Healthcare Legal

Hospitals can bring their case on disproportionate share hospital payments to the Supreme Court

The Supreme Court granted hospitals’ request that it hear their appeal about the formula for determining Medicare disproportionate share hospital (DSH) payments, landing the case on the docket for the 2024-25 term. More than 200 hospitals are plaintiffs in the case. A federal district court ruled for HHS and against the hospitals in 2022, and…

Nick Hut June 12, 2024

340B providers are at a disadvantage after the latest court ruling on contract pharmacies

A decision issued by an appeals court represents the latest setback for 340B providers hoping to secure widespread access to price discounts on Medicare Part B drugs. The U.S. Court of Appeals for the District of Columbia Circuit on May 21 upheld a district-court ruling that drug manufacturers can impose restrictions on the 340B discounts…

Nick Hut May 24, 2024

A new 340B dispute resolution process could create more opportunities for providers

Regulatory updates to the administrative dispute resolution (ADR) process in the 340B Drug Pricing Program seem likely to expedite the filing of claims over manufacturers’ refusal to offer discounts on drugs distributed at contract pharmacies. HHS and the Health Resources and Services Administration (HRSA), which administers the 340B program, published a final rule that modifies…

Nick Hut April 26, 2024

Experts forecast a busy year for healthcare M&A even with changes to regulatory oversight

A more exacting system for regulatory reviews is a factor in the short-term outlook for healthcare mergers and acquisitions. New M&A guidelines from the Federal Trade Commission (FTC) and the U.S. Department of Justice (DOJ) add a wrinkle to the process of consummating deals, especially in the short term as the parties adjust to the…

Nick Hut January 4, 2024

Cyberattack leaves hospitals scrambling in several states

A recent attack was the latest to illustrate the potential of cybercriminals to cause havoc across an interstate health system. The Los Angeles-based Prospect Medical Holdings system incurred a ransomware attack Aug. 3 that temporarily required some patients to be diverted from emergency departments and relegated hospitals to using paper records and incorporating other downtime…

Nick Hut August 7, 2023

The No Surprises Act arbitration portal is temporarily closed for business after providers’ latest legal victory (updated)

Note: See the bottom of this article for the latest updates. The U.S. Departments of Health and Human Services (HHS), Labor and Treasury on Friday temporarily shut down the system for settling disputes over out-of-network payment amounts under the No Surprises Act. A day earlier, a federal judge gave the Texas Medical Association (TMA) the…

Nick Hut August 4, 2023

Healthcare News of Note: 3 factors increase the likelihood that a physician has been sued

Some46.8% of physicians over the age of 54 report they have been sued compared to 9.5% of physicians under the age of 40. The revenue cycle management segment accounted for the largest revenue share in the global healthcare finance solutions market in 2022. Greater representation of Black primary care physicians (PCPs) in the PCP workforce…

Deborah Filipek May 26, 2023

Simon’s ensures the highest recovery rates and adheres to strict compliance standards

Find out how this debt collection services provider ensures its clients are updated on changes in state and federal compliance and law, while also leveraging digital components and maintaining the latest technology.

HFMA April 28, 2023

5 issues that are keeping healthcare compliance professionals up at night

Rarely has the compliance landscape been more muddled or presented more of a challenge for healthcare organizations. “I’ve been a compliance officer for about 20 years now, and I’ve been in healthcare forever,” said Kirsten Wild, RN, a nurse by background who now owns a healthcare compliance consultancy. “But the volume and the pace of…

Nick Hut April 28, 2023

Healthcare News of Note:  7 hospitals earn a Press Ganey award for outstanding nursing quality

Seven hospitals were recognized for elevating nursing excellence and improving patient outcomes with Press Ganey’s National Database of Nursing Quality Indicators Award for Outstanding Nursing Quality. Only 48% of Americans rank the quality of U.S. healthcare as excellent or good, according to results of a Gallup Health and Healthcare survey. Nearly half of Americans are…

Deborah Filipek February 20, 2023
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