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|HHS Launches New Payment and Delivery Model to Improve Oncology Care|
Eric A. Klein, Rachel Landauer; Sheppard, Mullin, Richter & Hampton LLP;
March 25, 2015, previously published on February 25, 2015Cancer care is notoriously complex, intensive and costly. With more than 1.6 million people diagnosed with cancer each year, there is a strong impetus towards reforming service delivery. Accordingly, the U.S. Department of Health and Human Services is launching a new payment and care delivery model...
|Supreme Court Limits Antitrust Immunity for Certain State Agencies|
Robert B. Craig, Aaron M. Herzig; Taft Stettinius & Hollister LLP;
March 25, 2015, previously published on March 2, 2015Last week, the United States Supreme Court issued an opinion that will have a broad impact on how states regulate professions through agencies and licensing boards. In North Carolina State Board of Dental Examiners v. FTC, No. 13-534, 574 U.S. &under;&under; (2015), the court ruled that the...
|Consultants’ Communications Privileged from Discovery|
Philip H. Lebowitz; Duane Morris LLP;
March 25, 2015, previously published on February 23, 2015In healthcare, companies often hire consultants to review billing and coding, privacy and security and a host of other technical issues that regular staff does not have the time or expertise to pursue. A recent discovery ruling in federal court in the Eastern District of Pennsylvania holds that...
|On the Eve of Oral Arguments before the U.S. Supreme Court in King v. Burwell: Obamacare in the Balance |
Ken Yood; Sheppard, Mullin, Richter & Hampton LLP;
March 25, 2015, previously published on March 2, 2015As every healthcare geek and Supreme Court wonk will tell you, on March 4, the U.S. Supreme Court will hear oral argument in King v. Burwell (an amalgamation of four cases - King v. Burwell, Halbig v. Burwell, Pruitt v. Burwell, and Indiana v. IRS). As the latest attack on the Affordable Care Act...
|Civil RICO Actions on the Rise to Combat Healthcare Insurance Fraud|
James J. Ferrelli; Duane Morris LLP;
March 25, 2015, previously published on February 17, 2015Over the past several years, insurance carriers have aggressively pursued civil suits against doctors and other medical providers in an effort to fight healthcare insurance fraud. Besides theories of liability based upon common law claims such as fraud and unjust enrichment, insurers have more...
|CMS Announces New Next Generation ACO Model|
Michaela ("Kayla") Tabela; Edwards Wildman Palmer LLP;
March 25, 2015, previously published on March 20, 2015On March 10, 2015, the Centers for Medicare & Medicaid Services (“CMS”) announced a new Next Generation ACO Model for Medicare accountable care organizations or “ACOs.” This proposal further expands the shared risk models already established under the Medicare Shared...
|U.S. Supreme Court Directs Lower Court to Rebalance Religious Freedom With Government Mandated Women’s Contraceptive Health Benefits for Religious Nonprofit Organizations|
Dave C. Bromund; Taft Stettinius & Hollister LLP;
March 25, 2015, previously published on March 12, 2015In its continuing consideration of the proper balance of religious freedom against government mandated women’s contraceptive health benefits, the U.S. Supreme Court vacated the 7th Circuit Court of Appeals’ 2014 decision against the University of Notre Dame’s religious objections...
|Medicare Advantage Insurers May See Positive Growth in 2016 Despite CMS’ 0.95% Payment Rate Cut Announcement|
Vinay Bhupathy, Florence T. Wang; Sheppard, Mullin, Richter & Hampton LLP;
March 25, 2015, previously published on March 5, 2015The Centers for Medicare and Medicaid Services (CMS) proposed a 0.95 percent decrease in Medicare Advantage payment rates for 2016 in its Advance Notice and Draft Call Letter released on February 20, 2015. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,”...
|States with Medical Marijuana See Falling Opioid Death Rate|
Stephen J. Burg; Burg Simpson Eldredge Hersh & Jardine, P.C.;
March 25, 2015, previously published on January 23, 2015Researchers from the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center discovered the number of opioid overdoses decreased overtime in states with legalized marijuana.
|Unions Unleash Safety Attacks on Fast Food Restaurants|
Howard A. Mavity; Fisher & Phillips LLP;
March 25, 2015, previously published on March 17, 2015Yesterday was one of those occasions when I wish that my predictions had been inaccurate. I have speculated that the SEIU and other unions harassing fast food restaurants would eventually add mass OSHA complaints to their joint employer, discrimination, living wage, and other attacks. Yesterday,...