Perspectives on Health Care

Headlines that Matter for Companies and Executives in Regulated Industries

The Determination of Need Program (certificate of need in other states) of the Massachusetts Department of Public Health (DON Program) has for many years had a moratorium on accepting and reviewing applications for construction that would add new nursing home beds to the healthcare system.

Health Care Practice Co-Leader Douglas Grimm will present about fraud and abuse investigations in the telehealth industry at Palmetto Care Connections’ Telehealth Summit of South Carolina on October 9.

With increased financial pressure on the health care delivery system, there is likely to be an increase in health care provider financial restructurings.

On September 24, 2020, the California Court of Appeal shed additional light on meeting the public interest requirements in anti-SLAPP motions in its opinion of Murray v. Tran (Cal. Ct. App., Sept. 24, 2020, No. D076104).

California Governor Newsom signed Senate Bill 1237 (SB 1237), broadening the certified nurse midwife (CNM) scope of practice, among other changes to the Nursing Practice Act and other Sections of the Business and Professions Code. 

The California Consumer Privacy Act (CCPA), the landmark privacy law making waves since taking effect earlier this year, has continued to evolve as legislators and the California Office of the Attorney General refine and clarify its requirements.

For the first time, California has granted nurse practitioners who meet certain qualifications a separate scope of practice. This eventually will allow them to practice specified medical functions independently, without standardized procedures.

Headlines that Matter for Companies and Executives in Regulated Industries

Arent Fox Partner David Greenberg is presenting on health care policy issues at Gallagher’s ‘2020 Election: Healthcare Policy Outcomes & Impacts to Plan Sponsors’ virtual town hall.

On September 25, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it streamlined the federal Clinical Laboratory Improvement Amendments (CLIA) certification process for laboratories applying to perform COVID-19 testing.

Last month, in Pharmaceutical Care Management Association v. Tufte et al. No. 18-2926 (8th Cir. August 7, 2020), the United States Court of Appeals for the Eighth Circuit invalidated legislation in North Dakota on the grounds that it was preempted by ERISA.

Headlines that Matter for Companies and Executives in Regulated Industries

HHS has finalized the CARES Act provider reporting and recoupment rules and they are different from those put forth in the proposed form. Providers should take careful note — the new requirements are significant and detailed.

On September 18, 2020, under the authority of the Center for Medicare and Medicaid Innovation, CMS finalized the new Radiation Oncology Alternative Payment Model (Model), with a new payment methodology for radiation therapy (RT) services.

In recent years, the US health care system has experienced unprecedented challenges, an increasing pace of change, and ever-growing complexity.

Health Care Partner Anne Murphy will moderate a panel discussion on the state of behavioral health care in an upcoming webinar hosted by the Boston Bar Association.

Following up on the recent New York State Executive Order the New York City Department of Health and Mental Hygiene issued an alert advising providers that all point-of-care COVID-19 test results must be reported electronically via the New York State Electronic Clinical Laboratory Reporting.

Headlines that Matter for Companies and Executives in Regulated Industries

Health Care Partner Stephanie Trunk will participate in an External Counsel Fireside Chat at Informa Connect’s virtual Medicaid Drug Rebate Program on Friday, September 18, 2020. She will also host an in-depth on-demand session on reimbursement and contract strategy.

The Centers for Medicare and Medicaid Services (CMS) has withdrawn its proposed Medicaid Fiscal Accountability Regulation (MFAR), according to a September 14, 2020, announcement via Twitter by Administrator Seema Verma.

Multiple members of Congress issued a letter to HHS Secretary Alex Azar on September 14, 2020, urging him to use his authority to compel pharmaceutical manufacturers to comply with the laws and regulations governing the 340B Drug Pricing Program.

The White House released a new Executive Order on September 13, 2020, related to drug prices titled “Lowering Drug Prices by Putting America First” the September Order), whose stated purpose is to address reimbursement for prescription drugs under both the Medicare Part B and Medicare Part D program

The FCC’s Connected Care Pilot Program is poised to defray eligible health care providers’ costs of providing certain telehealth services. On September 3, 2020, the FCC issued additional information and guidance for potential applicants.

Medical providers treating patients covered by ERISA-governed health plans on an out-of-network basis can assert state-law claims to hold plans to their payment promises without running afoul of ERISA’s preemption provision (ERISA § 514(a), 29 U.S.C. § 1144(a)).