News & Analysis as of

Healthcare Reform Price Transparency

Troutman Pepper

Illinois Introduces Third-Party Dental Financing Bill

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On February 6, a bill was introduced to the Illinois House of Representatives seeking to amend the Illinois Dental Practices Act to add provisions related to third-party financing for dental services....more

McDermott+

Healthcare Preview for the Week of: January 8, 2024

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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

McDermott+

McDermottPlus Check-Up: December 8, 2023

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Senate Finance Committee Examines Drug Shortages. The hearing addressed concerns and explored potential solutions related to drug shortages in the United States, particularly focusing on essential medications. The hearing...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+

The Major Regs Are Out! Will Congress Intervene in of the “Final” Policies?

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A few weeks ago, Regs & Eggs discussed the constant give and take between federal agencies and Congress as they both work on overlapping policies and objectives. The major regs released last week provide an excellent example...more

McDermott+

Healthcare Preview for the Week of: September 11, 2023

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This week the House returns from August recess, so both bodies of Congress will be here and working. There is a lot to accomplish prior to the September 30, 2023, deadline for Congress to act to fund the federal government....more

McDermott Will & Emery

CMS Pushes to Expand Hospital Price Transparency Requirements, Enforcement Activity

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On July 26, 2023, two days after the Centers for Medicare and Medicaid Services (CMS) issued its second largest civil monetary penalty for noncompliance with the hospital price transparency rule, CMS hosted a webinar...more

Nelson Mullins Riley & Scarborough LLP

Hospital Price Transparency Changes in the Calendar Year 2024 Hospital Outpatient Prospective Payment System Proposed Rule

As part of the Calendar Year 2024 Outpatient Prospective Payment System and Ambulatory Surgical Center Proposed Rule issued on July 13, 2023, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the...more

Sheppard Mullin Richter & Hampton LLP

CMS Releases Updates to Hospital Pricing Transparency Rule

On April 26, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released a fact sheet on Hospital Price Transparency Enforcement Updates (the “Fact Sheet”) under the Hospital Price Transparency Rule (the “Rule”)....more

McDermott+

McDermottPlus Check-Up: May 19, 2023

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The House and Senate were both in session this week, with significant healthcare activity at the committee level. The House Ways & Means Committee met to discuss healthcare price transparency, and the Ways & Means Health...more

Nelson Mullins Riley & Scarborough LLP

Price Transparency – CMS Updates Enforcement Process

As many are aware, compliance with price transparency requirements continues to lag. Under the final rule, effective January 1, 2021, hospitals are required to provide clear, accessible pricing information online about the...more

McDermott+

McDermottPlus Check-Up: April 28, 2023

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Congress was in session, and it was a busy healthcare week at the committee level, with six hearings focused specifically on health issues. On the House floor, Republicans passed the Limit, Save, Grow Act—a bill that raises...more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - March 20, 2023 - Additional Resources

Other Cost Containment Resources - The recommendations in Health Affairs’ new report, “A Road Map for Action: Recommendations of the Health Affairs Council on Health Care Spending and Value” (February 2023), span four...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health

Maynard Nexsen on

This week, Chris Severn of Turquoise Health joins Matthew and Tina for the 2nd time on Taking the Pulse to give us an update on all things price transparency. Chris provides insight on the market’s reaction to the price...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe

Maynard Nexsen on

Matthew and Amanda welcome Dr. Michael Havig, HealthMe founder and CEO, to episode 115. Michael is an orthopedic surgeon and sports medicine specialist who created HealthMe to help patients find the best health care and save...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

Woodruff Sawyer

Healthcare Price Transparency Empowers Employees and Employers

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As healthcare costs increase, how are employers and employees expected to keep up? It’s no secret that healthcare premiums are on the rise. PwC’s Health Research Institute found that medical costs rose 7% in 2021 and are...more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - February 2022: Leveraging APCDs and Other Data

Editor’s Note: Welcome to the latest edition of the Manatt State Cost Containment Update, a digital publication produced with generous support from the Robert Wood Johnson Foundation and in collaboration with the...more

Manatt, Phelps & Phillips, LLP

CMS Publishes Letters on No Surprises Act Enforcement in States

The federal Centers for Medicare & Medicaid Services (CMS) has begun publishing on its website letters that it sent to states beginning in December 2021 that provide important information regarding the manner in which the...more

Manatt, Phelps & Phillips, LLP

Assessing Implementation of Hospital Price Transparency

Executive Summary - While most stakeholders agree on the need for more transparency in our health care system, there is substantial debate about how to make meaningful progress toward this goal in specific cases. This...more

Proskauer - Health Care Law Brief

New York Enacts Landmark Legislation Regulating PBM

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen. This new law is amongst 100 ...more

Pullman & Comley - Connecticut Health Law

The Federal No Surprises Act: 10 Things Connecticut Providers Should Know Now

The Federal No Surprises Act (42 USC §300gg-111 et seq.), effective for plan years beginning January 1, 2022, restricts surprise bills for patients with job-based or individual health care coverage who receive...more

Manatt, Phelps & Phillips, LLP

States Begin to Issue Guidance on Implementing the No Surprises Act: Are You Ready?

The No Surprises Act (NSA), which was enacted in December 2020 as part of the Consolidated Appropriations Act, 2021, protects patients from surprise medical bills for emergency services and when they are treated by...more

ArentFox Schiff

2022 HOPPS Final Rule Addresses Hospital Price Transparency

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New Rule Finalizes Penalties for Violating the 2021 Price Transparency Rule - On November 2, 2021, CMS published the 2022 Hospital Outpatient Prospective Payment System Final Rule that addressed its previously-proposed...more

McDermott Will & Emery

CMS Will Finalize Heightened Penalties, Additional Requirements Under Hospital Price Transparency Rule

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On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that it will implement increased penalties for hospitals that do not comply with the Hospital Price Transparency Rule, effective January 1,...more

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