Newsletters

08.21.18

Refusing Room and Board Coverage Violates Mental Health Parity

On June 6, 2018, the Ninth Circuit revived a lawsuit, Danny P. et al. v. Catholic Health Initiatives, No. 16-35609, challenging the denial of a claim for an inpatient stay at a residential mental health treatment facility by a group health plan, taking issue with disparity in the plan’s ...


08.21.18

New Webinar Reveals How to Protect Your Organization From TCPA Litigation

Click Here to Register Free for “Telephone, Texts and the TCPA: Everything Healthcare Organizations Need to Know.” Join Us September 26 From 1:00 – 2:30 p.m. ET—and Earn CLE. 


08.21.18

Can Efficient Skilled Nursing Facility Placement Generate PAC Savings?

Focusing on joint replacement procedures—the most common inpatient procedure for the Medicare population—we developed two models to test whether an SNF’s cost performance in a prior year could be used to improve a health system’s SNF partnership and referral strategy.


08.16.18

CMS Finalizes Changes Advancing Its Meaningful Measures Initiative

On August 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the Inpatient Prospective Payment System (IPPS).


07.31.18

CMS Liberalizes Medicare Advantage and Part D Marketing Rules

On July 20, the Centers for Medicare & Medicaid Services (CMS) issued the new “Medicare Communications and Marketing Guidelines” (MCMG), which governs Medicare Advantage organizations (MAOs) and Part D plan sponsors.


07.30.18

CMS Responds to States’ Drug Pricing Proposals

The Trump administration (the Administration) has called for a reduction in drug spending.


07.24.18

Market Stability Remains a Work in Progress

As the 47 states, including the District of Columbia (DC), that conduct their own rate reviews continue their review processes, many have released at least some details about what insurers proposed in their rate filings for the 2019 individual market.


07.19.18

Sharing Behavioral Health Information Amid the Opioid Crisis

In the late 1990s, healthcare providers began prescribing opioids at greater rates to treat chronic pain.


07.19.18

Insights From the State AG Coordinated Opioid Investigation

Over the past 12 months, 23 state attorneys general have brought lawsuits against opioid manufacturers.


07.19.18

Telehealth: A New Frontier for Compliance Officers

States take varying approaches to defining the terms telemedicine and telehealth.