Newsletters

02.21.18

Hospitals and Health Systems Prepare for a Value-Based Future

There are six key drivers of the movement to a risk-based healthcare environment:


10.11.17

Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary

On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its MassHealth Section 1115 demonstration.


12.19.16

Balancing Gene Therapy’s Promise and Price

Gene therapy is the therapeutic delivery of polymers into a patient’s cells for the purpose of treating a disease. Polymers interfere with gene expression or correct mutations.


06.22.16

CMS Revises Process for Determining MMC Payments

In its April 25, 2016 Medicaid managed care final rule, the Centers for Medicare and Medicaid Services (CMS) provides a revised framework for determining how managed care plans should be paid by state Medicaid programs.


06.16.16

CMS Dramatically Expands Guidance on MMC Plan Payment

In its April 25, 2016 Medicaid managed care final rule, the Centers for Medicare and Medicaid Services (CMS) addresses a core issue: how managed care plans should be paid by state Medicaid programs.


04.26.16

How to Prepare for "Phase Two" HIPAA Compliance Audits: Tips on Getting Ready for Scrutiny

There are a few different steps that organizations can and should be taking to prepare for a possible audit. The first is that there should be an internal gap analysis conducted of the organization's HIPAA compliance program. The analysis should include comparing the organization's existing ...


09.24.15

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure

As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face increasing exposure under the federal False Claims Act (FCA), 31 U.S.C. §§ 3729–3733.


06.11.15

CMS Proposes Overhaul of Medicaid and CHIP Managed Care Rules

On May 26, 2015, the Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM) to overhaul the regulations governing Medicaid managed care and make conforming changes to the rules that govern the state Children’s Health Insurance Program (CHIP).