Value-based health care: issues for pharmaceutical companies
The Office of Massachusetts Attorney General (AG) Andrea Campbell announced the criminal indictment of several Massachusetts-based health care providers and their owners in connection with allegedly false claims they...more
On February 25, House Republicans narrowly passed a budget resolution that requires the House Energy and Commerce Committee to find $880 billion in spending cuts over the next 10 years. Budget realities—including the fact...more
Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate...more
The New York Department of Health (DOH) announced March 8 that the 2022-2023 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual is available....more
Medicaid providers and suppliers have likely discovered this the hard way. A provider’s or supplier’s enrollment in the Medicaid program may be insufficient to assure that their provision of a covered and medically necessary...more
On Friday, July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued its 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule on 2023 Medicare rates for skilled nursing facilities...more
In 2020, Congress passed the No Surprises Act (NSA) in an attempt to protect patients from surprise billing. Some sections of the NSA became effective January 1, 2022, while other sections are on hold until regulations are...more
By July 2022, the US Supreme Court is expected to release its opinion in American Hospital Association v. Becerra, a case that not only has significant ramifications for healthcare providers but may also impacts the deference...more
Family Health Centers of San Diego (Health Center) operates a federally qualified health center (FQHC) that has 49 locations throughout San Diego County, California, and provides a comprehensive range of primary and...more
If your company does business with the federal government or subcontractors of the federal government, you may have to require that your employees become fully vaccinated against COVID-19 by December 8, 2021. On...more
Drug Pricing Initiatives: On Aug. 24, 2021, the House of Representatives approved a $3.5 trillion budget framework, S. Cons. Res. 14, while also voting to advance the $1 trillion infrastructure bill. The deadline for the...more
On August 24, 2021, CMS announced that it is again increasing the Medicare reimbursement rate for providers who administer at-home COVID-19 vaccines. This rate increase aims to boost the rate of COVID-19 vaccination,...more
Epstein Becker Green invites you to join former CMS Administrators Tom Scully, Leslie Norwalk, and Marilyn Tavenner for a unique panel discussion on their thoughts, advice, and predictions for President Biden’s newly...more
In a recent letter to state governors, Acting Secretary of Health and Human Services Norris Cochran signaled the US Department of Health and Human Services’ (HHS’s) commitment to “predictability and stability” in the ongoing...more
Doctors, nurses, hospitals and other health care providers, should know that the pandemic has not deterred federal or state authorities from prosecuting false claims, HIPAA and other types of enforcement actions in...more
Yesterday (August 13), while in special session ordered by Gov. Bill Lee, the Tennessee General Assembly overwhelmingly passed an amended version of HB8002, which significantly enhances telehealth flexibility and payment...more
Approximately one week after announcing $4.9 billion in supplemental payments under the Public Health and Social Services Emergency Fund (the "Relief Fund") to skilled nursing facilities ("SNFs") for “critical needs such as...more
As part of the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 and Coronavirus Aid, Relief, and Economic Security (CARES) Act, the federal government expanded Medicare reimbursement for telehealth...more
The U.S. Department of Health and Human Services (HHS) has begun the release of $30 billion of the $100 billion Public Health and Social Services Emergency Fund that is part of the Coronavirus Aid, Relief, and Economic...more
As with other states, in response to the COVID-19 pandemic and the guidance that the federal government has issued, Governor Abbott of Texas issued a disaster declaration on March 13, 2020 (the Disaster Declaration) resulting...more
Lawmakers remain in negotiations among the three key committees in the House of Representatives: Energy & Commerce, Ways & Means, and Education & Labor, along with the Senate Committee on Health, Education, Labor and Pensions...more
Push to end surprise medical billing - The Senate Finance Committee heard from providers and health insurers on S.309, a bill that prohibits certain provisions in contracts between health insurers and health care...more
This is the second article in our series addressing important topics for federally qualified health centers (FQHC) and the providers who work with them. Our first post in the series offered five tips for contracting with...more
In a significant break from preceding court decisions, the United States District Court for the District of Columbia recently struck down CMS's "must bill" policy, which requires that Medicare providers bill Medicaid and...more