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Healthcare Reform

Bass, Berry & Sims PLC

Washington Enacts “Mini-HSR” Law, Expanding State-Level Premerger Filing Requirements

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On April 4, Washington became the first state to adopt the Uniform Premerger Notification Act (Act) when Washington Governor Jay Inslee signed the bill into law. The new statute imposes state-level premerger filing...more

McGuireWoods LLP

A View From the Top: Jerin Johnson of Prime Providers

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The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies....more

Seyfarth Shaw LLP

Cutting Out the Middle Man

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Arkansas has become the first state in the nation to enact legislation, effective starting in 2026, prohibiting pharmacy benefit managers (PBM’s) from owning or operating actual pharmacies within the state. We take a look at...more

Health Care Compliance Association (HCCA)

Advancing shared accountability to reduce regulatory burden, promote well-being

Introduction: A different perspective - Within the compliance profession, Cecilia Fellouse has noted, “Under the weight of incessant regulatory demands, individuals and teams often fall prey to compliance fatigue. This...more

Bradley Arant Boult Cummings LLP

Alabama CON Report - April 2025

I. II. Certificate of Need Program - A. AL2024-025, 211-213 Ana Drive Operations, LLC d/b/a Hilltop at Glenwood II, Lauderdale County, AL: Proposes to convert sixteen (16) existing assisted living facility (ALF) beds into...more

McDermott+

The Leaked OMB Passback Document: What It Is and Isn’t

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Last week, a sensitive internal government document was leaked to the public: the White House Office of Management and Budget’s (OMB’s) passback to the US Department of Health and Human Services (HHS) laying out proposed...more

Sheppard Mullin Richter & Hampton LLP

Navigating the Evolving Pharmacy Landscape in 2025: Challenges, Opportunities and Innovations

As we stride further into 2025, the pharmacy industry faces a landscape teeming with challenges and opportunities. From tackling drug price transparency to juggling implementation of artificial intelligence, the industry is...more

Weintraub Tobin

CMS Ramps Up Enforcement of Hospital Price Transparency Rule

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The Hospital Price Transparency Law, codified at 45 CFR Part 180 and effective as of January 1, 2021, was implemented to provide the public with accessible hospital pricing information, aiming to eliminate hidden fees and...more

Epstein Becker & Green

Breaking Down the Shifting Vaccine Policy Landscape – Diagnosing Health Care Video Podcast

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Important changes are unfolding in the vaccine space. How have vaccine exemptions posed a significant risk to populations across the country? What are the long-lasting effects of the new administration's federal health...more

McDermott Will & Emery

Special Report: Examining Group Health Coverage Alternatives for Small Employers - Update

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Originally published in February 2025, this updated report provides new material on physician practice management (PPM) arrangements, reference-based pricing arrangements, minimum essential coverage (MEC) and MEC+ plans, and...more

Quarles & Brady LLP

Arkansas Law Prohibits Pharmacy Benefit Managers from Obtaining or Holding Pharmacy Permits

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On April 16, 2025, Arkansas House Bill 1150 (the “Bill”) was signed by Governor Huckabee Sanders. The Bill will have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country....more

Dentons

Iowa 2025 Legislative Session – Week 14

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Last week, the energy changed under the golden dome as legislators gave the first indications they are moving towards ending this year’s legislative session. While ultimately not taken up by either chamber this week, Pharmacy...more

Alston & Bird

Health Care Week in Review | President Trump Announces Actions to Lower Drug Prices; Trump Administration Initiates Section 232...

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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

Ballard Spahr LLP

Section 1557: Deadlines Approach, But Long-Term Prognosis Unclear Under Executive Orders

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Section 1557 of the Affordable Care Act mandates nondiscrimination in health care programs managed or funded by the Department of Health and Human Services (HHS), with upcoming deadlines for compliance set for May and July...more

Sheppard Mullin Richter & Hampton LLP

CMS Issues CY 2026 Medicare Advantage and Part D Final Rule

On April 4, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released the contract year (“CY”) 2026 final rule for the Medicare Advantage (“MA”) program, Medicare Prescription Drug Benefit Program (“Part D”),...more

Cozen O'Connor

Democratic AGs Mount Fevered Challenge to Proposed Rule Impacting Affordable Care Act

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A group of 22 Democratic AGs submitted comments opposing the Centers for Medicare and Medicaid Services’s (CMS) Proposed Rule, which would change enrollment, eligibility, and coverage under the Patient Protection and...more

Spilman Thomas & Battle, PLLC

The Dome Report: Final Review of the 2025 Regular Session of the West Virginia Legislature

The 2025 regular session of the West Virginia Legislature concluded at midnight on April 12. As the dust settled, it became clear that Governor Patrick Morrisey was able to get the majority of his agenda enacted into law,...more

Benesch

Dialysis & Nephrology Digest - April 2025

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ESRD ETC among value-based care models being ended early by CMS - This decision to end the ESRD ETC payment model and several others on Dec. 31 aligns with CMS’ goal to focus on models that demonstrate potential for...more

Sheppard Mullin Richter & Hampton LLP

CMS to Withdraw Federal Medicaid Match for Workforce, Social Needs, and Infrastructure: What States, Health Care Providers and...

In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct...more

McDermott+

Inpatient Prospective Payment System (IPPS) Data Dashboard

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Updated to include Medicare claims data thru Q3 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

McDermott+

FY 2026 Proposed Rules Are Out! Overview of the IPPS Proposed Rule

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Last Friday, the Centers for Medicare & Medicaid Services (CMS) officially launched the health policy community into reg season, releasing in one fell swoop all the fiscal year (FY) 2026 Medicare proposed regulations for...more

McDermott Will & Emery

Beyond Private Equity Transaction Oversight: Mass. H.5159 Includes New Licensing Requirements

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H.5159, An Act Enhancing the Market Review Process, was signed into law in January 2025. The primary focus of H.5159 is to expand the Commonwealth’s healthcare oversight mechanisms, particularly with respect to private equity...more

Jones Day

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

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The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

Goldberg Segalla

Gov. Hochul’s Proposed Regulatory Changes to Workers’ Comp Treatment

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In her 2025 State of the State, Gov. Kathy Hochul outlined several proposals aimed at improving access to medical care within the New York State Workers’ Compensation system. These initiatives, detailed in her “Fighting for...more

Snell & Wilmer

Proposed Senate Bill in California Would Strengthen Restrictions on Hedge Fund and Private Equity Investments in Healthcare

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On February 12, 2025, Senator Christopher Cabaldon introduced Senate Bill 351 (“SB 351” or “the bill”), to strengthen and codify the corporate practice of medicine doctrine (CPOM) in California as it relates to private equity...more

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