Policy & Medicine

Community Health Systems Files Lawsuit Against MultiPlan, Alleging Conspiracy

Thomas Sullivan Jul 26, 2024 0

Community Health Systems (CHS) recently filed a lawsuit against MultiPlan, alleging that MultiPlan conspired with health insurers to lower payments to CHS providers. MultiPlan is an intermediary between insurers and health care providers, used to determine reimbursement for out-of-network claims via repricing tools and other measures. In the…

Policy and Medicine Compliance Update – November 2023…

Thomas Sullivan Dec 1, 2023 0

Policy and Medicine Compliance Update October 2023 Issue…

Thomas Sullivan Oct 20, 2023 0

Community Health Systems Files Lawsuit Against MultiPlan,…

Community Health Systems (CHS) recently filed a lawsuit against MultiPlan, alleging that MultiPlan conspired with health insurers to lower payments to CHS providers. MultiPlan is an intermediary…

Independent Medical Education & Grants Summit 2024

The Independent Medical Education & Grants Summit 2024 is set to be a landmark event for professionals in the medical and life sciences sectors. Scheduled to take place from October 21, 2024…

CMS Updates Medicaid Regulations

The Centers for Medicare & Medicaid Services (CMS) published two significant updates to its Medicaid regulations on May 10, 2024. The two Final Rules, a Medicaid Access Rule and a Medicaid Managed…

CMS Will Not Finalize Proposed Stacking Provision

The Centers for Medicare & Medicaid Services (CMS) announced on May 15, 2024 that it will not finalize, at this time, the proposed stacking provision set forth in the agency’s May 2023 Medicaid…

DC Circuit Upholds 340B Ruling Allowing Drugmakers to Impose…

A federal appeals court recently ruled that drugmakers are allowed to limit and impose conditions on pharmacies they send discounted drugs to under the 340B program. The ruling is a win for drug…

CBO Finds Factors that Contribute to – or Limit – Cost Savings…

The Congressional Budget Office (CBO) recently released a report, "Medicare Accountable Care Organizations: Past Performance and Future Directions.” This report summarizes findings about Medicare…

The Unintended Consequences of State Prescription Drug…

Recently, Health Affairs published a review of State Prescription Drug Affordability Boards (PDABs), covering unanswered questions and unintended consequences. The intent behind PDABs is to lower…

CMS Releases Data on 2023 Stark Law Settlements

The United States Centers for Medicare and Medicaid Services (CMS) recently released data regarding 2023 settlements of voluntary self-disclosures related to past or potential violations of the…

DOJ Announces First Criminal Drug Distribution Prosecution…

The United States Department of Justice (DOJ) recently announced its first criminal drug distribution prosecution related to a digital health company that distributed controlled substances through…

CMS Open Payments System Enhancements and Scheduled Downtime

The Centers for Medicare & Medicaid Services (CMS) is set to upgrade the Open Payments System to version 2.0, bringing enhanced performance and user experience. The system will be unavailable…

FDA Issues Draft Guidance on Diversity Action Plans

Recently, the United States Food and Drug Administration (FDA) released a draft guidance, “Diversity Action Plans to Improve Enrollment of Participants from Underrepresented Populations in Clinical…

PMCPA Issues Sanctions for Violations of the Code

Recently, four companies received violations from the Prescription Medicines Code of Practice Authority (PMCPA) in London for advertising violations, including Novartis, Pfizer, Otsuka, and Novo…