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ML Strategies Health Care Preview - Week of March 12th
March 12, 2018 | Blog
This week, Congress returns to Washington with 11 days to finalize a government spending bill. Standing in the way are a number of unresolved health care issues, including drug pricing and market stabilization.
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DOJ Announces Roundtable Series on Competition and Deregulation
March 8, 2018 | Blog | By Dionne Lomax
The Department of Justice ("DOJ") Antitrust Division recently announced plans to hold a series of public roundtable discussions to analyze the relationship between competition and regulation, and its implications for antitrust enforcement policy.
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Are HCT/Ps a Dark Spot in the Sunshine Act Requirements?
March 7, 2018 | Blog | By Benjamin Zegarelli
On February 22, the Wall Street Journal published an article about the tissue graft manufacturer MiMedx Goup, Inc. and its failure to report payments to physicians under CMS’s Open Payments Program established by the Centers for Medicare & Medicaid Services under the Patient Protection and Affordable Care Act (P.L. 111-148, Sec. 6002, amending Social Security Act Sec. 1128G), also known as the Physician Payments Sunshine Act (PPSA).
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ML Strategies Health Care Preview - Week of March 5th
March 5, 2018 | Blog
Congress has three weeks to finalize an omnibus spending package. There are a number of issues that are expected to come up, including market stabilization and drug pricing, among other issues. There's also activity at the state level on Medicaid waivers and work requirements. We cover this and more in this week's preview.
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DOJ Intervenes in False Claims Act Case Against a Compounding Pharmacy and a Private Equity Firm
March 5, 2018 | Blog | By Xavier Hardy, Karen Lovitch
The Department of Justice (DOJ) recently intervened in a False Claims Act (FCA) case that raises a variety of interesting allegations, including payment of kickbacks by a compounding pharmacy to contracted marketing companies in the form of percentage-based compensation, to TRICARE beneficiaries in the form of co-payment waivers, and to physicians who submitted prescriptions without seeing patients.
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CMS's Advance Notice and Call Letter: How Medicare Plans Can Report, Identify, and Address the Opioid Epidemic
March 1, 2018 | Blog | By Bridgette Keller, Tara E. Dwyer
CMS has slowly but surely been providing additional guidance to Medicare Plans (Medicare Advantage and Part D plans) regarding steps they can and should take to address the opioid epidemic as it relates to their beneficiaries. CMS’s most recent guidance to Plans regarding the opioid epidemic was included in the Advance Notice and Call Letter.
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ML Strategies Health Care Preview - Week of February 26th
February 26, 2018 | Blog
Congress is back in session and will begin its work in finalizing a final spending bill for fiscal year 2018. Both chambers are considering new ways to address the opioid crisis, and we should expect a renewed push around gun control and mental health.
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HIPAA Enforcement Survives Closure of Business
February 26, 2018 | Blog
The U.S. Department of Health and Human Services Office for Civil Rights (OCR) recently announced a $100,000 settlement with a company that is no longer in business. Filefax, Inc. (Filefax) was an Illinois company that provided storage and delivery services for medical records held by covered entities.
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Federal Enforcement Actions Continue to Focus on Opioid-Related Misconduct
February 20, 2018 | Blog | By Samantha Kingsbury
As we predicted in our year-end post on civil and criminal enforcement trends, 2018 is already off to strong start in opioid-related enforcement against individual providers and associated practices.
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Mintz’s Antitrust and Federal Regulatory Practice Releases Alert on DOJ Settlement With Allegiance
February 16, 2018 | Blog | By Xavier Hardy
Mintz’s Antitrust & Federal Regulatory Practice recently published a Health Care Antitrust Alert on the DOJ Antitrust Division’s announced settlement with Henry Ford Allegiance Health (“Allegiance”).
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ML Strategies Health Care Preview - Week of February 12th
February 12, 2018 | Blog
This week, the President's FY 2019 budget will be released, and the Administration will spend the next couple of weeks touting its goals. How this activity is received in Congress will play out in various committee hearings, as will issues like drug pricing, which the Administration is closely examining.
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The Administration's Budget Proposal for FY2019
February 12, 2018 | Blog
Today, the White House released its FY 2019 budget proposal, outlining its policy priorities for the fiscal year. In health care, the President's budget focuses on prescription drug pricing and opioid funding.
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The New Extender Timeline
February 8, 2018 | Blog
Based on the most up-to-date information on the budget deal, we have developed a new timeline for the major health care extenders. This new timeline is important because these provisions were once all tied together and now, they are not.
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Mintz’s Health Care Enforcement Defense Group Releases New Qui Tam Update
February 8, 2018 | Blog
Mintz’s Health Care Enforcement Defense Group recently published its most recent Health Care Qui Tam Update. This Update analyzes the 47 health care-related qui tam cases unsealed in August and September 2017.
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CMS Releases Advance Notice and Call Letter for Medicare Advantage and Part D
February 6, 2018 | Blog | By Tara E. Dwyer
Late last week, CMS released the Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 draft Call Letter (Advance Notice and Call Letter).
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February 5, 2018 Continuing Resolution: Health Care Provisions
February 6, 2018 | Blog
Late Monday night (February 5, 2018), the House of Representatives released a continuing resolution to keep the government funded and running until March 23, 2018. This CR includes many health care related provisions, specifically many of the health care “minibus” riders. In the chart below we summarize major health care provisions in this CR specific to the health care minibus.
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ML Strategies Health Care Preview - Week of February 5th
February 5, 2018 | Blog
This week, Congress needs to pass a government funding bill by Thursday. Will we get a final budget deal or another continuing resolution? There are still several important health care programs that need to be addressed as well as health care initiatives that have bipartisan support and could find their way into a deal.
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A Guide to New Jersey's New Limits on Pharmaceutical Industry Payments to Prescribers
February 1, 2018 | Blog
The pharmaceutical industry is facing new limits on payments to prescribers in New Jersey. Earlier this month the state's Division of Consumer Affairs finalized sweeping new rules prohibiting some types of payments and capping others. New Jersey now joins the ranks of other states, like California and Massachusetts, with specific payment prohibitions between manufacturers and prescribers.
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Perspective on DOJ Pivot on FCA Enforcement Policy
January 31, 2018 | Blog | By Laurence Freedman
Two new DOJ policies about False Claims Act enforcement became public last week.
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ML Strategies Health Care Preview - Week of January 29th
January 29, 2018 | Blog
This week, President Trump will deliver his first State of the Union address to a joint session of Congress. Following his speech, both parties will leave town for party retreats where they will discuss priorities for the year ahead.
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