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Healthcare Organizations and Entity Types: What You Need to Know About Benefit Corporations

When deciding on an entity type for a healthcare organization, including physician practices and specialty groups like oncology practices, many different aspects of the organization should be taken into consideration, including funding, taxability, profit distribution to owners, social objective/non-profit mission, and limitation on activities, among others. One option, incorporating as a benefit corporation, may legally protect an organization's goals by creating accountability towards the organization's social and environmental commitments. Benefit...

503A Compounding Alert: FDA Issues a Newly Revised Draft MOU

Earlier this year, the U.S. Food and Drug Administration (FDA) released its 2018 Compounding Policy Priorities Plan, aimed at providing an overview of the key priorities the FDA sought to pursue in its continued implementation of the federal law surrounding compounding. One of the FDA’s action items in the Compounding Priorities Plan was to revise the Memorandum of Understanding (MOU) policy that was initially drafted by the FDA in 1999...

New Medicare Shared Savings Program Proposed Rule for Accountable Care Organizations

The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule, which would institute a number of major changes to the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs). The proposed rule, which creates a redesigned program titled "Pathways to Success," changes the overall structure of the MSSP, and requires ACOs to assume more risk than they are required to under the current MSSP. Under the...

OIG Says Most Healthcare Providers are Not Appealing Medicare Advantage Claim Denials that are Likely to Be Overturned

During the last week of September 2018, the Office of the Inspector General (OIG) issued their findings on their review of the appeals process for Medicare Advantage (MA) plans. The report found that a significant number of Medicare Advantage Organizations (MAOs) overturned their own claim denials in 75% of filed appeals. The OIG report also found that only 1% of claims denials were appealed. This meant that in many circumstances...

Opioid Prescribing – Addressing Patients’ Needs While Avoiding Pitfalls

https://www.youtube.com/embed/IytgD0VHPUk In this recorded webinar, John E. Morrone, Esq., addresses opioid prescribing and avoiding pitfalls, including: • HHS’s 5-Point Strategy to Combat the Opioid Crisis • CDC Guidelines • State law limitation on prescribing • DEA enforcement and compliance • Compliance planning to avoid regulatory scrutiny • Naloxone prescribing and patient education This webinar will help prescribers: • Gain greater understanding of most up-to-date regulatory measures and enforcement actions •...