The cautionary tale of Tuomey (summaries can be found here and here), which illustrated the risks for hospitals structuring arrangements with physicians, is finally coming to a close. When the U.S. District Court for the District of South Carolina first ordered Tuomey Healthcare System, Inc. (“Tuomey”) to pay $237 million for violations of the Stark … Continue Reading
Lawmakers To Vie For House Ways And Means Gavel With Rep. Paul Ryan (R-WI) expected to succeed Rep. John Boehner (R-OH) as Speaker of the House, some Republican lawmakers are eyeing the opening Rep. Ryan would leave behind at the helm of the House Committee on Ways and Means. Several congressmen are expected to vie … Continue Reading
House To Vote On ACA Repeal Provisions House Majority Leader Kevin McCarthy (R-CA) has included two health-related bills on this week’s floor schedule. On Wednesday, the House is expected to consider S. 1362, a bill to amend title XI of the Social Security Act to clarify waiver authority regarding programs of all-inclusive care for the … Continue Reading
Health-Focused Reconciliation Recommendations Clear Three Committees Last week, three House committees considered and passed reconciliation recommendations that included health-related language. The House Committee on Ways and Means approved language that would repeal the individual and employer mandates, the excise taxes on medical devices and high cost employer-sponsored health coverage (also known as the Cadillac tax), … Continue Reading
Health Legislation Hits House Floor House Majority Leader Kevin McCarthy (R-CA) has announced that the following health-related bills will be considered this week under suspension of the rules: H.R. 1624, the Protecting Affordable Coverage of Employees Act, as amended, which provides that employers with 51 to 100 employees are small employers for purposes of health … Continue Reading
On August 31, 2015, the Environmental Protection Agency (“EPA”) Administrator signed the proposed Management Standards for Hazardous Waste Pharmaceuticals rule outlining management and disposal standards for hazardous waste pharmaceuticals that are generated specifically by healthcare facilities. Additionally, this rule “clarif[ies] the regulation of the reverse distribution mechanism used by healthcare facilities for the management of … Continue Reading
On August 27, the Health Resources and Services Administration (“HRSA”) released its long-awaited proposed guidance for covered entities – a class of providers that includes qualifying hospitals and clinics – contract pharmacies and drug manufacturers that participate in the 340B Program, a federal drug pricing program that helps underserved communities get access to prescription medications. … Continue Reading
In the months that have followed King v. Burwell, the spotlight on the ACA’s Cadillac tax has grown hotter for groups interested in the reform, and repeal, of the ACA. The King v. Burwell decision, in large part, moved the debate over the future of ACA from the courtroom to the other governmental branches, as … Continue Reading
House Committee on Energy and Commerce to Mark Up Health Legislation The House Committee on Energy and Commerce has announced that it will hold a markup on Tuesday, July 28. Several health bills are on the agenda: H.R. 1344, the Early Hearing Detection and Intervention Act of 2015, which reauthorizes a program for early detection, … Continue Reading
Republicans Postpone Reconciliation Actions Until After August Recess With the August District Work Period only weeks away, House Committee on the Budget Chairman Tom Price (R-GA) announced this past week that the House Committee on the Budget would not act on reconciliation until after the lawmakers reconvene in September. The three House committees and two … Continue Reading
Republicans Consider Obamacare Repeal Through Reconciliation Some GOP lawmakers continue to advocate for an Affordable Care Act repeal via the budget reconciliation process. Others, however, have been questioning whether this budget tactic would be better used for different policy objectives, such as tax reform. The budget resolution provided a July 24 deadline for the committees … Continue Reading
Like an episode of The West Wing, CMS followed the venerable tradition of announcing “bad news” before the start of a long holiday weekend. Last Monday, we predicted that the Medicare Payment Advisory Commission’s (MedPAC) June Report would be the final straw to pressure CMS to amend its controversial Two-Midnight Rule. Two days later, on … Continue Reading
Our public policy and healthcare teams recently published a piece analyzing the King v. Burwell decision and its implications. See Context is King: Analysis of the US Supreme Court Decision in King v. Burwell. In this piece, we discuss (1) the highlights of the decision’s rationale; and (2) immediate implications of the decision. There are, … Continue Reading
House to Consider 21st Century Cures Act Majority Leader Kevin McCarthy (R-CA) has announced that the House of Representatives will consider H.R. 6, the 21st Century Cures Act, this week. The House Committee on Rules will meet to consider the rules for the debate on Wednesday, July 8. Amendments to the legislation are to be … Continue Reading
The Medicare Payment Advisory Commission (MedPAC), recently issued its June Report to Congress. Echoing the comments of the healthcare community, MedPAC recommended that CMS rescind its Two-Midnight Rule. As a reminder, CMS implemented the Two-Midnight Rule in the FY 2014 IPPS Rulemaking. There are three main elements to the Rule: Amended the definition of “inpatient” … Continue Reading
On the heels of its announcement that it is “hiring additional lawyers to look into taking more administrative actions against” physicians, the Office of Inspector General (OIG) recently filed 75 indictments and 14 complaints against various parties. The OIG’s “national sweep” yielded prosecution of $712 million in false billings and led to charges against 46 … Continue Reading
House to Continue Consideration of IPAB Repeal Majority Leader Kevin McCarthy (R-CA) has announced that the House of Representatives will complete consideration of H.R. 1190, the Protecting Seniors’ Access to Medicare Act of 2015, this week. This bill repeals the sections of the ACA that establish the Independent Payment Advisory Board (IPAB), an entity to … Continue Reading
Only two days after releasing its latest fraud alert, a deputy director from HHS’s Office of Inspector General announced that the OIG will be hiring additional attorneys to look into taking more administrative actions against physicians in their individual capacity. This announcement emphasizes that the OIG means serious business – not only is the OIG … Continue Reading
House to Vote on Medical Device Excise Tax and IPAB Repeals In the House of Representatives, Majority Leader Kevin McCarthy (R-CA) has announced that several health care bills will be considered on the floor this week. Two of these bills dismantle portions of the Affordable Care Act (ACA). H.R. 160, the Protect Medical Innovation Act … Continue Reading
The World Economic Forum has identified that today’s global infrastructure demand is estimated at approximately US$ 4 trillion in annual expenditures, with a gap – or missed opportunity – of at least US$ 1 trillion every year. Despite existing supply of private capital, much more is needed to fill this gap. This demand for infrastructure … Continue Reading
This Week’s Hearings: Wednesday, June 10: The House Committee on Ways and Means will hold a hearing titled “Obamacare Implementation and the Department of Health and Human Services FY 2016 Budget Request.” Wednesday, June 10: The House Committee on Veterans’ Affairs Subcommittee on Oversight and Investigations will hold a hearing titled “Prescription Mismanagement and the … Continue Reading
On May 26, 2015, CMS released a proposed rule for Medicaid managed care plans with the objective of creating more standardized practices across states, and to align Medicaid managed care with other major sources of coverage, including those offered by the private market. The proposed rule would be the first update to Medicaid managed care … Continue Reading
Lawmakers Anticipate King v. Burwell Decision With the Supreme Court expected to issue its opinion in the statutory interpretation case of King v. Burwell this month, lawmakers are considering legislative options to address any potential changes to the Affordable Care Act (ACA). The issue in the case of King v. Burwell is whether the ACA … Continue Reading
Committee on Energy and Commerce to Mark Up 21st Century Cures Act On Tuesday, May 19, the House Committee on Energy and Commerce will begin its markup of the 21st Century Cures Act, to be continued on Wednesday, May 20. The legislation is the product of the bipartisan 21st Century Cures Initiative that was spearheaded … Continue Reading
