CO Changes Way PBMs Paid Colorado Gov. Jared Polis (D) signed a bill ( HB 1094 ) that, among other things, will allow pharmacy benefit managers, starting in 2027, to only be paid a flat service fee instead of earning income from rebates or other price-based fees...
Check out this practice note from Practical Guidance – Healthcare covering the legal and regulatory framework governing telehealth services in the United States, including licensure requirements, HIPAA and state privacy laws, telehealth reimbursement policies...
Check out this practice note from Practical Guidance – Healthcare that offers an introduction to physician recruitment strategies by hospitals, with a focus on how these strategies are governed by the fraud and abuse regulations set forth in the Stark Law...
Check out this checklist from Practical Guidance – Healthcare addressing items for covered entities (which includes most group health plans) and their business associates to consider in complying with HIPAA’s Security Rule for protected health information...
Check out this state law survey from Practical Guidance – Healthcare that addresses short-term hospital services for terminally ill patients, including those provided through Medicare programs. Highlighted issues include licensing/certification of inpatient...
WI Assembly Passes Multiple Healthcare Bills Wisconsin’s Assembly passed multiple healthcare-related bills with broad bipartisan support. One ( AB 43 ) would allow pharmacists to prescribe birth control to those 18 and older. It now moves to the Senate...
Check out this practice note from Practical Guidance – Healthcare for an overview of Academic Medical Centers (AMCs). The practice note defines AMCs, explains their three-part mission of clinical care, research, and education, and describes their governance...
IA Enacts Law Addressing Shortage of Birth Centers Iowa Gov. Kim Reynolds (R) signed a bill ( HF 887 ) exempting freestanding birth centers from having to obtain a certificate of need from the state’s Department of Inspections, Appeals and Licensing to...
Check out this visual checklist from Practical Guidance – Healthcare to guide you through the required types of notice that must be given regarding a data breach that constitutes a reportable breach of protected health information (PHI) under the Health Insurance...
WA Enacts Law Keeping Medical Debt Off Credit Reports Washington Gov. Bob Ferguson (D) signed a bill ( SB 5480 ) prohibiting collection agencies from reporting unpaid medical debt to credit agencies. The measure, which takes effect on July 27, is similar to a...
Check out this checklist from Practical Guidance – Healthcare to guide you through key legal and business considerations that healthcare providers, including group practices, hospitals, and healthcare systems, need to keep in mind when building a compliance...
State Lawmakers Target PSAOs After targeting pharmacy benefit managers for years for contributing to the high cost of prescription drugs, state lawmakers have begun setting their sights on pharmacy services administrative organizations, or PSAOs, which help independent...
Check out this practice note from Practical Guidance – Healthcare for an overview of Accountable Care Organizations (ACOs), including a discussion of the basic eligibility requirements for ACOs seeking to participate in the Medicare Shared Savings Program...
AR Lawmakers Pass Bill Banning PBMs from Running Pharmacies The Arkansas legislature passed a bill ( HB 1150 ) that would make the state the first in the nation to prohibit pharmacy benefit managers from operating retail pharmacies. A spokesman for Gov. Sarah...
Check out this practice note from Practical Guidance – Healthcare discussing the use of the False Claims Act and qui tam actions to combat fraud in the Medicare and Medicaid programs. Read now » Related Content Healthcare Fraud and Abuse Compliance...