Legislation and Public Policy


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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Starting the New Year with Hospital Price Transparency
January 8, 2019 | Cassandra Rivais | Affordable Care Act | Hospitals | Legislation and Public Policy | Medicare and Medicaid
As of January 1, hospitals are now required to post charges for their standard items and procedures online in an effort to increase price transparency. Section 2718(e) of the Public Health Service Act, part of the Affordable Care Act, requires each hospital in the U.S. “for each year [to] establish (and update) and make public …
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OB/GYN Practice Liable to Patient for Breach of Confidentiality
January 7, 2019 | Eric D. Fader | HIPAA | Legislation and Public Policy | Litigation
A Connecticut state court ruled in December that an obstetrics and gynecology practice must pay a former patient close to $2 million, the latest round in an 11-year saga in which the case was appealed to the state Supreme Court twice. The defendant medical practice was found to have breached the confidentiality of the plaintiff’s …
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HIPAA Clarity Coming for Coordinated Care
January 4, 2019 | Rivkin Rounds Staff | Electronic Health Records | HIPAA | Legislation and Public Policy
On December 12, the U.S. Department of Health and Human Services’ Office of Civil Rights (OCR) issued a Request for Information (RFI) seeking public input on how the HIPAA rules, especially the Privacy Rule, could be modified to promote coordinated, value-based healthcare. A January 1 article in Health Law360 entitled “Health Care Policy Moves To …
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Here’s Why Your Tax Dollars Are Overpaying for Medicaid
January 3, 2019 | Rivkin Rounds Staff | Legislation and Public Policy | Medicare and Medicaid
A January 2 article in Bloomberg Law’s Health Law & Business, “Here’s Why Your Tax Dollars Are Overpaying for Medicaid,” discussed the Medicaid program’s difficulty in recovering inappropriate payments made by states to doctors. A December 11 report by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) said the lack …
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Midterm Election Results: 6 Ways Healthcare Could Change in 2019
December 27, 2018 | Rivkin Rounds Staff | Affordable Care Act | Legislation and Public Policy | Medicare and Medicaid | Pharmaceuticals
A December 6 article in Managed Healthcare Executive, “Midterm Election Results: 6 Ways Healthcare Could Change in 2019,” discussed how Congress may attempt to address various healthcare issues next year. Rivkin Radler’s Eric Fader was quoted in the article. Eric pointed out that the recently enacted Know the Lowest Price Act and Patient Right to Know Drug Prices Act will …
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DOJ Files Amicus Brief Declaring Intention to Dismiss FCA Case
December 12, 2018 | Geoffrey R. Kaiser | False Claims Act | Fraud and Abuse | Legislation and Public Policy | Litigation | Pharmaceuticals
On November 30, the U.S. Department of Justice (DOJ) filed an amicus curiae brief urging the U.S. Supreme Court to deny a petition for a writ of certiorari filed by Gilead Sciences, Inc. from a Ninth Circuit Court of Appeals decision which had revived a declined False Claims Act (FCA) lawsuit brought by two former …
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DOJ Revisits the Yates Memo
December 5, 2018 | Geoffrey R. Kaiser | Fraud and Abuse | Legislation and Public Policy | Litigation
In remarks delivered on November 29 at the American Conference Institute’s 35th International Conference on the Foreign Corrupt Practices Act, Deputy Attorney General Rod J. Rosenstein announced that the U.S. Department of Justice (DOJ) had revised its policy concerning individual accountability in corporate cases. That policy, previously set forth in a September 2015 memorandum issued by …
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FDA Reviews Clinical Research Approval Process
November 28, 2018 | Cassandra Rivais | Legislation and Public Policy | Pharmaceuticals
The U.S. Food & Drug Administration (FDA) has contracted with Eastern Research Group, Inc. (ERG) to review the FDA’s investigational new drug (IND) approval process. The IND phase of drug development is when human trials of new drugs are conducted. The FDA receives 4,000 IND requests a year. In order for a new drug to …
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CMS Finalizes Reimbursement for New Virtual Services
November 21, 2018 | Eric D. Fader | Legislation and Public Policy | Medicare and Medicaid | Telehealth
The final 2019 Medicare Physician Fee Schedule released on November 1, 2018 by the Centers for Medicare & Medicaid Services (CMS) includes a section entitled “Modernizing Medicare Physician Payment by Recognizing Communication Technology-Based Services.” Effective January 1, 2019, physicians may be reimbursed for certain virtual interactions with patients using several new billing codes. One new …
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