Newsletters

01.27.14

Managing Potential Liability Risks of Patient-Generated Electronic Health Information

Patients are increasingly using new electronic tools, such as personal health records and mobile applications, to track details about their health and share those details with physicians—often in real time and wholly separate from traditional office visits. Some physicians, however, are ...


01.06.14

CMS Approves Michigan’s Amendment to Its Waiver Implementing ACA Medicaid Expansion

On December 30, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Michigan’s request to amend an existing waiver to implement the Affordable Care Act (ACA) Medicaid expansion effective April 1, 2014 through the “Healthy Michigan” program.1


12.19.13

The Debate over Specialty Pharmaceuticals: Is the Promise Worth the Price?

Specialty pharmaceuticals are a rapidly growing share of total drug expenditures by public and private health plans.


12.13.13

SPECIAL EDITION: CMS Approves Iowa’s Waivers to Implement ACA Medicaid Expansion

On December 10, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Iowa’s waivers to implement the Affordable Care Act (ACA) Medicaid expansion.


11.26.13

10 Megatrends That Are Shaping Healthcare’s Next 10 Years

The American healthcare system is undergoing massive change. From transformational policies to disruptive technologies to groundbreaking medical advances, powerful forces are coming together to re-create the healthcare environment.


11.13.13

AvMed Settlement Could Change the Landscape for Privacy Breach Class Actions

On October 21, Florida-based health insurer AvMed, Inc. (AvMed) settled a data breach class action lawsuit for $3 million, even though no plaintiffs in the class demonstrated that they had suffered identity theft or any other type of fraud as a result of the breach.


11.13.13

Final Mental Health Parity Rules Clarify Requirements Regarding Treatment Limitations

On November 8, 2013, over three years after issuing interim final regulations, the Obama administration released final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which is designed to ensure parity between mental health and ...


11.12.13

CMS Creates Clarity and Confusion on Application of Fraud and Abuse Laws to Qualified Health Plans

On October 30, 2013, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius sent a letter to U.S. Representative Jim McDermott stating that HHS does not consider qualified health plans (QHPs) sold through the Affordable Care Act’s (ACA’s) insurance exchanges to ...


10.28.13

Mapping The New Fraud And Abuse Landscape

In an age of increased government scrutiny and enforcement, providers, payers, pharmaceutical companies and medical device manufacturers, along with their business partners, must be mindful of the fraud and abuse laws regulating their business operations.


10.07.13

Special Edition: Insights on Arkansas’s “Private Option” Medicaid Expansion

On September 27, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Arkansas’s waiver to implement the Affordable Care Act (ACA) Medicaid expansion by using premium assistance to purchase QHPs in the Health Insurance Marketplace (Marketplace).