Articles and Blogs

Senate Committee Advances Major Health Legislative Package The Senate Health, Education, Labor, and Pensions (“HELP”) Committee passed a wide-ranging bill focusing on lowering health care costs to the chamber’s floor. This legislation is one of the only major health care bills that stands a chance at passing Congress this year. The measure aims to... READ MORE

Summary In a February 2019 report, No. A-01-17-00506, HHS Office of the Inspector General (“OIG”) determined that Medicare made Part B payments to ambulance suppliers for transportation services that were covered through the Medicare Part A payments to skilled nursing facilities (“SNF”) as part of consolidated billing requirements. With certain exceptions, the SNF Part... READ MORE

Presidential Budget for 2020 Proposes Major Health Care Cuts President Trump released his administration’s fiscal year 2020 budget this week. While this proposal stands little chance of being implemented in its entirety, it is a good indicator of where the administration’s priorities stand for the next year, and some of the provisions, especially those... READ MORE

On December 27, 2018, a federal judge ruled in favor of hospital associations and hospitals challenging the reduction in reimbursement for drugs purchased at a discount under the 340B Program established in the 2018 Outpatient Prospective Payment System final rule (“2018 OPPS Rule”). Judge Rudolph Contreras of the United States District Court in Washington,... READ MORE

The Secretary of Health and Human Services (“HHS”) recently announced that Medicaid may allow hospitals and health systems to use funds to pay for patients’ housing.[1] HHS has already experimented with this idea by providing states with waivers under Section 1115 of the Social Security Act to expand Medicaid coverage to individuals experiencing homelessness.[2]... READ MORE

On December 11, 2018, the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced that a critical access hospital in Colorado (the “Hospital”) will settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) by paying a civil penalty of $111,400 and adopting a corrective action... READ MORE

Health and Human Services (“HHS”) Secretary Alex Azar announced on Thursday, November 8, 2018 that HHS intends to reconsider some of the episode-based payment models that it withdrew almost one year ago. According to Secretary Azar, HHS is exploring new and improved episode-based payment models, including a mandatory bundled payment model for radiation oncology.[1]... READ MORE

Congress Sends Health Funding Package to President Congress completed the funding package for the 2019 Labor-HHS appropriations measure, which hikes funding for most Health and Human Services (“HHS”) agencies. On Wednesday, the House of Representatives voted, 361 to 61, to pass legislation to provide $178.1 billion in discretionary funding for the departments of Defense,... READ MORE

Ways and Means Subcommittee Explores Modernizing Stark Law On July 17, the House Ways and Means Committee Subcommittee on Health held a hearing on modernizing the Stark Law. Government and industry witnesses shared concerns about the inhibiting effect of the Stark Law on innovative payment models and value-based care. Subcommittee Chairman Peter Roskam (R-IL)... READ MORE

More Changes Ahead for 340B The Human Resources and Services Administration (“HRSA”) released a final rule delaying the effective date of implementation and enforcement of the previously issued final rule implementing the 340B Drug Discount Program. The delayed rule, which was originally published on January 5, 2017, established the methodology for calculating the 340B... READ MORE