As recently as March, 2020, before the coronavirus pandemic upended public life, the Colorado legislature was poised to enact significant new health care reforms. ...more
The Taxpayers Bill of Rights (TABOR) is enshrined in Colorado’s Constitution (Art. X, Sec. 20) as the Nation’s strictest tax and spending limitation. TABOR is the proverbial “elephant in the room,” arousing strong passions...more
The Affordable Care Act (ACA) removed pre-existing condition barriers, defined a broad range of essential health benefits, and improved access to coverage and care for millions of people nationwide. However, the ACA has thus...more
March 4, 2019 was the mid-point of the 120 day regular session of Colorado’s General Assembly. Before adjournment on May 3, 2019, significant legislative actions and resulting changes in the regulatory framework seem likely...more
Medicaid is a shared federal and state program. Federal and state dollars are combined so states can furnish Medicaid health coverage to poor and disabled Coloradans including many who need nursing facility care. ...more
The Centers for Medicare & Medicaid Services (CMS) recently published a final rule that cancels the Episode Payment Models (EPMs) and the Cardiac Rehabilitation (CR) incentive payment model, each of which were slated to begin...more
The Center for Medicare & Medicaid Innovation (CMMI) is seeking ideas on how to better drive change and reduce regulatory burden. CMMI solicited ideas to shape the agency’s future activities through a September 2017 “request...more
On August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule which would cancel the Episode Payment Models (EPMs) and the Cardiac Rehabilitation (CR) incentive payment model, each of which...more
Furthering the agency’s stated intention to pay for value over volume, the Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule representing the first expansion of mandatory hospital-centric bundled...more
In November, Colorado voters will cast ballots on Amendment 69, also known as ColoradoCare. ColoradoCare is an ambitious, far-reaching plan to amend the Colorado constitution which would establish a statewide universal...more
The promotion of “value not volume” in the health care delivery system is an important theme of the Affordable Care Act and many related efforts to reform the American health care system. In this context, Health and Human...more
Recent action by the Centers for Medicare and Medicaid Services (CMS) announces significant change in reimbursement methodology for high volume orthopedic surgical procedures in many markets nationwide. Affected stakeholders...more
10/9/2015
/ Anti-Kickback Statute ,
BPCI ,
CCJR ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Fee-for-Service ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicaid Reimbursements ,
Medicare ,
Medicare Part A ,
Medicare Part B ,
OIG ,
Physician Medicare Reimbursements ,
Skilled Nursing Facility ,
SNF
On February 25, 2015, the U.S. Supreme Court narrowed the scope of antitrust immunity for state regulatory boards whose members are active market participants in the occupation regulated by the boards. In North Carolina State...more
6/24/2015
/ Dental Practice ,
Federal Trade Commission (FTC) ,
Healthcare ,
LegalZoom ,
NC Board of Dental Examiners v FTC ,
Pain Management ,
Regulatory Standards ,
SCOTUS ,
Sherman Act ,
State Medical Board ,
Telemedicine
In This Issue:
- Norman PHO
- Key Conclusions
- Implications for Established and Newly Forming Networks
- Excerpt from Norman PHO:
The Norman PHO is comprised of a single hospital system and...more