Legislation and Public Policy


New Jersey to Set Up State Health Insurance Exchange
March 26, 2019 | Eric D. Fader | Affordable Care Act | Legislation and Public Policy | Private Insurers
New Jersey Governor Phil Murphy announced on March 22 that the state will create its own health insurance exchange for plan year 2021, replacing the federally run healthcare.gov marketplace. Gov. Murphy also gave notice of the change by sending a Declaration of Intent Letter to the federal government’s Center for Consumer Information and Insurance Oversight. …
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“Surprise Bill” Solution is on Senate’s To-Do List
March 20, 2019 | Eric D. Fader | Hospitals | Legislation and Public Policy | Private Insurers
A bipartisan group of U.S. senators is at work on federal “surprise bill” legislation that may be officially proposed within weeks. The proposal will target the common scenario in which an insured individual receives covered healthcare services from an in-network hospital, surgery center, imaging center or laboratory, while an out-of-network healthcare provider also provides non-emergency …
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EHR Exposé Shakes Up Industry
March 19, 2019 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medicare and Medicaid
A three-month joint investigation of electronic health records (EHR) systems has culminated in a release of a March 18 article in Kaiser Health News (KHN) and Fortune Magazine, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.” The lengthy, meticulously sourced article calls EHR systems “an unholy mess.” KHN and Fortune have made the …
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Managing “Social Determinants of Health” a Key Issue for Health Systems
March 14, 2019 | Rivkin Rounds Staff | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid
The World Health Organization (WHO) defines social determinants of health (SDOH) as the conditions in which people are born, grow, live, work and age that are primarily responsible for differences in health status. Rivkin Radler’s Robert Iseman recently penned a Thought Leaders’ Corner column for Population Health News in which he made suggestions regarding how healthcare organizations …
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CMS to Propose Significant Changes to Stark Law
March 7, 2019 | Cassandra Rivais | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
At the Federation of American Hospitals’ 2019 Public Policy Conference on March 4, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the agency’s plan to make dramatic changes to the federal physician self-referral prohibition, commonly known as the Stark Law. The changes are designed to support a value-based model of care in …
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Healthcare: The Next Frontier
March 5, 2019 | Rivkin Rounds Staff | Affordable Care Act | Employer/Employee | Hospitals | Legislation and Public Policy | Private Insurers
A March 1 article in Long Island Business News entitled “Healthcare: The next frontier” discussed the issues raised at a recent roundtable discussion on the current state of the healthcare industry. The panel included Rivkin Radler partners Robert Iseman and Benjamin Malerba; Dr. Zeyad Baker, ProHEALTH Care Associates’ president and CEO; Jeffrey Kraut, executive vice …
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OCR May Alter HIPAA Rules to Ease Compliance, Care Coordination
February 28, 2019 | Rivkin Rounds Staff | Cybersecurity | Electronic Health Records | HIPAA | Legislation and Public Policy
An article in the March issue of Healthcare Risk Management discussed a Request for Information (RFI) released in December by the U.S. Department of Health and Human Services’ Office of Civil Rights (OCR). The RFI, which seeks public input on how the HIPAA rules may be modified to promote coordinated, value-based healthcare, was previously discussed …
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CMS Proposed Rule Focuses on Patient Access to Health Info
February 21, 2019 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Medicare and Medicaid
Yesterday’s Rivkin Rounds post discussed the Proposed Rule on information blocking recently released by the Office of the National Coordinator for Health Information Technology (ONC). The Centers for Medicare & Medicaid Services (CMS) simultaneously released its own 251-page Proposed Rule, addressing some of the same concerns but focused on interoperability and patients’ access to their …
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ONC’s Proposed Info-Blocking Rule Includes Broad Exceptions
February 20, 2019 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy
The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services both recently released proposed rules regulating so-called information blocking, the practice of interfering with the exchange of electronic health information (EHI). Information blocking, a violation of HIPAA, occurs most commonly when a healthcare provider terminates its …
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FTC Investigations Could Bring Unwanted Scrutiny to Hospitals
January 18, 2019 | Rivkin Rounds Staff | Affordable Care Act | Antitrust | Hospitals | Legislation and Public Policy | Litigation | Private Insurers
An article in Relias Media’s Healthcare Risk Management newsletter, “FTC Investigations Could Bring Unwanted Scrutiny to Hospitals,” discussed potential investigations of hospitals’ anti-competitive behavior by the Federal Trade Commission.  Rivkin Radler’s Robert H. Iseman was featured prominently in the article. Bob noted that hospitals and health systems that are considered “must-have” participants in health insurance plans face …
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