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Healthcare Law Blog Sheppard Mullin

WebBy Michael Sutton, Sara Shanti & Phil Kim on April 23, 2024. In the rapidly evolving landscape of digital health, gamification has emerged as a powerful tool to enhance …

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California is Capping Health Care Cost Increases

WebAs we previewed last year regarding SB 184 and the establishment of the California Office of Health Care Affordability (OHCA), California now has taken a significant regulatory …

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CMS Issues Final Rule on Medicaid and CHIP Managed Care …

WebOn April 22, 2024, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule (), effective July 9, …

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The Intersection of Artificial Intelligence and Utilization Review

WebHealth plans and insurers in California would need to file written policies and procedures with state oversight agencies, including the California Department of Managed Health …

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Key Healthcare Provisions of the Consolidated Appropriations Act, …

WebOn December 29, 2022, President Biden signed the Consolidated Appropriations Act, 2023 (the “Act”). The Act provides for nearly $1.7 trillion in funding across a range of domestic …

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CMS Promotes Health Equity through Marketplace Standards and …

WebOn November 24, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (“ CMS ”) published a proposed rule to modify certain …

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Q&A: The No Surprises Act’s Protections for Uninsured (or Self-Pay

WebThese requirements apply to (1) a physician or other health care provider who is acting within the scope of practice of that provider’s license or certification under applicable …

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HHS Announces 42 Part 2 Final Rule to Align with HIPAA

WebThe U.S. Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) recently released the long anticipated …

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Healthcare Reforms Under the IRA: Expanding Access to Care

WebThe Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022. The expansive legislation includes key health care provisions, including drug …

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Putting the Brakes on Healthcare M&A and Provider/Payor …

WebHealth plans are, in turn, rewarded with preferred or discounted rates on healthcare provider services. These mutual benefits are negotiated at arms-length, and may represent a …

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Healthcare Antitrust Update: Key Antitrust Takeaways for Physician

WebLike other players in the healthcare industry, physician groups are facing increased antitrust scrutiny from the Biden administration, with the Federal Trade Commission (the “FTC”) …

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HHS OIG Report On Prior Authorizations Under Medicare Advantage

WebIn an article published on April 29, 2022, America’s Health Insurance Plans (“AHIP”) blasted the Report claiming that, “ [w]hen looked at properly, the data actually tell a compelling …

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HHS Issues Proposed Rule to Provide Clarity on Rights of …

WebOn January 5, 2023, the U.S. Department of Health and Human Services (“HHS”) published a notice of proposed rulemaking entitled “Safeguarding the Rights of Conscience as …

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HHS OIG Issues Report Critical of Medicare Advantage Risk …

WebEarlier this month, the U.S. Department of Health and Human Services Office of the Inspector General (the “OIG”) released a report highlighting concerns about the extent to …

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Florida Bans Offshoring of Certain Patient Information

WebThe Act is slated to take effect on July 1, 2023. Qualifying health care providers should assess where electronic patient information is stored, including whether third-party …

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Medi-Cal Rx: California to Transition Medi-Cal Pharmacy Benefits …

WebOn April 1, 2021, the California Department of Health Care Services (“DHCS”) will be transitioning all Medi-Cal pharmacy benefits from managed care to fee-for-service …

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Trends in Digital Health Funding and Transactions: A Tremendous …

WebFurther, Rock Health noticed that over one quarter of all digital health companies funded in the first half of 2021 were direct-to-consumer-only startups. This was the largest …

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At HLTH 2023: General Catalyst’s HATCo Introduces a Radically …

WebFor HATCo and Risant Health, data analytics and value-based care will go hand-in-hand, as their use of data analytics may help health systems unlock major care delivery and …

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The “State” of Telehealth: Texas Healthcare Law Blog

WebTexas Makes Significant Strides to Expand Telehealth. On April 14, 2021, the Texas House passed House Bill 4 (the “Bill” or “HB4”), a telehealth bill seeking to make permanent the …

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2024 Brings Expansion to Medicaid in New York State

WebOn Tuesday, January 9, 2024, the Centers for Medicare & Medicaid Services (“CMS”) approved a request from New York State (“NYS”) to amend its Medicaid section 1115(a) …

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The “State” of Telehealth: Utah Healthcare Law Blog

WebUtah Bill Uses Telehealth to Address Mental Health. On March 2, 2021, Utah Governor, Spencer Cox, signed Senate Bill 41 (“SB41”) into law. The bill, sponsored by State …

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Connecticut Governor Signs Health Care Legislation to Reduce …

WebToday, Connecticut Governor Ned Lamont signed into law HB6669, “An Act Protecting Patients and Prohibiting Unnecessary Health Care Costs” (“the Act”), which seeks to …

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