Value-based health care: compliance infrastructure
Measures of success: How value-based pricing may change the pharmaceutical industry
Health care M&A
On August 28, as part of its Fiscal Year 2025 Hospital Inpatient Prospective Payment System (IPPS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the Transforming Episode Accountability Model (TEAM)...more
The Centers for Medicare & Medicaid Services (CMS) recently proposed the Transforming Episode Accountability Model (TEAM) – a new, mandatory, episode-based alternative payment model in the Fiscal Year 2025 Hospital Inpatient...more
On December 15, 2023, the CMS Innovation Center (CMMI) announced a new voluntary model for state Medicaid agencies called Transforming Maternal Health (TMaH). TMaH was developed in response to the profound maternal morbidity...more
On July 1, 2024 the Center for Medicare and Medicaid Innovation (“CMMI”) will be inaugurating a new value-based payment model designed specifically to address the devastating impacts that a diagnosis of dementia or...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
Live from Nashville, the epicenter of US healthcare, we’re convening the top healthcare innovators, policy shapers and dealmakers for a day focused on the most critical business and policy issues facing companies in the...more
Introduction - Hospital-at-home programs enable patients to receive acute care in their home environment. These programs have proliferated due to the COVID-19 pandemic and subsequent surge in hospitalizations, which has...more
WHAT YOU NEED TO KNOW IN A MINUTE OR LESS - Over the past decade, health care payors and providers have come together to revolutionize how health care services are reimbursed....more
Steve Pine and Alexa Sengupta address the Centers for Medicare and Medicaid Services’ emerging focus on ESG and health equity priorities, and how these priorities are impacting health data collection and Medicare value-based...more
Please join us as Christopher Kutner, a partner in the Health Services Practice Group, and Ashley Algazi, an Associate in the Health Services Practice Group, discuss the following topics: - Framework and regulatory review...more
This is the second in a five-part series discussing the new Value-Based Regulations adopted last year by the Centers for Medicare & Medicaid Services and the Office of Inspector General. Creating a “value-based enterprise”...more
Editor’s Note: In a new report commissioned by the David and Lucile Packard Foundation, the J.B. and M.K. Pritzker Family Foundation, and Genentech Charitable Giving, Manatt Health—in partnership with DCR Initiatives and the...more
On Friday, November 20, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released final regulations to remove certain barriers to the implementation of physician compensation arrangements under value-based payment...more
In this week’s episode, Limo Cherian, Carla Dewberry and Steven Pine discuss recent changes to value-based health care payment arrangements triggered by the current COVID-19 emergency. In particular, the presenters discuss...more
The ongoing pandemic caused by the novel coronavirus has upended the American health care system in many ways. One of the many effects of COVID-19 will likely be substantial disruption in value-based payment arrangements...more
Part of the Centers for Medicare and Medicaid Services' (CMS) proposed changes to the regulations interpreting the Physician Self-Referral Law (Stark Law), released on October 9, 2019, includes three new exceptions for...more
Last week, the Office of Inspector General (OIG) released a proposed rule that would add a suite of additional safe harbors to the Federal Anti-kickback Statute as well as modify existing safe harbors. These changes are...more
Nearly a decade after the Affordable Care Act signaled a transition of the U.S. health care system to value-based care, the Department of Health and Human Services (HHS) published on October 9 two long-awaited proposed rules...more
On October 9, 2019, the Centers for Medicare and Medicaid Services (CMS) and Department of Health and Human Services Office of Inspector General (HHS-OIG) issued long-awaited proposed changes “to modernize and clarify the...more
Connecticut Governor Ned Lamont recently signed into law Public Act No. 19-117 (PA 19-117), which contains provisions affecting health care providers, including revisions to the hospital provider tax, a prohibition on...more
The Centers for Medicare and Medicaid Services (CMS) is launching new value-based programs with great fervor as a central strategy to bend the healthcare cost curve. Value-based reimbursement models linked to achieving the...more
Last summer The Centers for Medicare and Medicaid Services (CMS) solicited input on potential amendments to the federal Physician Self-Referral Law (the Stark Law)....more
As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more
As addressed in a previous Epstein Becker Green (“EBG”) Client Alert, earlier this summer, the Centers for Medicare & Medicaid Services (“CMS”) published in the Federal Register a “request for information” (“RFI”) regarding...more
Editor’s Note: Primary care practices are under increasing pressure from payers and regulators to move toward a medical home model and participate in value-based payment (VBP) contracts. The changes required—new staff, skills...more