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

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.

Rivkin Radler’s Geoffrey R. Kaiser authored an article for Law360 entitled “False Claims Act, Medical Necessity and Government Regulation of Medicine.” The full article can be found here.

On April 30, the Centers for Medicare & Medicaid Services (CMS) announced numerous regulatory waivers and rule changes to, among other things, expand Medicare beneficiaries’ access to coronavirus testing and telehealth services. CMS also made changes to address financial concerns that had been raised by many accountable care organizations (ACOs).

The changes included adding behavioral

On April 26, the Centers for Medicare and Medicaid Services (CMS) announced that it will no longer accept new applications from physician practices, medical equipment suppliers, and other providers for its Advance Payment Program. CMS will continue to accept applications from hospitals for loans under its Accelerated Payment Program but will be reevaluating the amounts

In 1969, noted economist Milton Friedman coined the term “helicopter money” to describe the monetary policy of injecting liquidity into the market, much like dropping money to people from helicopters, as an alternative to quantitative easing. The CARES Act, popularly referred to as the Provider Relief Fund is a “helicopter” that dropped a lot of

The New York State Department of Health has issued a General Information System (GIS) message clarifying the impact of COVID-19 related payments on Medicaid eligibility determinations.

The GIS confirms that pursuant to sections 2104 and 2201 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 certain pandemic-related payments will not impact Medicaid

On April 7, the Centers for Medicare & Medicaid Services announced that it had paid out over $34 billion under the Medicare Accelerated and Advance Payment Program to healthcare providers affected by the coronavirus public health emergency. Two days later, the figure had grown to $51 billion.

CMS announced an expansion of the program on

An April 13 article in Part B News, “Seeking a lifeline: COVID-19 loans, advance payments on offer, but watch terms,” discussed programs under which healthcare providers can seek financial assistance during the COVID-19 pandemic, including Medicare’s Accelerated and Advance Payment Program and the U.S. Small Business Association’s Paycheck Protection Program (PPP). Rivkin Radler’s Robert Iseman

In the latest installment of Rivkin Radler’s COVID-19 Business Briefing Series, held on April 14, Geoffrey Kaiser and Ada Kozicz presented on the recent issuance by the U.S. Department of Health and Human Services (HHS) of blanket Stark Law waivers for certain types of business arrangements, intended to help address the current health emergency. On