HC Topics Archives
Special Alert (April 25, 2024)
Volume 17, Issue 3 (March 2024)
- False Claims Act Recoveries Reach Historic High
- Valuation of Diagnostic Imaging: Competitive Environment
Volume 17, Issue 2 (February 2024)
Volume 17, Issue 1 (January 2024)
Volume 16, Issue 12 (December 2023)
Volume 16, Issue 11 (November 2023)
Volume 16, Issue 10 (October 2023)
- OIG Issues Favorable Advisory Opinion on Bonus Compensation Agreements
- Valuation of Accountable Care Organizations: Technological Environment
Volume 16, Issue 9 (September 2023)
- Price Discrepancies in Hospital Services Revealed
- Valuation of Accountable Care Organizations: Regulatory Environment
Volume 16, Issue 8 (August 2023)
- FTC & DOJ Announce Revised Merger Guidelines
- Valuation of Accountable Care Organizations: Reimbursement
Volume 16, Issue 7 (July 2023)
- CMS Proposes Updates to the OPPS
- Valuation of Accountable Care Organizations: Competitive Environment
Volume 16, Issue 6 (June 2023)
- Projected National Health Expenditures to Surpass $7 Trillion
- Valuation of Accountable Care Organizations: Introduction
Volume 16, Issue 4 (April 2023)
- IPPS/LTCH PPS Proposed Rule Released
- Valuation of MA Plans: Reimbursement & Technological Environments
Volume 16, Issue 3 (March 2023)
- Corporate Moves in Healthcare Continue to Disrupt the Industry
- Valuation of MA Plans: Introduction & Competitive Environment
Volume 16, Issue 2 (February 2023)
- 2022 DOJ False Claims Act Recoveries Surpassed $2.2 Billion
- Valuation of Clinical Laboratories: Regulatory Environment
Volume 16, Issue 1 (January 2023)
- 2022 M&A in Review: Indications for 2023
- Valuation of Clinical Laboratories: Technology & Reimbursement
Volume 15, Issue 12 (December 2022)
- Healthcare Spending Slowed in 2021 due to COVID-19
- Valuation of Clinical Laboratories: Introduction and Competitive Environment
Volume 15, Issue 11 (November 2022)
- Amazon’s Healthcare Act II: The Introduction of Amazon Clinic
- Valuation of Remote Therapeutic Monitoring: Technological Environment
Volume 15, Issue 10 (October 2022)
- Non-Traditional Players Moving into the Insurance Space
- Valuation of Remote Therapeutic Monitoring: Competitive Environment
Volume 15, Issue 9 (September 2022)
- CVS Acquires Signify Health for $8 Billion
- Valuation of Remote Therapeutic Monitoring: Regulatory Considerations
Volume 15, Issue 8 (August 2022)
- FTC Discourages Certificates of Public Advantage Laws
- Valuation of Remote Therapeutic Monitoring: Reimbursement Environment
Volume 15, Issue 7 (July 2022)
- Coordinated Actions Indicate Growing Scrutiny of Telemedicine
- Valuation of Remote Therapeutic Monitoring: Introduction
Volume 15, Issue 6 (June 2022)
- FTC Scrutiny Results in Several Scrapped Hospital Deals
- Valuation of Home Health Agencies: Technological Environment
Volume 15, Issue 4 (April 2022)
- Biden Administration to Overhaul Vertical Merger Guidelines
- Valuation of Home Health Agencies: Reimbursement Environment
Volume 15, Issue 3 (March 2022)
- New Initiatives Announced to Improve Nursing Home Quality & Safety
- Valuation of Home Health Agencies: Regulatory Environment
Volume 15, Issue 2 (February 2022)
- Study: Most Physician Compensation Plans Still Productivity-Based
- Valuation of Home Health Agencies: Introduction
Volume 15, Issue 1 (January 2022)
- Exorbitant Healthcare Spending in 2020 due to COVID-19
- Valuation of Internal Medicine Services: Technology
Volume 14, Issue 12 (December 2021)
- Hospital Settles False Claims Act Allegations for $18.2 Million
- Study: Vertical Integration Not Financially Beneficial for Physicians
- Valuation of Internal Medicine Services: Competition
Volume 14, Issue 11 (November 2021)
- CMS Finalizes 2022 Physician Fee Schedule
- Federal ACO Performance Results for 2020 Released
- Valuation of Internal Medicine Services: Regulatory
Volume 14, Issue 10 (October 2021)
- CMS Innovation Center Launches “Bold New” Strategy
- Healthcare Industry Hit with the Great Resignation & Retirement
- Valuation of Internal Medicine Services: Reimbursement
Volume 14, Issue 9 (September 2021)
- Valuation of Internal Medicine Services: Introduction
- Literature Review Debunks Claims Against Physician-Owned Hospitals
- Additional $20 Million Directed to Rural Telehealth Expansion
Volume 14, Issue 8 (August 2021)
- CMS Releases 2022 IPPS Final Rule
- Bundled Payment Model Success Unaffected by Type of Participation
- 2021 Projected Physician Shortages Down from 2020 Report
Volume 14, Issue 7 (July 2021)
- CMS Releases CY 2022 Physician Fee Schedule Proposed Rule
- U.S. Supreme Court to Hear 340B Case
- MedPAC Examines Private Equity Involvement in Medicare
Volume 14, Issue 6 (June 2021)
- Supreme Court Leaves ACA in Place
- Walmart’s Push to Create Healthcare ”Super Centers”
- Healthcare Costs Projected to Grow in 2022
- IPPS and LTCH PPS Proposed for 2022
- Effect of Negative Credit Shocks on Hospital Quality
- Valuation of ASCs and OBLs Part IV: OBL Value Drivers
Volume 14, Issue 4 (April 2021)
- SPAC Popularity Soaring in Healthcare
- The Rise of Unregulated Convenience Care
- Valuation of ASCs and OBLs Part III: ASC Value Drivers
Volume 14, Issue 3 (March 2021)
- Amazon’s New Moves in Healthcare
- New Evidence for Private Payor Savings Through Bundled Payments
- Valuation of ASCs and OBLs Part II: Regulatory Environment
Volume 14, Issue 2 (February 2021)
- M&A Activity Slowed in 2020, But is Poised to Accelerate in 2021
- The Future of Healthcare in 2040: A Reflection Post-COVID-19
- Valuation of ASCs and OBLs Part I: Distinctions
Volume 14, Issue 1 (January 2021)
- Stark & Anti-Kickback Revisions Finalized: New Safe Harbors
- Personal and National Healthcare Expenditures Grow in 2019
- Valuation of Telemedicine: Technology
Volume 13, Issue 12 (December 2020)
- Stark & Anti-Kickback Revisions Finalized: New Stark Exceptions Established
- Valuation of Telemedicine: Competition
Volume 13, Issue 11 (November 2020)
- Stark & Anti-Kickback Revisions Finalized: Changes to Stark’s Big Three Provisions
- CMS Final Rule Brings Transparency to Healthcare Industry
- Valuation of Telemedicine: Regulatory
Volume 13, Issue 10 (October 2020)
- Methodist Healthcare Accused of Paying Kickbacks to Oncologists
- 2019 MSSP Performance Results Shows Promise for Pathways to Success Model
- Valuation of Telemedicine: Reimbursement
Volume 13, Issue 9 (September 2020)
- Gap Between Private Insurance and Medicare Hospital Payments Increased in 2018
- Valuation of Telemedicine: Introduction
- Fraud and Abuse Costs and Cases Rose in 2019
Volume 13, Issue 8 (August 2020)
- Executive Order Expands Telemedicine and Eases Burden on Rural Providers
- CMS Includes Several Changes in OPPS Proposed Rule
- Final Rule Payment Changes Released for SNFs, Hospices, and IPFs
Volume 13, Issue 7 (July 2020)
- Piedmont Pays $16 Million to Settle Kickback and Overbilling Allegations
- Valuation of Senior Healthcare: Technology
- Are Primary Care Physicians Finally Ready for Value-Based Reimbursement?
Volume 13, Issue 6 (June 2020)
- Post-Coronavirus Physician Practice Acquisitions: Proceed with Caution
- CMS Proposed Rule Supports Value-Based Purchasing for Drugs
- Valuation of Senior Healthcare: Competition
- Is Healthcare Recession-Proof?
- COVID-19: The Role of Revenue Cycle Management in Physician Practices
- Valuation of Senior Healthcare: Regulatory
Volume 13, Issue 4 (April 2020)
Volume 13, Issue 3 (March 2020)
Volume 13, Issue 2 (February 2020)
- Comprehensive Care for Joint Replacement Model Revised & Extended
- Healthcare "Disrupters" Continue to Attract Capital
- MedPAC Issues Several Notable Medicare Reimbursement Recommendations
- New Vertical Merger Guidance Could Implicate Healthcare M&A
Volume 13, Issue 1 (January 2020)
- Valuation Firms at Center of False Claims Act Lawsuit
- Bundled Payment Models Miss Medicare Savings and Quality Objectives
- Corporate Solutions in Healthcare
- Valuation of Ambulatory Surgery Centers (ASCs): Technology
Volume 12, Issue 12 (December 2019)
- ACA Individual Mandate Ruled Unconstitutional
- Hospitals Sue to Keep Prices Secret
- Healthcare Spending Accelerates in 2018
- Valuation of Ambulatory Surgery Centers (ASCs): Regulatory
Volume 12, Issue 11 (November 2019)
- CMS Finalizes 2020 Physician & Outpatient Fee Schedules
- Trump Administration Brings Transparency to Healthcare
- Private Sector’s Innovative Approaches to Rising Healthcare Costs
- Valuation of Ambulatory Surgery Centers (ASCs): Reimbursement
Volume 12, Issue 10 (October 2019)
- Proposed Stark Law Changes: Healthcare Valuation Implications
- Proposed Anti-Kickback Statute Changes: Healthcare Valuation Implications
- Valuation of Ambulatory Surgery Centers (ASCs): Competition
Volume 12, Issue 9 (September 2019)
- 11th Circuit Holds: No Remuneration for Fair Market Value
- Telemedicine CEO Pleads Guilty to $424 Million Fraud Conspiracy
- Valuation of Ambulatory Surgery Centers (ASCs): Introduction
Volume 12, Issue 8 (August 2019)
- Hospitals to See Big Changes in Reimbursement in 2020 & 2021
- CMS Publishes 2020 OPPS/ASC PPS Proposed Rule
- CMS Proposes Updates to Physician Fee Schedule for 2020
- Hospital CEO Searches Increasingly Seeking Physicians
Volume 12, Issue 7 (July 2019)
- Parties Argue Constitutionality of ACA before 5th Circuit
- Newly-Announced Program Shifts Dialysis Services to the Home
- Emboldened Antitrust Scrutiny of Healthcare Transactions
- Valuation of Rural Health Clinics: Technology
Volume 12, Issue 6 (June 2019)
- Widening Payment Gap between Medicare and Commercial Insurance
- New Data Questions Viability of CMS Oncology Model
- Florida Legislature Votes to Repeal Hospital CON Program
- Valuation of Rural Health Clinics: Regulatory
- CMS Proposes IPPS Updates for 2020
- CMS Announces New Primary Care Reimbursement Model
- Do You See What I See? Smart Glasses in Healthcare
- Valuation of Rural Health Clinics: Reimbursement
Volume 12, Issue 4 (April 2019)
- Healthcare Utilization Increases in Non-Traditional Settings
- Valuation of Rural Health Clinics: Competition
Volume 12, Issue 3 (March 2019)
- News Alert - DOJ Agrees that Entire ACA Should Be Struck Down
- MedStar Pays $35 Million to Settle Kickback Allegations
- CMS Releases ET3 Pilot Model
- MedPAC Recommends Raising Hospital Payments
- Valuation of Rural Health Clinics: Introduction
Volume 12, Issue 2 (February 2019)
- Hospital Prices Drive Healthcare Spending
- Walgreens and Microsoft Form Alliance for Healthcare Innovation
- HHS Proposes Removal of Safe Harbor Protection for PBMs
- Valuation of Dialysis Centers: Technological
Volume 12, Issue 1 (January 2019)
- DOJ Recovers Over $2.8 Billion in False Claims Act Cases in 2018
- Hospitalist Pilot Model Sparks Controversy
- National Healthcare Spending Slows for Second Straight Year
- Valuation of Dialysis Centers: Regulatory
Volume 11, Issue 12 (December 2018)
- Judge Rules Entire ACA Unconstitutional
- Federal Agencies Recommend Policies to Increase Healthcare Competition
- Medicare Part D Proposed Rule Seeks to Lower Drug Spending
- Valuation of Dialysis Centers: Reimbursement
Volume 11, Issue 11 (November 2018)
- The State of Medicaid Expansion Post-Midterms
- Drug Pricing Proposal Targets High Pharma Expenditures
- New State Innovation Waiver Guidance Increases Flexibility, Decreases Coverage
- Valuation of Dialysis Centers: Competitive Environment
Volume 11, Issue 10 (October 2018)
- Community Health Systems Settles with OIG for $262 Million
- DOJ Approves CVS-Aetna Merger
- Valuation of Dialysis Centers: Introduction
Volume 11, Issue 9 (September 2018)
- CMS Seeks Comments on Anti-Kickback Statute Reform
- Valuation of Urgent Care Centers in an Era of Reform
- Nonprofit Hospital Executive Salaries Outpace Those of Clinicians
- The New Kid on the Block: The Technological Environment of Micro-Hospitals
Volume 11, Issue 8 (August 2018)
- CMS Proposes Revamp of Federal ACO Program
- CMS's Continued Payment System Overhaul: OPPS Proposed Rule
- 340B’s Uphill Legal Battle for Hospital Associations
- The New Kid on the Block: The Competitive Advantage of Micro-Hospitals
Volume 11, Issue 7 (July 2018)
- CMS to Review Stark Law Relevance Once Again
- SCOTUS Nominee Brett Kavanaugh’s Paper Trail & Influence on U.S. Healthcare Laws
- 2019 Physician Payment Proposed Rule – Cutting the Red Tape
- The New Kid on the Block: The Micro-Hospital Reimbursement Environment
Volume 11, Issue 6 (June 2018)
- Healthcare Reform Update
- Trade Secrets: Fair Market Value Considerations
- The New Kid on the Block: The Micro-Hospital Regulatory Environment
- CMS Inpatient Reimbursement Rate Updates Proposed for 2019
- The New Kid on the Block: An Introduction to Micro-Hospitals
- MedPAC Votes to Lower Urban Freestanding Emergency Department Payments
- Renewed Public & Private Efforts to Increase Access to Patient Data
- Management Services Agreements: Considerations for Fair Market Value
Volume 11, Issue 4 (April 2018)
- Trump Administration Continues Efforts to Overhaul U.S. Healthcare
- MedPAC Outlines Proposed MIPS Replacement Program
- Capitalism in U.S. Healthcare: The Case of Walmart
- What’s Your Brand Worth? The Benefits of a Brand to the Grantor
Volume 11, Issue 3 (March 2018)
- Amazon Joint Venture to Create Healthcare Company
- The Implications of Medicaid Expansion on Hospital Finances and Viability
- Hospitals Form Pharmaceutical Company to Combat Rising Drug Prices
- What’s Your Brand Worth? The Benefits of a Brand to the Grantee
Volume 11, Issue 2 (February 2018)
- Checking up on Healthcare's Hot Trend: Value-Based Reimbursement
- What's Your Brand Worth? The Benefits of a Brand to Consumers
- Department of Justice Recovers $3.7 Billion in False Claims Act Cases
- The Due Diligence Imperative: Conclusion (Part 6 of a 6 Part Series)
Volume 11, Issue 1 (January 2018)
- Valuation of Healthcare Service Enterprises for Purposes of Private Equity Investment: Private Equity's Healthcare Future (Part 3 of a 3 Part Series)
- What's Your Brand Worth? Valuation Considerations for Healthcare Enterprises (Part 1 of a 4 Part Series)
- Healthcare Spending Slows in 2016
- The Due Diligence Imperative: Technology (Part 5 of a 6 Part Series)
Volume 10, Issue 12 (December 2017)
- Valuation of Healthcare Service Sector Enterprises for Purposes of Private Equity Investment: Valuation Considerations (Part 2 of a 3 Part Series)
- The Due Diligence Imperative: Competition Part 4 of a 6 Part Series
- FDA Announces Approval of a Digital Pill that Tracks Pill Consumption
- Massive Cuts Made to 340B Prescription Drug Discount Program
Volume 10, Issue 11 (November 2017)
- CMS Publishes 2018 Payment Rate Updates
- Valuation of Healthcare Service Sector Enterprises for Purposes of Private Equity Investment: Introduction (Part One of a Three Part Series)
- The Due Diligence Imperative: Regulatory Environment (Part Three of a Six Part Series)
- CVS Announces Potential Acquisition of Aetna
Volume 10, Issue 10 (October 2017)
- Percent Annual Increase Triples for C-Suite Executive Pay
- Now You See It, Now You Don't: Bundled Payment Programs Cancelled
- The Due Diligence Imperative: Healthcare Reimbursement Environment (Part Two of a Six-Part Series)
- U.S. Circuits Split on False Claims Act Issues
Volume 10, Issue 9 (September 2017)
- The Due Diligence Imperative for the Valuation of Healthcare Enterprises, Assets, and Services (Part One of a Six-Part Series)
- Spiraling Drug Costs - Proposed Solutions (Part Two of a Two-Part Series)
- The Opioid Epidemic - Economic Ramifications
- Tech Giants Target Healthcare AI
Volume 10, Issue 8 (August 2017)
- Something for Everyone - 2017 OIG Work Plan Update
- Decision Tree Analysis - Valuing Physician Non-Compete Clauses
- Perpetual Motion - Pharma Cost Spiral Persists
- Opioids: Part II of III - Legislation and Regulation Combat Epidemic
Volume 10, Issue 7 (July 2017)
- Obamacare Repeal and Replace – In the Heat of the Night
- Opioid Epidemic - Physicians Financially Incentivized to Prescribe? (Part One of a Three-Part Series)
- Valuing Healthcare Market Entrance Barriers
- Artificial Intelligence in Healthcare – Competition (Part Four of a Four-Part Series)
Volume 10, Issue 6 (June 2017)
- Telemedicine: State Legislation Update
- ACO Models - Studies Examine Sustainability
- Free Parking for Physicians? Federal Court Dismisses Whistleblower Suit
- Artificial Intelligence in Healthcare - Technological Advancements (Part Three of a Four-Part Series)
- House Votes to Repeal & Replace Obamacare
- Value-Based Payments Under MACRA - Tension with Fraud and Abuse Laws (Part Two of a Two-Part Series)
- FTC Halts Merger of Chicago Health Systems
- Artificial Intelligence in Healthcare - The Regulatory Environment (Part Two of a Four-Part Series)
Volume 10, Issue 4 (April 2017)
- TrumpCare v. ObamaCare
- Artificial Intelligence in Healthcare - Reimbursement (Part One of a Four-Part Series)
- Tort Reform: The Impact of the ACA on Medical Malpractice (Part Three of a Three-Part Series)
- The Outlook of Value-Based Payments Under MACRA (Part One of a Two-Part Series)
Volume 10, Issue 3 (March 2017)
- Trump Executive Orders - Federal Agencies Begin Implementation
- Two Letters to Trump from Healthcare Leaders – Continue Focus on Value-Based Payment
- Tort Reform: Examining the Current Environment (Part Two of a Three-Part Series)
- Courts Examine Use of Statistical Sampling in False Claims Act Cases
Volume 10, Issue 2 (February 2017)
- President Trump Issues Executive Order on ACA
- Aetna-Humana and Anthem-Cigna Mergers Blocked by D.C. Federal District Court
- Application of False Claims Act Limited By First Circuit Court of Appeals
- Potential for Tort Reform Under Republican Rule (Part One of a Three-Part Series)
Volume 10, Issue 1 (January 2017)
- New Cardiac and Orthopedic Payment Models
- Wide-Ranging 21st Century Cures Act Signed into Law
- OIG Releases 2017 Work Plan
- S-Corporation Valuation Debate - The Impact of Cecil v. Commissioner
Volume 9, Issue 12 (December 2016)
- The 2016 Election and the ACA: The Future of Healthcare Reform (Part Two of a Two-Part Series)
- CMS Issues Final Rule Implementing MACRA
- Valuation of Compensation for Healthcare Services: Medical Director Compensation (Part Four of a Four-Part Series)
- Statistical Methods in Valuation Analysis: Monte Carlo Simulation Analysis (Part Six of a Six-Part Series)
Volume 9, Issue 11 (November 2016)
- The 2016 Election and the ACA: A Report Card on Healthcare Reform (Part One of a Two-Part Series)
- Rationale Against Physician-Owned Hospitals Receives Further Scrutiny
- Valuation of Compensation for Healthcare Services: Physician On-Call Services (Part Three of a Four-Part Series)
- Statistical Methods in Valuation Analysis: Regression Analyses (Part Five of a Six-Part Series)
Volume 9, Issue 10 (October 2016)
- Valuation of Compensation for Healthcare Services: Physician Executive Services (Part Two of a Four-Part Series)
- Employer Adoption of Private Exchanges Lower than Projected
- Telehealth Coverage Expands under Next Generation ACO Model
- Statistical Methods in Valuation Analysis: Data Sets and Samples (Part Four of a Six-Part Series)
Volume 9, Issue 9 (September 2016)
- Valuation of Compensation for Healthcare Services: Physician Clinical Services (Part One of a Four-Part Series)
- Reputable Hospitals Score Low in CMS Hospital Rankings
- Outlook for the Pharmacy Benefit Management Industry (Part Two of a Two-Part Series)
- Statistical Methods in Valuation Analysis: Coefficient of Variation (Part Three of a Six-Part Series)
Volume 9, Issue 8 (August 2016)
- Stark Law Reform Debated by Senate Committee
- Express Scripts Sued by Anthem and Shareholders (Part One of a Two-Part Series)
- ACA CO-OP Closures: Impact on U.S. Health Insurance Markets (Part Two of a Two-Part Series)
- Statistical Methods in Valuation Analysis: Descriptive Statistics (Part Two of a Six-Part Series)
- "Implied False Certification" Theory Under False Claims Act Upheld by Supreme Court
- Statistical Methods in Valuation Analysis: Review of Principles and Applications (Part One of a Six-Part Series)
- 16 of 23 ACA CO-OPs Closed (Part One of a Two-Part Series)
- Cost of Patient Access to Medical Information: Recent HHS Guidance
- FTC v. Pinnacle: Antitrust Concerns vs. Reform-Based Consolidation
- "Pharmacy on Demand" To Revolutionize Drug Manufacturing
- Pharmaceutical Pay-for-Delay Agreements in Decline Since 2013
- Rural Hospital Closure Rates Higher in Non-Medicaid Expansion States
- Practice Loss Postulate: Regulatory Barrier to Healthcare Integration
- Fraud and Abuse in Healthcare: CMS Extends Moratorium on the Certification of New Home Health Agencies in Certain Areas
- CMS Issues MACRA Proposed Rule One Year After Passage
- New Electroceutical Technologies May Revolutionize Medical Care
- Tax-Exempt Status: IRS Denies Commercial ACO Tax-Exempt Status Under Section 501(c)(3) (Part Two of a Two-Part Series)
Volume 9, Issue 4 (April 2016)
- Value-Based Reimbursement: Mastering the Behemoth (Part Three of a Three-Part Series)
- Valuation of Telemedicine Services (Part Four of a Four-Part Series)
- Tax-Exempt Status: Illinois Hospital Loses Tax-Exempt Status - Again (Part One of a Two-Part Series)
- 2016 Supreme Court Healthcare Cases: Post Scalia
Volume 9, Issue 3 (March 2016)
- Value-Based Reimbursement: Be Careful What You Wish For - Number of Quality Programs Expands Post-ACA (Part Two of a Three-Part Series)
- Telemedicine: Professional Practice Standards (Part Three of a Four-Part Series)
- Disruptive Innovation in Healthcare
- An Ounce of Prevention is Worth a Pound of Cure: Distribution of Medical Malpractice Claims - Implications for Healthcare Organizations
Volume 9, Issue 2 (February 2016)
- Value-Based Reimbursement: What You Always Wanted to Know, But Were Afraid to Ask (Part One of Three-Part Series)
- Telemedicine: The Reimbursement Environment (Part Two of Four-Part Series)
- ACA's Cadillac Tax Delayed Until 2020
- HCA Hit with $400 Million Judgment by Missouri Court
Volume 9, Issue 1 (January 2016)
- Medicare Physician Fee Schedule 2016 Updates
- Telemedicine Series Part 1: Utilization and Trends
- SCOTUS to Weigh in on Definition of "False" Under FCA
- The Re-Emergence of Provider-Sponsored Plans
Volume 8, Issue 12 (December 2015)
- Congress Changes Reimbursement Rules for Off-Campus Facilities
- OIG Releases 2016 Work Plan
- Updated Two-Midnight Rule Released
- Medicare Releases Comprehensive Care for Joint Replacement Model
- HCC - 2015 - Our 23rd Year of Achievements!
Volume 8, Issue 11 (November 2015)
- ACO Waivers Final Rule Issued
- 2016 Stark Law Changes Issued
- CMS Delays Enforcement of Stage Three Meaningful Use Requirements
- ICD-10 Rollout Relatively Smooth, Insurers Say
- FTC Releases Antitrust Guidance for State Medical Boards
Volume 8, Issue 10 (October 2015)
- Commercial Reasonableness: Why It Matters to an ACO's Board
- Regulatory Scrutiny for Physician Compensation Continues
- Patient Wait Times for Medical Care Often Excessive
- Great Variability in Geographic Access to Primary Care Facilities
Volume 8, Issue 9 (September 2015)
- Commercial Reasonableness and ACOs: Installment 1 of 3
- Appraiser Files Multiple Qui Tam Suits Against Health Systems
- Venture Capital Funding in Healthcare Industry Remains Strong in Second Quarter 2015
- Potential Repeal of the Medical Device Tax: Another ACA Challenge
Volume 8, Issue 8 (August 2015)
- Commercial Reasonableness and ACOs: Installment 1 of 3
- Impact of the "Per-Click" Ruling on Valuing Diagnostic Outpatient Enterprises
- The Morristown Decision & its Potential Impact on Tax-Exempt Entities
- King v. Burwell: What's Next?
- Court Strikes Down Per-Click Restrictions, or Does It?
- Fraud Alert Puts Added Pressure on Physicians
- Proposed Medicare Physician Fee Schedule Changes for 2016
- SCOTUS Finds Obamacare Insurance Subsidies Legal
- Criminal Healthcare Cyberattacks on the Rise
- New Healthcare Index Developed
- Improving Physician Efficiency for Patient-Centered Care
- Telemedicine Considerations
- The Next Generation ACO Model
- Increased Scrutiny of Provider-Based Status Compliance
- The Rise of Start Up Healthcare Entities and Their Transformation of the Market
- Is AI the Cure for Cancer?
Volume 8, Issue 4 (April 2015)
- President Obama Signs Bill to Permanently Repeal SGR
- False Claims Act: FY 2014 in Review
- Hospitals Fight Back against Proposed Site Neutral Payment Policy
- Senior Housing Concerns for 2015
Volume 8, Issue 3 (March 2015)
- Highest and Best Use - An Imperative Concept in Healthcare Valuation
- Outlook Increasing For Future of Telemedicine
- Transition Timeline Set for Medicare Reimbursement Payments
- Barriers to Medical Innovation
Volume 8, Issue 2 (February 2015)
- Cleveland Clinic & TedMed Medical Innovations: Impact of Medical Technologies 2015
- Physicians Foundation Issues List of Physician Concerns for 2015
- The Economic Costs of Antimicrobial Resistance
- Mental Health Status of Inmates & the Homeless Population
Volume 8, Issue 1 (January 2015)
- Threshold of Commercial Reasonableness: Quantitative Analysis
- Interventional Cardiology Recognized as Distinct Specialty by CMS
- Private Exchange ACOs Emerge as Next Generation ACO Model
- The State of Mental Health Services, Treatment, and Stigma
Volume 7, Issue 12 (December 2014)
- Utilization of Asset/Cost Approach in Appraising Outpatient Enterprises
- Threshold of Commercial Reasonableness: The Qualitative Analysis
- ACO Quality Improvement Methods
- The Advancement Toward Personalized & Evidence-Based Medicine
Volume 7, Issue 11 (November 2014)
- The Utilization of the Market Approach in Appraising Outpatient Enterprises
- The Threshold of Commercial Reasonableness
- Use of Technology for Patient Outreach
- 2015 MPFS and New Quality Benchmarks
Volume 7, Issue 10 (October 2014)
- Utilizing the Income Approach to Appraise Outpatient Enterprises
- Access to Healthcare Remains Stable Under Affordable Care Act
- ACOs Achieving Quality with Shared Savings
- Physicians Increasingly Targeted in Fraud & Abuse Lawsuits
Volume 7, Issue 9 (September 2014)
- Appropriate Use of Extraordinary Assumptions and Hypothetical Conditions
- GAO Issues Report on CMS Post-Payment Claims Review
- Provider Concentration and Antitrust Implications
- Health Insurance Exchange Changes Expected for Enrollment Year 2015
Volume 7, Issue 8 (August 2014)
- Determination of the Appropriate Standard of Value & Premise of Value
- Healthcare Prices Rise Slowly, Employment Growth Remains Volatile
- Health Systems Continue to Acquire Insurers
- ACA Employer Mandate Requires Decisions Regarding Health Insurance Offerings
- Health System Consolidation Expands to Post-Acute Care
- Congressmen Question Reach of Fraud & Abuse Enforcement
- Navigating Hospital Rating Systems Can Be Difficult for Consumers
- Co-Ops Remain Available in Health Insurance Marketplace Despite Low Enrollment
- Health Insurance Exchanges Impact Patient Enrollment
- CMS Issues Final Prospective Payment System for FQHCs
- Telemedicine Guidelines Adopted by State Medical Boards
- Jimmo Case Re-Review Deadline Approaching
- CBO Shaves $100 Billion from ACA's Ten-Year Cost Projection
- AHA Sues HHS Over Two-Midnight Rule
- Diminishing Returns in Healthcare Series - Part 3 of 3: ACA's Efforts to Make Healthcare More Affordable
- CMS Proposes New Fire Safety Regulations for Hospitals
Volume 7, Issue 4 (April 2014)
- CMS Releases Medicare Advantage Final Call Letter for 2015
- St. Luke's Health System Ordered to Unwind Acquisition of Physician Group
- OIG Reports Fraud Vulnerabilities in Electronic Health Records
- Decreasing Marginal Utility in Healthcare Series, Part 2 of 3: Causes of Wasteful Spending in the U.S. Healthcare System
Volume 7, Issue 3 (March 2014)
- Decreasing Marginal Utility in Healthcare Series, Part 1 of 3: The High Cost of Healthcare
- Physician Shortage Series, Part 3 of 3: Shortage of Specialty Physicians
- Tax-Exempt Hospitals Face Increasing Tax Scrutiny
- Retail Clinics and Health Systems Coordinate Care
Volume 7, Issue 2 (February 2014)
- OIG Work Plan for 2014 Released
- Healthcare Fraud & Abuse Series Part III of III: Increasing Scrutiny of Healthcare Fraud & Abuse Laws
- The High-Tech Patient Room of the Future
- Physician Shortage Series II of III: Surgical Shortages Worsen
Volume 7, Issue 1 (January 2014)
- U.S. Primary Care Shortage Continues
- Brief Review of Healthcare Fraud & Abuse Prosecutions
- Opposition to the "Two-Midnight" Rule Heating Up
- Hospital Merger Faces Class Action Lawsuit for Price Inflation
Volume 6, Issue 12 (December 2013)
- Will the SGR Finally be Retired?
- 2014 to See Reduction in Capital Healthcare Expenditures?
- Emboldened Government Pursuit and Prosecution of Healthcare Fraud and Abuse
- Hospital Operating Efficiency Under Healthcare Reform
Volume 6, Issue 11 (November 2013)
- Seattle Children's Hospital Sues Washington State Insurance Commissioner over Exchanges
- Anti-Kickback Statute Not Applicable to Title I ACA Facilitated Healthcare Exchange Programs
- Does CEO Compensation at Non-Profit Hospitals Need to be Tied to Quality Metrics?
- How Will Rising Costs of Cancer Care Fare Under the ACA?
Volume 6, Issue 10 (October 2013)
- Increasing Challenges for Health Exchange Enrollment
- Regulatory and Reimbursement Changes Under the FY 2014 IPPS Final Rule
- Turning Hospitals into Hotels: How Increasing Amenities Could Sacrifice Quality
- Prospective Payment System Proposed for QHCs under the ACA
Volume 6, Issue 9 (September 2013)
- CMS Releases Final Rule on Health Exchanges
- IRS Finds Extensive Non-Compliance Among Tax-Exempt Colleges and Universities
- Nurse Practitioners Seek Expansion in Scope of Practice
- Wellness Program Woes
Volume 6, Issue 8 (August 2013)
- Big Data Series Part IV of IV: Application of "Big Data" in Today's Healthcare Environment
- Infection Control and "Never Events" Series Part IV of IV: The Future of Patient Safety for Healthcare Stakeholders
- Medical Reversals: The Challenge of Replacing Outdated Medicine
- Battling Public Concerns Regarding Healthcare Costs
- Big Data Series Part III of IV: "Big Data" Impact on Healthcare Regulation and Reimbursement
- Infection Control and "Never Events" Series Part III of IV: Data Metrics for "No Pay" Events: How Accurate is it?
- New Consumer Health Insurance Exchange Options Likely to Vary by State
- Challenges to Contain Costs and Standardize End-of-Life Care
- Big Data Series Part II of IV: "Big Data" Privacy and Security Challenges Under HIPAA/HITECH
- Infection Control and "Never Events" Series Part II of IV: Regulatory and Reimbursement Penalties for "No Pay" Events
- Proposal to Repeal the Flawed SGR System
- The Role of Potential Overutilization on Increased Healthcare Spending: A Case Study Regarding Colonoscopies
- Big Data Series Part I of IV: What is "Big Data" and What Does It Mean for Healthcare?
- Infection Control and "Never Events" Series Part I of IV: An Overview of Infection Control and Patient Safety in an Era of "Never Events"
- IRS Proposes Requirements to Make Charitable Hospitals More "Charitable"
- CMS Proposes Changes to Medicare Incentive and Enrollment Programs to Combat Fraud
Volume 6, Issue 4 (April 2013)
- HIPAA Series Part III of III: HIPAA and the Delivery of Healthcare
- Intermountain Pays $25.5 Million in Stark Violations
- Healthcare Fraud and Abuse Program Nets $4.2 Million in FY 2012
- The ACA in 2013: What Can Stakeholders Expect?
Volume 6, Issue 3 (March 2013)
- HIPAA Series Part II: Effect on Business Associates
- Clinical Integration Beyond ACOs: The New Frontier
- 2013 Medicaid Changes Under ACA
- CO-OP Health Insurance Program: October 2013 Implementation
Volume 6, Issue 2 (February 2013)
- HIPAA Series Part I: History and Overview of HIPAA Legislation
- The Sunshine Act and Health Care Transparency
- Increased Fraud and Abuse Scrutiny of Hospice Reimbursement
- Advancements in Mobile Health Technology
Volume 6, Issue 1 (January 2013)
- Healthcare Valuation Series Part IV: Regulatory Issues Related to Exempt Organizations
- The Impact of the American Taxpayer Relief Act
- Concurrent Care: Improving Access to End of Life Treatments
- OIG Annual Solicitation of Safe Harbor Proposals
Volume 5, Issue 12 (December 2012)
- Healthcare Valuation Series Part III: The Valuation of Physician Services
- ACO Value Metrics Series Part IV: Evaluating the Monetary and Non-Monetary Value of ACO Formation
- Certificate of Need (CON) Law Series Part IV: The Impact of the Affordable Care Act on CON
- Mobile Health: The Newest Wave of Healthcare IT
Volume 5, Issue 11 (November 2012)
- Healthcare Valuation Series Part II: The Valuation of Intangible Assets
- ACO Value Metrics Series Part III: Determining an ACO's Financial Feasibility
- Certificate of Need (CON) Law Series Part III: CON and the Changing Landscape of Healthcare
- 2013 OIG Work Plan Released
Volume 5, Issue 10 (October 2012)
- Healthcare Valuation Series Part I: A Look at Fair Market Value and Commercial Reasonableness
- ACO Value Metrics Series Part II: A Cost-Benefit Analysis of ACO Formation
- Certificate of Need (CON) Law Series: The Current State of CON Programs Across the Country
- New IOM Report Calls for Better Learning and Adoption
Volume 5, Issue 9 (September 2012)
- Value Metrics Series: Part I - Need To Know Basics on the Costs of Forming an ACO
- CON Law Series Part I: A Controversial History
- Stage 2 Meaningful Use: What's Coming Down the Pike
- Shared Decision Making: A Step Towards Patient-Centered Care
Volume 5, Issue 8 (August 2012)
- Provider Supply Series Part IV - The Physician Workforce: What the Future Holds
- Medicaid Expansion: A Fiscal Decision to Ensure Access to Care
- Value-Based Payment Modifier: Another Step Toward Value-Driven Healthcare
- Update on Pediatrics
- Provider Supply Series-Part III-The Primary Care Deficit: Is It Too Late to Fix?
- Aftermath of the SCOTUS Ruling
- Preventative Care: What Is An Ounce Really Worth?
- Individual Insurance Under Healthcare Reform: A Boon For Policyholders
- Provider Supply Series: The Aftermath of GMENAC
- CMS Auditing Program: Back to the Drawing Board?
- Hospital Expansion: Coordinated Care or a Vie for Insured Patient
- Office-Based Surgery Provides Greater Autonomy for Physicians
- Provider Supply Series: GMENAC: The Start of Supply Regualtion
- Legislative Action to Replace the Sustainable Growth Rate
- Better Patient Outcomes Through Pay-for-Performance: Wishful Thinking?
- A Tough Pill to Swallow: The Merger of Express Scripts and Medco
Volume 5, Issue 4 (April 2012)
- Public Health Series: Payroll Tax Cut May Affect Access to Preventative Care
- HHS Releases Final Rule on State Insurance Exchanges
- Capital Spending in the Current Healthcare Environment
- Retrospective: Whistling Past the Graveyard - Part IV: "The Flim-Flam Man"
Volume 5, Issue 3 (March 2012)
- Public Health Series: Crowding vs. Access - Effects of Upfront Emergency Room Payments
- What the New Form 990 Means for Exempt Organizations
- AHRQ Quality Indicators Toolkit Offers Hospitals Implementation Guidance
- Retrospective: Whistling Past the Graveyard - Part III: The Healthcare Application Tango
Volume 5, Issue 2 (February 2012)
- Public Health Series: Health Disparities - What is Being Done?
- Congress Approves "Doc-Fix" to Maintain Medicare Payment Amounts
- CMS Continues Self-Referral Disclosure Protocol (SRDP) Settlements
- Retrospective: Whistling Past the Graveyard - Part II: The Software Solution
Volume 5, Issue 1 (January 2012)
- Public Health Series: The New Language of Healthcare
- HIPAA Version 5010: What and When
- Medical Loss Ratio Final Rule Divides Consumers and Insurers
- One Year of RAC Audits: MO is the "Big Winner"
- Retrospective: Whistling Past the Graveyard - The Scenario
Holiday News Alert (December 2011)
Volume 4, Issue 12 (December 2011)
- CMS Auditing Series: More Stringent Provider Penalties
- Dealing With the Medicare Doughnut Hole
- The Expense of the ICD-10 Conversion
- Who is Marilyn Tavenner?
Volume 4, Issue 11 (November 2011)
- CMS Auditing Series: Identifying High Risk Hospitals
- 2012 OIG Work Plan Released
- CMS Bundled Payment Initiative: Four Models for Coordinated Care
- Forced Transparency for Health Insurers
Volume 4, Issue 10 (October 2011)
- Accountable Care Organizations Series: How Are ACOs Compliant?
- CMS Auditing Series: Establishing Medicaid RACs
- The Sustainable Growth Rate Saga Continues
- In the Electronic Age, Is PHR Adoption Lagging Behind?
Volume 4, Issue 9 (September 2011)
- Accountable Care Organizations Series: When Are ACOs?
- CMS Auditing Series: RAC Attack
- Final Rule Could Compromise Value-Based Purchasing Program
- U.S. Life Expectancy - What Factors Contribute to Low Rates?
Volume 4, Issue 8 (August 2011)
- Accountable Care Organizations Series: Where Are ACOs?
- Proposed Rule on State Exchanges Released
- Medicare's PECOS System
- The Increased Use of Air Medical Services (AMS)
- Accountable Care Organizations Series: Who Are ACOs?
- Insurers Subject to ERISA Liabilitys
- Statutory Elimination of Physician-Owned Hospital Exceptions
- Supreme Court Overturns State Law Restrictions on Data-Mining
- Accountable Care Organizations Series: What Are ACOs?
- CMS Bars Medicaid Payments For Preventable Conditions
- Insurer-Run Care Expanding Into Retail Clinics
- Vermont Adopts Single-Payor System
- Accountable Care Organizations Series: Why Do We Need ACOs?
- Medicare Advantage Plans Squeezed in 2012 Under Healthcare Reform
- CMS Finalizes Rule on Telemedicine
Volume 4, Issue 4 (April 2011)
- Healthcare Reform: Impact on States
- CMS Issues Proposed Rule on Accountable Care Organizations
- Federal Efforts to Improve Healthcare Quality
- Opportunities and Challenges for Telemedicine
Volume 4, Issue 3 (March 2011)
- Healthcare Reform Series: Impact on Employers
- Federal Fraud Task Force Has Largest Takedown to Date
- Healthcare Reforms Tax Provisions Strain IRS Resources
- Healthcare Employment Resists Effects of Recession
Volume 4, Issue 2 (February 2011)
- Healthcare Reform: Impact on Physicians
- CMS Develops Center for Medicare & Medicaid Innovation
- Maryland Court Upholds Physician Self-Referral Law
Volume 4, Issue 1 (January 2011)
- Healthcare Reform: Impact on Hospitals
- ACOs and the Stark Law-How to Co-exist
- Government Task Forces Issue Medicare Spending Recommendations
Volume 3, Issue 12 (December 2010)
- Healthcare Reform Series: Impact on Individuals
- Medicare Recovers Millions in Nov 2010 Fraud & Abuse Settlements
- Health Reform and the Private Insurance Market
- Relative Value Scale Update Committee Scrutinized
Volume 3, Issue 11 (November 2010)
- Physician Cost Profiling
- American Health Benefits Exchanges
- OIG Regulatory Scrutiny: An Examination of Recent Cases
- Optometry Now Part of Primary Care Under ACA
Volume 3, Issue 10 (October 2010)
- Emerging Healthcare Organizations Series: Bundled Payments
- Standalone Hospitals Struggling to Survive
- Plan Administrator Abuses Discretion Under ERISA
- Beyond RACs: ZPICs, MICs, & MACs
Volume 3, Issue 9 (September 2010)
- Emerging Healthcare Organizations: Medical Home Models
- CMS Regulations for Stark Rural & Whole Hospital Exceptions
- CMS Changes Reimbursement Method for End Stage Renal Disease
- U.S. Decreasing Healthcare Utilization
Volume 3, Issue 8 (August 2010)
- Emerging Healthcare Organizations: Accountable Care Organizations
- Improper Payments Elimination and Recovery Act
- Anti-Kickback Statute: No Private Cause of Action
- Co-Management Arrangements Aligning Physicians and Hospitals
- CMS Proposes 0% Change in 2011 ASC Payment Rates
- CMS and ONC Issue Final Rules about Meaningful Use
- MedPAC Changes to Stark In-Office Ancillary Services
- OIG Releases “Free Pre-Authorization” Advisory Opinion
- CMS Issues New ASC Guidelines
News Alerts
- News Bulletin: Update- Senate Votes to Rescind Medicare Physician Payment Cut
- News Bulletin: Senate Fails to Stop Physician Payment Cut
- CMS Reverses Reimbursement Cuts to Nuclear Imaging
- U.S. Investigates Health Network for Possible Antitrust Violations
- Outpatient Surgeries Show Dramatic Increase
- Physicians Face Expiration of Board Certification
Volume 3, Issue 4 (April 2010)
- Qui Tam Action Alleging Violation of Stark & Anti-kickback Headed to Trial
- Increased Regulatory Scrutiny Possible with Expanded Use of Billing & Coding Audits
- Impact of Healthcare Reform on Specialty Hospitals
Volume 3, Issue 3 (March 2010)
- CMS Clarifies Anti-Markup Rule for Diagnostic Tests
- U. S. Health Spending in 2009: Largest Increase in 40 Years
- The Regulation of Mid-Level Provider Practice
Volume 3, Issue 2 (February 2010)
- ASCs Antitrust Claim Survives Summary Judgment
- Shift from Independent Private Practice to Hospital-Centric Practices
- Houston's Largest Hospital Reaches Antitrust Settlement Agreement
- The Scope of Non-Physician Provider Practice
Volume 3, Issue 1 (January 2010)
- IRS Prepares for New Initiative Scrutinizing Executive Compensation
- Concierge Medical Practice Network Acquired by P&G
- Self-Pay Patients: A Cautionary Tale
Volume 2, Issue 12 (December 2009)
- Physicians Face Hits to Medicare Reimbursement
- New Proposals for Accountable Care Organizations
- NJ Cardiologists Settled With DOJ in Anti-Kickback Case
- NJ Appellate Court - Codey Law: Private Entities Lack Standing
Volume 2, Issue 11 (November 2009)
- Antitrust in Healthcare Under Reform
- Congress Fails to Postpone Medicare Physician Payment Cuts
- Recovery Audit Contractors Continue Program Phase-in Schedule
Volume 2, Issue 10 (October 2009)
- New Jersey Cardiologists Settle in Anti-Kickback Case
- OIG Announces its FY 2010 Work Plan
- Changes to Exempt Organizations Safe Harbor not Offered in Health Care Reform Markup
Volume 2, Issue 9 (September 2009)
- Iowa's Covenant Medical Center Settles False Claims with DOJ
- OIG Releases Report on "Incident-to" Services
- America’s Healthy Future Act
Volume 2, Issue 8 (August 2009)
- Bonus and Incentive Compensations: Emblems of Fraud?
- Red Flag Rules Finally Implemented, Enforcements Begin Nov. 1, 2009
- Medical Device Manufacturers Sued for Off-Label Promo & Upcoding
- IRS Publishes New Tax-Exempt Organization Guidelines
- Imaging Reimbursement Cuts Proposed
- Medicare Physician Fee Schedule Updates
- June 2009 MedPAC Report
- Senate Proposes Minimum Charity Care Requirements
- OIG Issues Advisory Opinion Regarding On-Call Compensation
- OIG and HHS Turn On The HEAT
- Payment Bundle Initiatives Proposed by Senate & CMS
- Obama Signs HITECH Act for Healthcare IT
- Senate Healthcare Reform
- Fraud Enforcement and Recovery Act of 2009 (FERA)
- Medicare Enrollment and Billing
Volume 2, Issue 4 (April 2009)
- Workforce Disruptions Hit Healthcare
- Gainsharing Comment Period Extended
- OIG Limits Stark Law Violation Self Disclosure Protocol
Volume 2, Issue 3 (March 2009)
- Economic Recession Hits Healthcare
- Shakeup in New Jersey Related to Physician-Owned ASCs
- IRS Issues Report on Not-for-Profit Executive Compensation
Volume 2, Issue 2 (February 2009)
- Final SCHIP Bill Passes Without Physician Ownership Language
- Chicago-Based MRI Provider Settles Anti-Kickback Lawsuit for $1.2 Million
- Heightened Hospital Charity Care Requirements on the Horizon
- United Health Settles Conflict of Interest Lawsuit for $50 Million
Volume 2, Issue 1 (January 2009)
- Office of Inspector General (OIG) Work Plan 2009 Overview
- Gainsharing Activities and Part-Time Physician Employment Receive Approval from OIG
- CMS Issues 2009 Final Rule Regarding HOPD/ASC Payments
- Cardiology Specialty Hospital Barred from Network - Antitrust Suit Dismissed
- Update on Stark Gainsharing Exception
- OIG Report on MRI Provider Relationships Under the MPFS
- Cardiologists Sue Over Stark Changes
- Surviving Fair Market Value & Commercial Reasonableness Thresholds
- CMS Regulatory Updates: 2009 IPPS Rules Finalized
- Health Net Settles Ingenix Reimbursement Rate Suit
- Growing Support of Gainsharing Arrangments
- Anti-Markup Rule Provision Injunction
- Antitrust Implications of Physician Owned Facilities vs. General Hospitals
- OIG Issues Open Letter Regarding Refinements to Provider Voluntary Self-Disclosure Protocol
- Physician Antitrust Update: Fifth Circuit Affirms FTCs Decision in North Texas
- Stark Law Update: Recent Developments
- ASC Payment System Update for 2008
- The Future of Managed Care: Resurgence of IPAs and PHOs
- Improving Quality through Physician Rankings, P4P and Patient Safety Organizations
- IRS Publishes Final Regulations under Section 501(c)(3) of IRS Code
- Proposed Amendment to New Jerseys Codey Act Allowd Self-Referral to Physician-Owned ASCs