Understanding Pharmacy Benefit Managers: The PBM Landscape Explained
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
PODCAST: Williams Mullen's Benefits Companion - Health Plan Transparency Requirements
Thinking About a Concierge Medical Practice? Assure Compliance with Payor Requirements and the Law
PODCAST: Williams Mullen's Benefits Companion - New Prescription Drug and Health Coverage Reporting Requirements
Video: Getting Ready for the No Surprises Act - Thought Leaders in Health Law
Podcast: What Is the Future of the Acute Care Hospital Industry? - Diagnosing Health Care
PODCAST: Williams Mullen's Benefits Companion - Can Employers Impose a Health Insurance Surcharge on Plan Participants Not Vaccinated for COVID-19?
Compliance Into The Weeds - Delta Airlines Responds to the Delta Variant
On October 2, the Centers for Medicare & Medicaid Services (CMS) released final guidance outlining how the agency will implement the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program (the “Program”) for...more
McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts. October 10, 2024 – For several years, the Center for Medicare & Medicaid...more
On September 13, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 24-08, in which it declined to approve a proposal by a Medicare Advantage organization (MAO)...more
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
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
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
News Briefs - State Governments Taking Steps to Make Rules on Healthcare AI - In the absence of federal guardrails on artificial intelligence in healthcare, state governments are figuring out their own rules of the road....more
Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final procedural notice for the new Transitional Coverage for Emerging Technologies (TCET) pathway for certain US Food & Drug Administration (FDA)...more
The Centers for Medicare & Medicaid Services (CMS) released the Part D national average bid amount and Part D base beneficiary premiums for 2025. These figures set the premium costs and government subsidies for Medicare...more
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
While the Supreme Court decision in Loper Bright Enterprises v. Raimondo was making headlines, other courts were considering recent regulations of another agency—the Centers for Medicare and Medicaid Services (CMS)—that are...more
Under certain circumstances, Medicare allows physician practices to bill eligible non-physician practitioners (NPPs) under a supervising physician’s provider number and at 100 percent of the supervising physician’s allowable...more
The Centers for Medicare & Medicaid Services (CMS) finalized the second part of its guidance on implementation of the IRA’s Medicare Prescription Payment Plan (MPPP), known informally as Part D monthly out of-pocket...more
Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more
In the complex and frequently changing landscape of health care in the United States, Medicaid stands out as a vital program. Since 1965, it has provided essential coverage to millions of low-income individuals and families....more
Summary On June 17, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released a notice of funding opportunity (NOFO) for Innovation in Behavioral Health...more
On June 27, 2024, the Department of Justice (DOJ) announced its 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants for alleged participation in various health care...more
On June 17, the U.S. Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion 24-03, approving an arrangement under which a pharmaceutical manufacturer provides travel, lodging, and...more
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
The U.S. Supreme Court’s June 6 decision is a victory for Tribal Nations, affording them new opportunities to recover contract support costs pertaining to healthcare programs. In Becerra v. San Carlos Apache Tribe, the...more
The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more
By Heidi McNeil Staudenmaier and Kelsey Haake In a momentous decision on June 6, 2024, the U.S. Supreme Court delivered a resounding victory for Native American tribes. The Court ruled that the Indian Health Service (IHS)...more
On May 17, the Senate Finance Committee released a long-awaited white paper describing its legislative effort focused on bolstering chronic care through physician payment. Following a committee hearing April 11, the white...more
On April 11, 2024, a jury convicted Northern Kentucky Center for Pain Clinic owner Dr. Timothy Ehn (who was not a medical doctor) and medical director, Dr. William Lawrence Seifert, for their roles in a scheme that defrauded...more