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Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

4 ways state innovation waivers can't deliver on promise of reform

Though state innovation waivers allowed under Section 1332 of the Affordable Care Act look like a promising way for states to dismantle components of the ACA, actually doing so is not as simple as it seems, according to a  Health Affairs   Blog  post.  

Arizona Supreme Court: Hospitals don't have to return payments from Medicaid patients

Arizona's Medicaid program has won a narrow legal victory in state court regarding its ability to file liens against patients if they were hospitalized due to a personal injury and received a payment from a third party for damages.

ACEP sues feds over out-of-network emergency patients

The American College of Emergency Physicians has filed a lawsuit against the Department of Health and Human Services over emergency reimbursement rules it says run the risk of insufficient payments.

Physician leaders still have an opportunity to shape MACRA implementation

Medicare's plans for a new physician payment system o ffers doctors a better alternative to the widely unpopular sustainable growth formula, but physician leaders need to speak up in order to help shape the proposed law into a more effective vehicle for payment reform, write two health policy experts in the  Journal of the American Medical Association.

Insurer mergers gain more ground in state regulatory review process

Though recent events have renewed concerns about the prospect of Anthem-Cigna and Aetna-Humana closing on their proposed mergers, both deals have continued to collect approvals from state insurance regulators.  

Physician groups oppose VA plan to expand nurse practice authority

Some physician groups oppose the Department of Veteran Affairs' proposed rule to give advanced practice registered nurses expanded practice authority, citing concerns about a lack of clinical oversight from physicians.

CMS officials counter fears about HCAHPS surveys

Common misperceptions persist regarding the role of Hospital Consumer Assessment of Healthcare Providers and Systems surveys, Medicare officials write in a commentary for the Journal of the American Medical Association.

Population health programs must think beyond clinical measures

To scale their population health management efforts to their specific systems, healthcare providers must think beyond clinical measures and partner with vital resources from inside and outside the industry, according to a new report from PwC.

CMS launches new Hospital Improvement and Innovation Network program

The Centers for Medicare & Medicaid Services plans to launch a series of "Hospital Improvement and Innovation Networks" to strengthen patient safety, improve hospital care quality and reduce readmissions.

The law both giveth and taketh away patients' rights to access their records

In a year where patient access to their medical records--a right conferred by law--is a priority issue for the Department of Health and Human Services' Office for Civil Rights (OCR), it turns out that the law itself is an added obstacle.