Susan HuntingtonOn January 18, the Centers for Medicare & Medicaid Services (CMS) published a fact sheet announcing a broad array of Medicare Advantage (MA) health plan…
CMS Proposes New Rule to Expand Telehealth Benefits Under Medicare Advantage Plans
Day PitneyThe Centers for Medicare & Medicaid Services (CMS) has proposed a new rule that, effective plan year 2020, would allow Medicare Advantage (“MA”) insurers to…
Day Pitney’s Michael Furey was quoted in a July 24 article, “An inside look at how Horizon used hospital costs – and quality – in plan…
A June 27 article in The Star-Ledger and on NJ.com, “Confidential documents suggest Horizon misled public on how it picked hospitals for OMNIA program,” discussed confidential reports and…
NJ “Surprise Bill” Restrictions Finally Become Law
On June 1, New Jersey Governor Phil Murphy signed into law the “Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act,” making New Jersey the…
Yet Another Delay for 340B Drug Pricing Program Rule
On June 5, the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services, published a final rule that further delays…
CMS Plans $25 Billion Quality Initiative
The Centers for Medicare & Medicaid Services (CMS) recently announced a proposed contract action for a program entitled “Network of Quality Improvement and Innovation Contractors…
July 1 Deadline for Meaningful Use Hardship Exception Applications
Under the American Recovery and Reinvestment Act of 2009, payment adjustments are made to Medicare-eligible hospitals and critical access hospitals (“Eligible Hospitals”) that are not…
Survey: Many ACOs Will Leave Program if Required to Assume Risk
According to a recent survey by the National Association of Accountable Care Organizations (NAACOS), most of the ACOs that joined the Medicare Shared Savings Program…
An April 25 article in Law360, “Horizon Can’t Divvy Up Trial With Hospitals Over Tiered Plan,” discussed a court decision rejecting Horizon Healthcare Services Inc.’s request…