VNSNY Agrees to $57 Million Settlement
June 29, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid

The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY,

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Hospital Price Transparency Rule Upheld
June 24, 2020 | Eric D. Fader | Affordable Care Act | Hospitals | Legislation and Public Policy | Litigation | Private Insurers

On June 23, the U.S. District Court for the District of Columbia ruled against the American Hospital Association and other associations and individual hospitals that had sued the U.S. Department of Health and Human Services (HHS) to block a new price transparency rule that will take effect on January 1, 2021. The rule, which was finalized

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Wearables Brands Fight for Healthcare Space
June 23, 2020 | Eric D. Fader | COVID-19 | Electronic Health Records | Employer/Employee | Legislation and Public Policy | Medical Devices and Wearables | Telehealth

Manufacturers of activity trackers and smartwatches have been fighting over the “serious” healthcare market for several years. Companies such as Apple (previously discussed here), Fitbit (previously discussed here), and Garmin (previously discussed here) have all announced research partnerships with academic and clinical institutions to expand their businesses from the “exercise and fitness” market into healthcare

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Drug Price Disclosure Rule Rejected Again
June 17, 2020 | Eric D. Fader | Legislation and Public Policy | Medicare and Medicaid | Pharmaceuticals

On June 16, the U.S. Court of Appeals for the District of Columbia Circuit upheld a ruling from a year ago that struck down a federal regulation requiring pharmaceutical companies to disclose wholesale prices of prescription drugs in television advertisements. The appeals court agreed with the lower court’s opinion that the rule exceeded the legal

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HHS Finalizes Civil Rights and Anti-Discrimination Rule
June 16, 2020 | Ada Janocinska | Affordable Care Act | Hospitals | Legislation and Public Policy

The U.S. Department of Health and Human Services (HHS) has finalized a new rule under Section 1557 of the Affordable Care Act in an effort to enforce civil rights laws and protect against discrimination in healthcare. The rule, entitled “Nondiscrimination in Health and Health Education Programs or Activities: Delegation of Authority,” attempts to restore civil

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NYC Health Department Updates Guidance on COVID Testing
June 4, 2020 | Ada Janocinska | COVID-19 | Legislation and Public Policy

On June 2, the New York City Department of Health and Mental Hygiene issued Health Advisory #18 which recommends that all New Yorkers receive testing for COVID-19 regardless of whether or not they present symptoms or are considered to be at an increased risk for the virus. This is a change from prior guidance which

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Navajo National Collaboration Could Greatly Boost Molina’s Flagging Fortunes in New Mexico
June 2, 2020 | Rivkin Rounds Staff | Medicare and Medicaid | Private Insurers | Telehealth

A recent article in Health Payer Specialist, “Navajo National Collaboration Could Greatly Boost Molina’s Flagging Fortunes in New Mexico,” discussed how Molina Healthcare, through the Navajo Managed Care Organization (MCO), is working to better the healthcare of the Navajo Nation while bolstering its own bottom line. Rivkin Radler’s Chris Kutner was quoted in the article.

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