A federal judge disagreed with AstraZeneca’s claims that the Inflation Reduction Act causes harm by disincentivizing innovation and violates its constitutional rights to due process. Blockbuster AstraZeneca drug Farxiga is one of 10 medications selected for the Medicare drug price negotiation program created by the law.
Forty-two safety net hospitals recently sued HHS, alleging that the Medicare program “unlawfully withheld and unreasonably denied” DSH payments for decades. The plaintiff hospitals said that HHS' failure to recalculate DSH payments have cost them "tens of millions of dollars in funds that should have been paid to them many years ago."
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The scheme started in New York but became a complex international endeavor as the two men attempted to launder money received from fraudulent Medicare claims for cancer drugs during the pandemic.
The Act, along with mandating the adoption of electronic prior authorization, requires greater levels of transparency, approval rates, and rationale for denied requests.
Following litigation battles and multiple iterations of the Act, the final rules address the arbitration process for insurers and provide more transparency for patients.
The Act left out individuals who are covered by private insurance, and left pharmacy benefit managers, who negotiate drug prices, off the hook.
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
The road to value-based care is evolving as technology advances. An important tool for this journey is artificial intelligence and machine learning.
A CMS rule, which went into effect December 31, requires that providers publish up-to-date digital contact information regarding their compliance, using approved methods. Noncompliant hospitals will be publicly listed, akin to the Office of Civil Rights’ breach notification portal, the so-called “Wall of Shame.”
Six years in, the subtext of the scheduled reimbursements increase for 2022 is that CCM has proven to be an essential part of the care continuum, particularly in the wake of the Covid-19 pandemic, and has real value for patients, providers, and payers.
The Center for Medicare and Medicaid Services proposes covering Biogen Alzheimer’s disease drug Aduhelm only for people enrolled in a clinical trial. In explaining this proposal, the agency cited the unclear benefit to patients as well as the documented safety risks associated with the drug, which can be best monitored within the context of a clinical trial.
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
The price of Biogen Alzheimer’s disease drug Aduhelm will be cut in half at the start of 2022, a move that comes as a Medicare recommendation on coverage is expected early next year. Meanwhile, Biogen is preparing corporate measures projected to save $500 million annually, cost-cutting made necessary in part due to slow market uptake of Aduhelm.
The Department of Health and Human Services put out a series of strategies to reduce the amount of time physicians spend on documentation on Monday. The report includes suggestions to standardize certain elements of EHRs, and bring federal reporting requirements up to date.
Ambulatory Surgery Centers are yet to get Medicare coverage for total knee replacements, giving hospitals a headstart to win this population.
The project will fund up to 44 separate experiments over five years.
Also, more insight on the future of Theranos and pricing data from patients on video consults.