Tag Archives: providers

Provider Competition Matters—Even for “Reference Pricing”

In a recent blog post, three Federal Trade Commission (FTC) economists splashed some cold water on advocates of “reference pricing” that seem to imply that such pricing “will increase competition between providers.”  In the FTC economists’ view, “reference pricing does not and cannot create provider competition[,] because [it] is simply a tool health insurers and … Continue Reading

It Is Finally Here─the Sun Shines on a New Era

The Centers for Medicare and Medicaid Services (CMS) publicly launched a database this week detailing the payments doctors and teaching hospitals have received from drug and medical device manufacturers. Under the Physician Payments Sunshine Act—a provision of the 2010 Affordable Care Act—CMS is required to collect and make available information about these payments, which certain manufacturers … Continue Reading

Susan Feigin Harris and Christopher J. Swift Author Article on Hospital Premium Subsidies for Law360

In a June 24, 2014, article authored for Law360, partners Susan Feigin Harris and Christopher J. Swift discuss questions surrounding whether healthcare entities may subsidize premium payments for individuals enrolling in insurance through the health insurance exchange marketplaces established under the Affordable Care Act (ACA). In the article (“Risks and Rewards from Hospital Premium Subsidies”), … Continue Reading

The Orphan Drug Wars: HHS’s Rebuttal to Its Recent Loss to PhRMA

On June 18, 2014, the U.S. Department of Health and Human Services (HHS) publicly stated that the recent decision of the U.S. District Court for the District of Columbia to vacate HHS’s regulation covering orphan drugs and the Section 340B Drug Pricing Program (340B Program), would not prevent the agency from moving forward with its … Continue Reading

Healthcare Providers Face Increasing Financial Pressure and Bankruptcy Risk

The health of the healthcare industry can be summarized as follows: as go federal reimbursement rates, so goes the financial viability of healthcare providers, whether hospitals, nursing homes or medical practices. These declining reimbursement rates, combined with the uncertainty surrounding implementation of the Affordable Care Act (ACA), have put especially severe strains on middle-market healthcare … Continue Reading

The Orphan Drug Wars: HHS’s Recent Loss to PhRMA

On May 27, 2014, almost a year following the promulgation of its final rule, the U.S. Department of Health and Human Services (HHS) had its rule vacated by the U.S. District Court for the District of Columbia under an injunction and the granting of a motion for summary judgment brought by the Pharmaceutical Research and … Continue Reading

Annual Legislative Seminar Celebrates 25 Years

This year’s Annual Legislative Seminar, held on May 7, marked the event’s 25th anniversary and featured a distinguished lineup of speakers, including 19 members of the Senate and the House who addressed issues, such as federal tax reform, the federal budget, implementation of the Affordable Care Act and proposed legislation addressing patent reform. The event, … Continue Reading

Is It a Violation to Help?

In a May 21, 2014, letter to the President of the American Hospital Association (AHA), U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius confirmed HHS’s position that private, not-for-profit foundations may, within certain parameters, pay for premiums and cost-sharing expenses for enrollees in qualified health plans (QHPs) sold through the health insurance … Continue Reading

Will Camp Tax Plan Impact Charitable Giving and Tax-exempt Organizations?

Editor’s Note: The following article was originally published to BakerHostetler’s WealthDirector blog. In late February 2014, House Ways and Means Committee Chairman Dave Camp (R-Mich.) released a nearly 1,000 page discussion draft addressing tax reform. Chairman Camp’s proposal includes changes to numerous sections of the Internal Revenue Code (Code), including changes with respect to the … Continue Reading

Do You Know What Your Hospital Board Members Are Doing?

David Chandler was appointed to serve as chairman of Tri-Lakes Medical Center (TLMC), a community hospital in Panola County, Mississippi. As chairman, Chandler set board meeting agendas, regularly dealt with the administrator and communicated with department heads to obtain various reports. Chandler also arranged for the hospital’s administrator to meet with a nurse staffing company. … Continue Reading

NLRB’s Heavy Hand Against Wal-Mart Has Implications for Healthcare Providers

On November 19, 2013, the National Labor Relations Board (NLRB) announced that its general counsel has authorized the issuance of multiple complaints against Wal-Mart Stores, Inc. (Wal-Mart) over a variety of statements made and acts taken by Wal-Mart on or around November 22, 2012, the infamous “Black Friday” when Wal-Mart employees participated in various job … Continue Reading
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