In a decision last week that could affect $12 billion that insurers assert is owed by the federal government, the Federal Circuit decided that HHS was not required to pay amounts required by statute because Congress had repealed or suspended those obligations through riders to appropriations bills. In Moda Health Plan, Inc. v. United States
New York State Receives Passing Grades On Its First DSRIP Report Card
Earlier this month the New York State Department of Health released the first results of its recently adopted Medicaid redesign efforts, the Delivery System Reform Incentive Payment (“DSRIP”), in four core areas: (1) metric performance, (2) success of projects, (3) total Medicaid spending and (4) managed care expenditures. The passing scores stem from the
NYS Department of Health Announces Workforce Retraining Funding Opportunity
The New York State Department of Health (DOH), in consultation with the Department of Labor (DOL), recently announced a Request for Applications for the Health Workforce Retraining Initiative (HWRI). This program was established pursuant to NYS Public Health Law §2807-g and is funded through the State’s Health Care Reform Act. The 2018-19 Enacted New York
DOH Issues Additional Guidance on New LHCSA Moratorium and other Restrictions Imposed by the 2018-19 Enacted New York State Budget.
As we reported in our annual series highlighting the various healthcare related provisions of the 2018-19 New York State Budget (here), the Enacted Budget reflects the state’s overall policy towards consolidation of the home care marketplace. Nowhere is the effort to force consolidation more
Worker Cooperatives and Health Care
New York State healthcare policymakers have always had a lukewarm relationship with for-profit providers. While in some sectors the for-profit provision of care is common (e.g., nursing homes and home care), in others, there are few to no for-profit providers (e.g., hospitals and primary care clinics). In fact, some in the industry are under the
EDNY Decision Highlights False Claims Act Public Disclosure Bar, Original Source Rule
EDNY Judge Brian Cogan recently addressed the False Claims Act public disclosure bar and original source rule in a decision based on a qui tam Relator’s claims that defendants marketed a test to measure the levels of a certain hormone knowing that the test was flawed. In United States ex rel. Patriarca v. Siemens Healthcare
Seeking Interoperability: Centers for Medicare & Medicaid Services
As we have discussed in an earlier blog post, the federal administrative agencies have been placing greater emphasis on being more transparent and promoting “interoperability”.
As such, on April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) proposed changes to its Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System
Cannabis Industry Update – April 2018
With so much happening in the cannabis industry we thought we’d take this time to highlight some of the industry’s most recent happenings.
- Increasing Support for Decriminalization of Marijuana (Federal): On April 20, 2018, Senate Minority Leader Chuck Schumer of New York said he’ll introduce a bill taking marijuana off the federal list of controlled
Sexual Harassment Legislation Imposes New Employer Obligations
New York’s FY 2019 Executive Budget includes new legislation aimed at combatting sexual harassment in the workplace. According to the Governor, the legislation purports to be the “most comprehensive anti-sexual harassment protections in the nation….” Here are the highlights:
- Effective Immediately: The new legislation prohibits sexual harassment of “non-employees in the employer’s workplace,” including
The Broadest Impact: 2018-19 New York State Managed Care Budget Highlights
This, the last of our posts on the 2018-19 New York State Health Budget (the “Enacted Budget”), focuses on an area of healthcare that has perhaps the broadest impact of the sector as a whole — managed care. A prior