Written by Gary Bacher and Josh Booth On May 7th and 8th, the Center for Consumer Information and Insurance Oversight (CCIIO) held a public meeting on risk adjustment, the process through which, under the Affordable Care Act (ACA), funds are transferred from health plans that attract relatively low-risk enrollees to plans that attract relatively high-risk enrollees, such… Continue Reading
Category Archives: Health Care Reform
Subscribe to Health Care Reform RSS FeedML Strategies Posts Weekly Health Care Reform Update on May 14, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
ML Strategies Posts Weekly Health Care Reform Update on May 7, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
CMS, CCIO, and IRS Release Guidance Proposals on Employer Health Insurance Coverage
Posted in Health Care Reform, Payors & PBMs, UncategorizedWritten by: Gary Bacher and Joshua Booth The Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight (CCIIO) and the Internal Revenue Service (IRS) recently released four important documents related to the implementation of the Affordable Care Act (ACA) that address employer-provided health insurance plan reporting requirements and the availability of… Continue Reading
Sunshine Act Implementation Delayed Until 2013
Posted in Health Care Reform, Pharma & Medical DevicesWith little fanfare, the Centers for Medicare & Medicaid Services (CMS) announced today on the CMS Blog that it is delaying data collection under the Sunshine Act until 2013. Pharmaceutical and medical device manufacturers and group purchasing organizations covered by the Sunshine Act thus will not have to begin collecting data before January 1, 2013. … Continue Reading
Open Letter from Senate Finance Committee Seeks Fraud-Fighting Input
Posted in Fraud & Abuse, Health Care Reform, State & Federal Audits, Investigations & LitigationYesterday the Senate Finance Committee posted an open letter on its website to the health care sector soliciting industry stakeholder insights on ways to combat fraud, waste, and abuse in the Medicare and Medicaid programs. This letter comes on the heels of an April 25th hearing at which the members questioned government officials from the Department of Health and… Continue Reading
OIG Advisory Opinion 12-05 Approves Consumer Rewards Program
Posted in Fraud & Abuse, Health Care Reform, Payors & PBMs, PharmaciesWritten by Theresa Carnegie In OIG Advisory Opinion 12-05, the OIG found that a consumer rewards program (the “Program”) offered by a supermarket chain with in-store and independent pharmacies (the “Requestor”) would not be subject to enforcement under the Anti-Kickback Statute (the “Kickback Statute”) or the beneficiary inducement prohibition found in the civil monetary penalties… Continue Reading
ML Strategies Posts Weekly Health Care Reform Update on April 30, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform
Senate Committee Holds Hearing on Health Care Fraud Enforcement
Posted in Fraud & Abuse, Health Care Reform, State & Federal Audits, Investigations & LitigationWritten by: Stephanie Willis and John Custer, ML Strategies Intern A hearing titled Anatomy of a Fraud Bust: From Investigation to Conviction held by the Senate Committee on Finance (Committee) on April 24th allowed federal health care agencies to both tout their fraud-fighting successes, and defend their failure to implement all of the fraud-fighting initiatives created by… Continue Reading
ML Strategies Posts Weekly Health Care Reform Update on April 23, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
ML Strategies Posts Weekly Health Care Reform Update on April 16, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
Industry Trends in Criminal Health Care Fraud Enforcement
Posted in Fraud & Abuse, Health Care Reform, State & Federal Audits, Investigations & Litigation, UncategorizedMintz Levin’s Health Care Enforcement Defense Group has issued a new Client Advisory: Industry Trends in Criminal Health Care Fraud Enforcement – Part III in a Continuing Series on Health Care Enforcement. Written by Hope Foster, Tracy Miner, Stephanie Willis, Samantha Kingsbury, and Brian Dunphy, this third and final installment reviewing criminal health care fraud enforcement activities in 2011 and… Continue Reading
CMS Selects 27 ACOs
Posted in Accountable Care Organizations, Health Care Reform, UncategorizedIn another step toward implementation of Accountable Care Organizations (ACOs), on April 10, 2012, the Centers for Medicare & Medicaid Services (CMS) selected 27 ACOs in 18 states to participate in the Medicare Shared Savings Program (Shared Savings Program). These ACOs will serve an estimated 375,000 beneficiaries and, according to CMS, are comprised of 10,000… Continue Reading
ML Strategies Posts Weekly Health Care Reform Update on April 9, 2012
Posted in Health Care Reform, Mergers, Acquisitions & Other Transactions, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
ML Strategies Posts Weekly Health Care Reform Update on April 2, 2012
Posted in Health Care Reform, Pharma & Medical Devices, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform. This week’s Update discusses last week’s oral arguments before the U.S. Supreme Court in the multi-state challenge to the Affordable Care Act,… Continue Reading
HHS Issues Report to Congress on the Self-Referral Disclosure Protocol
Posted in Clinical Laboratories, Fraud & Abuse, Health Care Reform, Hospitals & Health Systems, Physicians, State & Federal Audits, Investigations & LitigationWritten by Tom Crane and Brian Dunphy On March 23, 2012, the Department of Health and Human Services (HHS) issued its statutorily required report to Congress (Report) describing the implementation of the Medicare Physician Self-Referral Disclosure Protocol (SRDP) and the status of disclosures under the SRDP to date. The SRDP was authorized by the Affordable Care… Continue Reading
ML Strategies Posts Weekly Health Care Reform Update on March 26, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform. This week’s Update leads with oral arguments in the multi-state challenge to the Affordable Care Act, and provides links to transcripts… Continue Reading
Advisory on Upcoming Supreme Court Review of the Affordable Care Act
Posted in Health Care ReformIn recognition of the Supreme Court argument that begins on Monday, March 26th, our Health Law Practice and government relations affiliate, ML Strategies, have published an advisory that reviews the key arguments in Florida v. HHS. Over three days of oral argument, all eyes will be on the Supreme Court as it considers the constitutional issues raised by the Affordable Care… Continue Reading
CMS Clarifies Key ACO Eligibility Requirements
Posted in Accountable Care Organizations, Health Care Reform, UncategorizedWritten by: Christi Braun and Stephanie Willis Responding to questions from Medicare Shared Savings Program (MSSP) applicants and their counsel, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum on March 16. CMS’ memo focuses on three specific areas: (1) clarification regarding Accountable Care Organization (ACO) participants, ACO providers and suppliers, and their participation… Continue Reading
ML Strategies Posts Weekly Health Care Reform Update on March 19, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform
ML Strategies Posts Weekly Health Care Reform Update on March 12, 2012
Posted in Accountable Care Organizations, Health Care Reform, Pharma & Medical Devices, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
ML Strategies Posts Weekly Health Care Reform Update on March 5, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
CMS Proposed Rules for Reporting AMP and Best Price May Have Impact Beyond Medicaid Drug Rebates
Posted in Health Care Reform, Payors & PBMs, Pharma & Medical DevicesWritten by Theresa Carnegie, Ellyn Sternfield and Nili Yolin On February 2, 2012, CMS issued proposed regulations that further refine and define how pharmaceutical manufacturers must calculate Medicaid drug rebates in the wake of health care reform (the Proposed Rule). Specifically, the Proposed Rule changes the definition of “bona fide services fee,” which is a key… Continue Reading
ML Strategies Posts Weekly Health Care Reform Update on February 20, 2012
Posted in Health Care Reform, UncategorizedML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
