On Friday, February 9, 2018, President Trump signed the Bipartisan Budget Act of 2018 (the “Budget”), a two-year budget which, in significant part, made substantial revisions to Medicare, including the Medicare Advantage (MA)...more
2/16/2018
/ Bipartisan Budget Act ,
Budget Control Act of 2011 ,
Federal Funding ,
FQHC ,
Health Care Providers ,
IPAB ,
Low-Income Issues ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Pharmaceutical Industry ,
Supplemental Benefits ,
Telehealth ,
Trump Administration
In November of last year, we wrote about a preliminary injunction being sought by hospital advocacy groups attempting to stop implementation of the Trump administration’s cuts to the 340B Drug Pricing Program (“340B...more
1/5/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Final Rules ,
Hospitals ,
Medical Reimbursement ,
Medicare ,
Medicare Payment Reform ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Section 340B
The December 2017 Tax Reform Bill and the Repeal of the ACA’s Individual Mandate -
The tax reform bill signed into law by President Trump on December 22, 2017, notably includes the repeal of the Affordable Care Act’s...more
December 22, 2017, President Trump signed into law a sweeping tax reform bill passed by the House and the Senate on Wednesday that will materially affect virtually every sector in the economy, including, perhaps to a greater...more
On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the final rule, “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting...more
11/20/2017
/ Ambulatory Surgery Centers ,
American Hospital Association ,
Budget Cuts ,
Centers for Medicare & Medicaid Services (CMS) ,
Covered Entities ,
Drug Pricing ,
Final Rules ,
Health Clinics ,
Healthcare Facilities ,
Hospitals ,
HRSA ,
Medical Reimbursement ,
Medicare ,
Medicare Payment Reform ,
New Rules ,
Outpatient Prospective Payment System (OPPS) ,
Outpatient Quality Reporting ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Presidential Memorandum ,
Public Health Service Act ,
Section 340B ,
Trump Administration
The fifth Open Enrollment period under the Affordable Care Act (ACA) started on November 1st, and will continue for a scant 45 days ending on December 15, 2017. This year, not only has the Open Enrollment been cut in half,...more
11/6/2017
/ Affordable Care Act ,
Cost-Sharing ,
Federal Funding ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
Healthcare.gov ,
Individual Mandate ,
Insurance Industry ,
Open Enrollment ,
Public Health Insurance Marketplace ,
Trump Administration
Thursday, October 12th, on the heels of the recent and repeated failures to repeal and replace the Affordable Care Act (“ACA”), President Donald Trump signed an executive order nominally aimed at increasing competition in the...more
10/16/2017
/ Affordable Care Act ,
Cost-Sharing ,
Employee Benefits ,
Employer Group Health Plans ,
Executive Orders ,
Health Insurance ,
Healthcare Reform ,
Public Health Insurance Marketplace ,
Repeal ,
Subsidies ,
Trump Administration
After months of veiled threats, President Trump formally announced that his Administration will cease funding Cost-Sharing Reduction (“CSR”) payments, a key component of the Affordable Care Act (“ACA”) intended to help...more
While congressional Republicans spent much of September pushing for passage of the Graham-Cassidy “repeal and replace” bill, other time-sensitive legislative tasks were left to languish, including a September 30 deadline to...more
While September 30, 2017 has been an important procedural deadline for purposes of the GOP’s most recent legislative push to repeal the Affordable Care Act (ACA), it also serves a critical funding deadline for purposes of the...more
Even as Senators continue to consider “Graham-Cassidy,” the latest Affordable Care Act (ACA) repeal legislation, insurance markets are already reacting to uncertainty and instability brought about by persistent GOP efforts to...more
In a proposed rule published Tuesday, August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its intention to roll back a handful of payment models introduced under the Obama Administration. If...more
The Future of CSRs – A Tale Told in Tweets. In follow-up to our May 5, 2017 blog post, “ACA Cost-Sharing Reductions: An Uncertain Future,” on August 16, 2017, the Trump Administration made an announcement (Announcement) that...more
As reported by the New York Times in an article dated July 13, 2017, in an effort to crack down on fraud and abuse, and with a particular focus on opioids, the Department of Justice (“DOJ”) is charging 412 individuals for...more
In Part VII of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we described the Better Care Reconciliation Act of 2017 (“BCRA”), the Senate GOP’s latest Obamacare repeal and...more
Caveat: As of the date of this writing, there are indications that revisions to the Better Care Reconciliation Act of 2017 (“BCRA”) are in the works and may be issued as soon as Friday, June 30, 2017. If a revised BCRA is...more
6/30/2017
/ Abortion ,
Affordable Care Act ,
American Health Care Act (AHCA) ,
Employer Mandates ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Reform ,
Individual Mandate ,
Medicaid ,
Proposed Legislation ,
Repeal ,
Tax Credits ,
Trump Administration
“Cost-sharing reductions” (CSRs) are one of the primary mechanisms under the Affordable Care Act (ACA) to make health coverage affordable for consumers. CSRs are government payments to insurance companies for the purpose of...more
In Part V of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we outlined some of the key provisions of the American Health Care Act (AHCA). Roughly two weeks after our post...more
On Friday, April 8, 2017, a federal jury in California sent shockwaves throughout the healthcare and legal community when it returned a $454 million verdict against Kimberly-Clark Corp. and its affiliate Halyard Health Inc....more
On March 16, 2017, President Trump Administration released his first budget outline for the 2018 fiscal year (FY 2018). In an effort to “shrink the role of government,” the $1.1 trillion budget proposal calls for a $54...more
In Part IV of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we discussed a few post-inauguration developments with respect to the Affordable Care Act (ACA). In this Part V,...more
3/10/2017
/ Abortion ,
Affordable Care Act ,
Employer Mandates ,
Health Insurance ,
Health Savings Accounts ,
Healthcare Reform ,
Individual Mandate ,
Medicaid ,
Planned Parenthood ,
Proposed Legislation ,
Repeal ,
Tax Credits ,
Trump Administration
On January 12, 2017, just a week prior to President Trump’s Inauguration, the Department of Health and Human Service (HHS) Office of Inspector General (OIG) published a final Rule (Rule) regarding one of its most important...more
3/9/2017
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Final Rules ,
Health Care Providers ,
Healthcare Fraud ,
OIG ,
Permissive Exclusion Authority ,
Physicians ,
Regulatory Freeze ,
Statute of Limitations ,
Trump Administration
On January 30, 2017, the proposed 340B Drug Pricing Program (the “340B Program”) Omnibus Guidance (the “Guidance”) first issued by the Health Resources and Services Administration (HRSA) in August of 2015 was withdrawn from...more
In Parts I-III of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we considered the healthcare landscape before implementation of the Affordable Care Act (ACA), and explored...more
In Part II of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we considered potential healthcare market consequences of a partial repeal of the Affordable Care Act (ACA). In...more
12/21/2016
/ Affordable Care Act ,
Health Insurance ,
Health Insurance Exchanges ,
Health Savings Accounts ,
Healthcare Reform ,
Malpractice Insurance ,
Medicaid ,
Medicare ,
Preexisting Conditions ,
Repeal ,
Tax Credits ,
Trump Administration