant) activities in the health care delivery system this year and beyond....more

McDermott+

Healthcare Preview for the Week of: January 8, 2024

McDermott+ on

The Senate is back in session today, and the House comes back tomorrow. The beginning of 2024 is looking a lot like the end of 2023, with the big factor being the need to address government funding for fiscal year (FY) 2024....more

Akin Gump Strauss Hauer & Feld LLP

Unfinished Health Care Business: 10 Issues to Watch as Congress Rings in the New Year

Health care was one of the most active issue areas in 2023 and this trend is expected to continue when Congress returns in the New Year for the second session of the 118th Congress. The activity by the health committees of...more

Nelson Mullins Riley & Scarborough LLP

Expanded Behavioral Health Access, Enhanced Price Transparency, and the 340B Remedy in the CY 2024 Hospital Outpatient and...

The Centers for Medicare & Medicaid Services (CMS) has announced new measures to enhance access to behavioral health services for Medicare beneficiaries and improve hospital price transparency as part of the final rule for...more

McDermott+

Previewing the Final Hospital Outpatient Medicare Payment Reg

McDermott+ on

Sharpen your pencils and locate your reading glasses: the final Medicare payment regulations for calendar year (CY) 2024 will be released within the next week. In the last Regs & Eggs blog post, I discussed a major issue...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - July 2023 #3

News Briefs - FTC-Proposed Merger Guidelines Could Slow Healthcare Deals - Newly proposed merger guidelines from the Federal Trade Commission could chill dealmaking in the healthcare sector, as well as increase the costs and...more

McDermott+

Breaking Down the CY 2024 Hospital Outpatient Proposed Reg

McDermott+ on

As most of you already know, the Centers for Medicare & Medicaid Services (CMS) recently released two Medicare payment regulations: the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) proposed reg and the CY 2024...more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - March 20, 2023 - Health Data Corner

The Health Data Corner compiles the latest state health care data capacity innovations and policy developments and showcases select novel data use cases emerging from states. ...more

Greenbaum, Rowe, Smith & Davis LLP

Many Hospitals Remain in Noncompliance with Price Transparency Rule: House Committee Urges More Oversight

What You Need to Know- •The Hospital Price Transparency Rule requires hospitals to annually make public a comprehensive list of the hospital’s standard charges for provided items and services, including a display of charges...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | September 2022 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity between August 21 and September 20, 2022, including a guilty plea from a telemedicine physician who wrote prescriptions for...more

King & Spalding

Price Negotiation, Medicare Rebates, and Benefit Reform

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Key Drug Pricing Implications of the Inflation Reduction Act of 2022 - I. Introduction - On Sunday, August 7, 2022, the United States Senate passed the most consequential drug and biologics pricing legislation in almost...more

White & Case LLP

Drug Pricing Issues to Watch in 2022

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Among the drug pricing developments to watch in 2022, those at the top include legislation that would allow Medicare price negotiation and alter antitrust rules for the pharmaceutical industry, Federal Trade Commission...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2022

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On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

Sheppard Mullin Richter & Hampton LLP

Elijah E. Cummings Lower Drug Costs Now Act: The Long and Winding Road to Drug Pricing Reform

As reintroduced in the U.S. House of Representatives by Rep. Frank Pallone, Jr. (D-NJ-6) on April 22, 2021 after originally being introduced on September 19, 2019, H.R. 3, also known as known as the Elijah E. Cummings Lower...more

White & Case LLP

HHS Report Reiterates Biden Administration Support for Wide-Ranging Action to Address Drug Prices

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On September 9, 2021, the Department of Health and Human Services ("HHS") released its widely anticipated "Comprehensive Plan for Addressing High Drug Prices." The HHS report supports far-reaching legislative and...more

Latham & Watkins LLP

Healthcare & Life Sciences: Drug Pricing Digest - September 2021

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Drug Pricing Initiatives: Congress is proceeding with the budget reconciliation process, which includes proposed measures related to drug pricing. House committees are beginning to mark up sections of the legislation related...more

Sheppard Mullin Richter & Hampton LLP

CMS Backs Off Price Transparency for Providers and Plans

On August 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its hospital inpatient prospective payment system (“IPPS”) final rule (“Final Rule”) for fiscal year 2022. In addition to a number of other...more

Epstein Becker & Green

CMS Proposes to Increase Significantly Hospital Penalties for Price Transparency Violations

Epstein Becker & Green on

On July 19, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposal that would significantly increase the fines that would be imposed on hospitals for price transparency violations. This proposal,...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Proposed Rule for CY 2022

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On July 19, 2021, CMS published a proposed rule to update the payment policies, payment rates and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more

King & Spalding

Court of Appeals Upholds CMS Rule Requiring Public Disclosure of Prices Negotiated Between Hospitals and Insurance Companies

King & Spalding on

On December 29, 2020, the U.S. Court of Appeals for the District of Columbia Circuit upheld a CMS final rule promulgated in November 2019 that requires hospitals to disclose various forms of pricing information related to the...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 45. News Briefs: December 2020 #2

Report on Medicare Compliance 29, no. 45 (December 21, 2020) - CMS said Dec. 18 it will audit a sample of hospitals for compliance with price transparency requirements, which take effect Jan. 1, according to MLN Connects....more

Verrill

Hospital Price Transparency Rule: Full Steam Ahead

Verrill on

Neither COVID-19 nor continued legal challenges appear likely to derail the Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule from going into effect on January 1, 2021. Hospitals therefore should...more

Husch Blackwell LLP

The Price Transparency Rule Goes Into Effect January 1, 2021 – Is Your Hospital Ready?

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Effective on January 1, 2021, the Price Transparency Rule (the “Rule”) requires all hospitals operating within the United States to make public a list of their standard charges for items and services via the Internet in a...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes Medicare Advantage Price Transparency Requirements, Despite Industry Criticism

On September 2, 2020, the Centers for Medicare and Medicaid Services (“CMS”) filed the unpublished version of the forthcoming Inpatient Prospective Payment Systems (“IPPS”) Final Rule for 2021. One of the more controversial...more

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