If you overheard Medicaid providers breathe audible sighs of relief on April Fool’s Day, it may be because on April 1, 2019, the Health Resources & Services Administration of the Department of Health and Human Services (“HRSA”) finally updated the Office of Pharmacy Affairs 340B Information System website (the “340B Website”) to allow 340B Drug Pricing Program (the “340B Program”) providers – including 340B Program-eligible hospitals and other eligible healthcare providers– to use the 340B…
Aging is inevitable. As the general population trends older, so do the physicians providing care across the United States. While data differs depending on the source, somewhere between one in three and one in four practicing physicians are over the age of 65, with this percentage rising even higher in many specialties. With this aging comes concerns that the cognitive and/or physical dexterity skills of those physicians may deteriorate over time. The resulting potential injury…
Vorys today announced that Alicia D. Smith has joined Vorys Health Care Advisors (VHCA) as its new president. Smith has over 25 years of experience in health care policy.  More specifically, she brings to VHCA a wealth of experience regarding the Medicaid program and other public assistance programs, and has worked extensivelywith mental health and substance use disorder systems and providers. “We’re ecstatic that Alicia has taken on the role of VHCA president,” said Jolie…
On April 18, 2019, the Department of Health & Human Services Office for Civil Rights (OCR) issued five new FAQs addressing the applicability of HIPAA to the use of software applications (apps) by individuals to receive health information from their providers. The new FAQs are available here under the Header “Access Right, Apps and APIs.” In the FAQs, OCR: Emphasizes that an individual’s right to access her/his protected health information (“PHI” or “ePHI”) under HIPAA…
Even as American corporations twist themselves into pretzel shapes to persuade shareholders of their devotion to maximizing profits, why are they throwing an estimated $8 billion annually at workplace wellness programs that, according to a growing body of evidence, don’t work? The zeal for wellness programs — which aim to get workers to exercise, lose weight, avoid smoking, drink in moderation, and stress less — is just one more flashing red indicator of
Representatives Jackie Speier (D-California) and Dina Titus (D-Nevada) have introduced HR 2143, the Promoting Integrity in Medicare Act of 2019 (PIMA), which – if enacted – would narrow the “Stark” law’s exceptions and have a direct impact on the services provided by physicians who self-refer for the performance of certain designated health services. The 2019 bill is similar to previous proposals introduced by Representative Speier in prior years. PIMA would strengthen the Stark law by…
On Tuesday, April 23, the Centers for Medicare & Medicaid Services (CMS) published its Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Proposed Rule and Request for Information.  The proposed rule is available here.  A CMS Fact Sheet describing the final rule is available here.  The proposed rule would increase Medicare IPPS payment rates by a net 3.2 percent in…
On April 22, 2019, the U.S. Department of Health and Human Services (“HHS”) and Centers for Medicare & Medicaid Services (“CMS”) announced the CMS Primary Cares Initiative (the “Initiative”), which consists of new payment models that seek to transform primary care in order to deliver better value for patients. The Initiative aims to improve quality and patient experience of care while reducing administrative burdens and lowering overall healthcare costs. The Initiative consists of five (5)…
On March 27, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a $1.65 million competition to accelerate development of AI solutions in health care. The Artificial Intelligence (AI) Health Outcomes challenge seeks innovative, AI-driven solutions that can predict unplanned hospital and skilled nursing facility (SNF) admissions and adverse events. The challenge is a 1-year, three stage competition; the Launch State is open to the public and seeks to attract a wide range of…
On Wednesday, April 17, a three-judge panel of the Eighth Circuit heard oral arguments in an appeal from the United States District Court for the Eastern District of Missouri in Horton v. Midwest Geriatric Management LLC. Although the forthcoming Eighth Circuit decision would add to the split among the federal circuits as to whether the prohibition against sex discrimination in Title VII applies to discrimination based on sexual orientation, today’s order list indicates that SCOTUS…

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