ACOs and patient choice—What providers need to knowBy Elias N. Matsakis & Sabrina CuaHealth Care Law, December 2013The Affordable Care Act authorized the Center for Medicare and Medicaid Services (CMS) to establish the Medicare Shared Savings Program (MSSP). To accomplish its goals, this program, relies on accountable care organizations (ACOs) that contract with CMS. This issue of the Health Care Lawyer includes an article by Elias N. Matsakis and Sabrina Cua of Holland & Knight discussing ACOs with a focus on issues related to patient choice in receiving care.
Drug compounding: Clear authority and more reliable data needed to strengthen FDA oversightHealth Care Law, September 2013In the last year, there have been several instances of contamination and patient injury in widely used drugs supplied to physicians and hospitals by drug compounding companies. The most recent incident was in August of this year involving a Texas compounding company. The Government Accountability Office (GAO) released a report in July 2013 looking at the issue of regulatory oversight of compounding companies. A summary of the GAO report is included in this issue.
The Affordable Care Act—Will stand-alone hospitals sink or swim?By John J. TufanoHealth Care Law, March 2013For many stand-alone hospitals, merging, partnering, or affiliating with larger hospital networks may be their only option to remain viable and achieve certain scales required by the Patient Protection and Affordable Care Act.
All the latest developments in health care lawBy W. Eugene Basanta, Brittany Pape, & Nicholas SchroerHealth Care Law, March 2013U.S. Supreme Court rejects state action defense in antitrust action involving hospital sale. In doing so the Court rejects analysis of Eleventh Circuit Court of Appeals.
The Affordable Care Act—Will stand-alone hospitals sink or swim?By John J. TufanoBusiness and Securities Law, January 2013For many stand-alone hospitals, merging, partnering, or affiliating with larger hospital networks may be their only option to remain viable and achieve certain scales required by the Patient Protection and Affordable Care Act.
The amendment to the Health Care Services Lien ActBy Bridget DuignanTort Law, December 2012The amended Act provides certainty and a more level playing field for insurance companies and individual insureds within the context of bodily injury and death claims.
Estimates for the insurance coverage provisions of the Affordable Care Act updated for the recent Supreme Court decisionHealth Care Law, September 2012In July, the Congressional Budget Office (CBO) released two reports, one looking at the budgetary impact of the U.S. Supreme Court’s decision regarding expansion of the Medicaid program under the Affordable Care Act (ACA) and the other examining the budgetary costs associated with a possible repeal of the ACA. Summaries of these reports are included in this issue of the Health Care Lawyer.
Patents, medication, and WHO controls them: A look inside a potential negotiator of the patented drug tradeBy Veena TripathiInternational and Immigration Law, August 2012Global health is plagued by the inefficiencies of developing countries to gain access to medications. The inability for these countries to access these medications can be often blamed on the lack of patent regulation. The author reports on the past and current state of global patents for necessary medications and suggests that the World Health Organization, a branch of the United Nations, can be the mediator in this relationship.
Drug shortages—FDA’s ability to respond should be strengthenedHealth Care Law, March 2012As recently reported by NPR, many US hospitals are perilously close to running out of a common cancer drug, methotrexate because a principal supplier of injectable the drug shut down in November after it failed an FDA inspection. Drug shortages in the US have in fact become a major public health concern. A recent report from the Government Accountability Office, summarized in this issue, suggests FDA authority needs to be enhanced to address this problem.
A strategy for dealing with medical providers who refuse to submit their bills to health insuranceBy Dennis L. BerkbiglerTort Law, February 2012There are a number of situations where the personal injury client may benefit more by having his or her medical expenses paid by health insurance rather than out of the tort recovery. The following letter, or some variation of it, may be used in an attempt to induce the recalcitrant provider to comply with the demand to submit the client’s bills to his or her health insurance.
Essential Health Benefits: Balancing coverage and costHealth Care Law, December 2011As part of recent Patient Protection and Affordable Care Act, Congress has directed that the Department of Health and Human Services (HHS) develop a package of basic essential benefits to be furnished by health insurance plans. The Institute of Medicine (IOM), in October, reported to HHS suggesting criteria to use in developing this package. The IOM report summary is included in this issue.
Specialty healthcare: The NLRB rewrites rules on bargaining unitsBy Michael D. GiffordLabor and Employment Law, December 2011As a result of the recent decision of Specialty Healthcare and Rehabilitation Center of Mobile, unions will be able to organize a minority share of an employer’s workforce although a majority of workers may not favor the union.
Covenants not to compete in Illinois—The muddle of the legitimate business interest testBy Harold B. OakleyIntellectual Property, September 2011This article first examines Steam Sales and Reliable. It then addresses what these decisions, which dealt with sales positions wholly unrelated to the health care industry, may nevertheless mean for health care providers in Illinois.
Don’t fear the reaperBy Kevin Lovellette & Mary Jane AdkinsGovernment Lawyers, June 2011As government attorneys, we should have the ability to speak with a Coroner to gather all the information necessary to properly defend or prosecute on behalf of the People.
