In an effort to gain market access for new drugs and to shift the conversation from one of “volume” to one of “value,” pharmaceutical manufacturers are increasingly offering and agreeing to alternative payment models that set the price of a... Read More
On January 30, 2023, the Biden Administration announced that the COVID-19 Public Health Emergency (“PHE”), which has been in effect since January 2020, is set to expire on May 11, 2023. Considering the impending end to the PHE, healthcare... Read More
The National Cancer Institute (NCI), a part of the National Institutes of Health (NIH), selected four academic institutions to award $23 million to establish centers of excellence to research delivery of cancer-related care through telehealth. The... Read More
As independent pharmacies across the country look for ways to diversify and grow the scope of products available to their patients, many consider expanding into the durable medical equipment (DME) space, such as wheelchairs, walkers, crutches, and... Read More
Worldwide there are fewer than 500,000 people with hemophilia, a genetic disease that inhibits a patient’s blood clotting ability. Hemophilia is caused by genetic mutations in a patient and is hereditary, meaning that the condition is often passed... Read More
In late July 2021, the Department of Justice announced that the federal government had decided to intervene in six pending False Claims Act (“FCA”) actions against Kaiser Permanente (“Kaiser”) for alleged Medicare Advantage risk adjustment... Read More
Physician groups contracting with government-regulated health plans such as Medicare-Advantage Organizations, Medicaid Managed Care Organizations, or ACA Marketplace Individual/Small Group Issuers often enter into capitated payment models with... Read More
If there were ever any doubts about the seriousness of CMS’ commitment to transitioning the nation’s healthcare system from one based on volume-based to value-based compensation models, those doubts were squashed by a recent CMS blog post and... Read More
