K&l Gates Health Care Triage

Sinopse

Triage: Rapid Legal Lessons for Busy Health Care Professionals has been created by K&L Gates to convey information about developments in health law through short, three to ten minute podcasts. If you work in the health care industry, you have grown accustomed to frequent changes in laws and regulations. On some days, it may seem like an insurmountable task to keep up with every change, especially as a new presidential administration and new policies take shape. The K&L Gates Health Care practice will regularly create Triage podcasts to help you learn about the latest developments in health law. Our lawyers will identify the most important changes and analyze the impact of these changes on our clients.

Episódios

  • KL Gates Triage: CMS Cease and Desist Letters to COVID Labs and Reimbursement Dispute

    K&L Gates Triage: CMS Cease and Desist Letters to COVID Labs and Reimbursement Dispute

    23/10/2020 Duração: 07min

    In this episode, Stephen Bittinger discusses the recent announcement that cease and desist letters from the Centers for Medicare & Medicaid Services (CMS) have been sent to 171 facilities testing for COVID-19 without proper CLIA certifications. Stephen outlines the impact of these cease and desist letters to the facilities, including potential implications for reimbursement of COVID-19 testing. Presenter: Stephen Bittinger

  • KL Gates Triage: COVID-19: State and Federal Developments in the Regulation of Long-Term Care Facilities

    K&L Gates Triage: COVID-19: State and Federal Developments in the Regulation of Long-Term Care Facilities

    21/10/2020 Duração: 18min

    In this week’s episode, Myla Reizen and Jackie Hoffman discuss recent developments on the state and federal level related to the operation of long-term care facilities in light of the ongoing COVID-19 public health emergency. In particular, the presenters discuss recent federal regulatory and executive actions, as well as important state developments in Florida and Texas. Presenters: Myla Reizen and Jackie Hoffman

  • KL Gates Triage: ACO Quality Reporting in 2021: Key Changes from the Medicare Physician Fee Schedule Proposed Rule

    K&L Gates Triage: ACO Quality Reporting in 2021: Key Changes from the Medicare Physician Fee Schedule Proposed Rule

    08/10/2020 Duração: 16min

    In this week’s episode, Limo Cherian, Steve Pine, and Macy Flinchum discuss some of the key changes for Accountable Care Organizations (ACOs) in the recent Medicare Physician Fee Schedule proposed rule. In particular, the presenters discuss the implications and potential challenges for ACOs if the proposed changes to quality reporting and the metrics on which ACOs are scored are finalized for 2021.

  • KL Gates Triage: The Preventing Harm Exception to the ONC Information Blocking Rule

    K&L Gates Triage: The Preventing Harm Exception to the ONC Information Blocking Rule

    02/10/2020 Duração: 27min

    In this week’s episode, Gina Bertolini, Lindsey Rogers-Seitz and Maggie Power discuss the Preventing Harm Exception to the Information Blocking Rule, which was recently finalized in the Office of the National Coordinator for Health Information Technology (ONC) final rule implementing the Interoperability, Health IT Certification and Information Blocking requirements under the 21st Century Cures Act. The presenters begin by providing some general background on the ONC Information Blocking Rule, then discuss how the Preventing Harm Exception may protect certain lawful practices engaged in by health care providers that may otherwise constitute information blocking under the new Information Blocking Rule.

  • KL Gates Triage: Updates to Mental Health Parity in California and Nationwide

    K&L Gates Triage: Updates to Mental Health Parity in California and Nationwide

    28/09/2020 Duração: 12min

    In this week’s episode, Carla DewBerry and Kelsey Jernigan discuss issues in mental health parity in the context of recent California legislation. In particular, the presenters discuss how a new California bill has sparked a renewed discussion on parity for mental health and substance use disorder treatment and how it should work in practice. The presenters further address trends across the federal landscape and the interplay with the COVID-19 pandemic.

  • COVID-19: KL Gates Triage: OIG Updates Work Plan to Include Audits of COVID-19 Related Reimbursement and CARES Act Funding

    COVID-19: K&L Gates Triage: OIG Updates Work Plan to Include Audits of COVID-19 Related Reimbursement and CARES Act Funding

    18/09/2020 Duração: 15min

    In this week’s episode, Matt Hubbell and Stephen Bittinger discuss the addition of two new items to the Department of Health and Human Services Office of the Inspector General (OIG) work plan: auditing of COVID-19 related reimbursement during the public health emergency, and auditing of CARES Act provider relief funds. The presenters discuss the ways in which OIG is likely to scrutinize the use of CARES Act and other funding received by health care providers during the COVID-19 public health emergency, and how providers should prepare for OIG inquiries.

  • KL Gates Triage: Rutledge v. Pharmaceutical Care Management Association

    K&L Gates Triage: Rutledge v. Pharmaceutical Care Management Association

    10/09/2020 Duração: 08min

    In this episode of Triage, Leah D’Aurora Richardson and Victoria Hamscho discuss next month’s Supreme Court oral arguments in Rutledge v. Pharmaceutical Care Management Association, including its potential impact on nearly forty state laws that regulate the conduct of pharmacy benefit managers (PBMs) and at least nine state laws prohibiting PBMs from engaging in two-tier pricing models in regard to the 340B Drug Pricing Program. Presenters: Leah D’Aurora Richardson, Victoria K. Hamscho

  • COVID-19: KL Gates Triage: COVID-19 and Social Determinants of Health -- A Closer Look at the Disparate Impact of COVID-19 on Ethnic and Racial Minorities

    COVID-19: K&L Gates Triage: COVID-19 and Social Determinants of Health -- A Closer Look at the Disparate Impact of COVID-19 on Ethnic and Racial Minorities

    04/09/2020 Duração: 12min

    In this episode, Mary Beth Johnston and Nora Becerra discuss recent COVID-19 federal data and the disparate impact of the disease on ethnic and racial minorities; they examine the data through the lens of social determinants of health and propose potential solutions moving forward.

  • KL Gates Triage: QA: What Sponsors and Investigators Need to Know about FDA’s ClinicalTrials.gov Reporting Requirements

    K&L Gates Triage: Q&A: What Sponsors and Investigators Need to Know about FDA’s ClinicalTrials.gov Reporting Requirements

    27/08/2020 Duração: 10min

    FDA’s recent release of new guidance on civil money penalties for the failure to submit required information to the ClinicalTrials.gov data bank may indicate a renewed interest in the enforcement of these requirements. On this week’s episode, Lindsey Rogers-Seitz and Kenneth Kennedy discuss the scope of FDA’s clinicaltrials.gov reporting requirements, as well as the penalties responsible parties may face for failing to meet them. Presenters: Lindsey Rogers-Seitz and Kenneth Kennedy

  • KL Gates Triage: HIPAA: Do Hospitals Need a Business Associate Agreement with their Health System Parent Corporation?

    K&L Gates Triage: HIPAA: Do Hospitals Need a Business Associate Agreement with their Health System Parent Corporation?

    20/08/2020 Duração: 10min

    In this week’s episode, Rebecca Schaefer and Hannah Maroney discuss a string of recent HIPAA enforcement actions which demonstrate that the HHS Office of Civil Rights (OCR), the agency tasked with enforcing HIPAA, is increasingly focused on ensuring that affiliated hospitals within a health system, typically comprising an Affiliated Covered Entity (ACE), have HIPAA business associate agreements in place with the parent corporation to allow for the lawful exchange of PHI. The presenters discuss the circumstances in which a business associate agreement may be required, and address several questions regarding related ACE organizational considerations. Presenters: Rebecca Schaefer, Hannah Maroney

  • 340B Update: Appellate Court Upholds 340B Payment Reduction as CMS Proposes Further Reductions for 2021

    340B Update: Appellate Court Upholds 340B Payment Reduction as CMS Proposes Further Reductions for 2021

    13/08/2020 Duração: 08min

    In this week’s episode, Darlene Davis, Andrew Ruskin, and Gabriel Scott discuss notable recent developments for reimbursement under the Hospital Outpatient Prospective Payment System (“OPPS”) of drugs purchased under the 340B Drug Pricing Program. In particular, the presenters discuss the implications of the recent D.C. Circuit decision in American Hospital Association v. Azar, as well as certain provisions of the new OPPS proposed rule released by CMS on August 4, 2020. Presenters: Andrew Ruskin, Darlene Davis, Gabe Scott

  • Michael P. v. BCBS of Texas

    Michael P. v. BCBS of Texas

    05/08/2020 Duração: 09min

    In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage determinations can, in some instances, favor the patient. Mr. Qualls discusses how this case was decided and what providers can learn from the court’s reasoning.

  • KL Gates Triage: Recent Developments in the 340B Drug Pricing Program

    K&L Gates Triage: Recent Developments in the 340B Drug Pricing Program

    23/07/2020 Duração: 12min

    In this episode, Richard Church, Andrew Ruskin, and Victoria Hamscho discuss recent developments in the 340B Drug Pricing Program, including recent actions by drug manufacturers to limit contract pharmacy access to 340B pricing and impose new reporting requirements on 340B covered entities, as well as a new legislative proposal that would temporarily waive 340B hospital eligibility requirements. Presenters: Richard Church, Andrew Ruskin, Victoria Hamscho

  • COVID-19: KL Gates Triage: COVID Audits

    COVID-19: K&L Gates Triage: COVID Audits

    17/07/2020 Duração: 09min

    In this week’s episode, Stephen Bittinger discusses the impending resumption of Medicare error-based audits, which were temporarily suspended following the onset of the COVID-19 crisis. Mr. Bittinger discusses the different forms of audits that are set to resume, potential focus points that auditors may target, and measures providers should take to prepare. Download Presentation Materials

  • COVID-19: KL Gates Triage: Alternative Payment Models: Tied to an Improved COVID-19 Response?

    COVID-19: K&L Gates Triage: Alternative Payment Models: Tied to an Improved COVID-19 Response?

    01/07/2020 Duração: 14min

    In this week's episode, Gabe Scott and Steve Pine discuss recent data showing how health systems participating in Alternative Payment Models compare to other health systems in responding to the COVID-19 crisis, and discuss the future of APMs. Presenters: Steve Pine, Gabe Scott

  • COVID-19: KL Gates Triage: United States vs Australia-Future of Nursing Homes and Long Term Care Facilities and What it Will Take to Succeed

    COVID-19: K&L Gates Triage: United States vs Australia-Future of Nursing Homes and Long Term Care Facilities and What it Will Take to Succeed

    25/06/2020 Duração: 22min

    In this week’s episode, Myla Reizen and Paris Petranis are joined again by Bruce Spurlock, President and CEO of Cynosure Health, and Judi Coombe, a Senior Operations Consultant at Ansell Strategic, to continue their discussion of the effects of the COVID-19 pandemic on nursing homes and long term care facilities in the United States and Australia. This week, the presenters focus on the ways in which regulatory authorities and industry leaders in the United States and Australia may adapt and change the face of long term and aged care as the COVID-19 pandemic continues, and beyond. Presenters: Myla Reizen and Paris Petranis Download Presentation Materials  

  • COVID-19: KL Gates Triage: Community Health Center Response to COVID-19 and the Evolving Landscape of Delivery of Care

    COVID-19: K&L Gates Triage: Community Health Center Response to COVID-19 and the Evolving Landscape of Delivery of Care

    22/06/2020 Duração: 28min

    In this week’s episode, Carla DewBerry is joined by with Carlos Olivares, Executive Director of the Yakima Valley Farm Workers Clinic, a community based health center in the Pacific Northwest serving low-income, migrant and seasonal farm workers and communities of color for over 40 years. Ms. DewBerry and Mr. Olivares discuss how the COVID-19 pandemic has impacted the organization and community at large, as well as the innovative projects the Yakima Valley Farm Workers Clinic has undertaken, and potential changes in the health care delivery system in years to come. Presenter: Carla DewBerry

  • COVID-19: KL Gates Triage: Nursing Homes and Long Term Care Facilities in the COVID-19 Environment: Huge Disparity between United States and Australia

    COVID-19: K&L Gates Triage: Nursing Homes and Long Term Care Facilities in the COVID-19 Environment: Huge Disparity between United States and Australia

    11/06/2020 Duração: 25min

    In this week’s episode, Myla Reizen and Paris Petranis are joined by Bruce Spurlock, President and CEO of Cynosure Health, and Judi Coombe, a Senior Operations Consultant at Ansell Strategic, to discuss the effects of the COVID-19 pandemic on nursing homes and long term care facilities in the United States and Australia. The presenters discuss the full scope of issues COVID-19 has created for the long term and aged care industries to date, and the ways in which regulatory authorities and industry leaders are addressing these issues in both the United States and Australia. Presenters: Myla Reizen and Paris Petranis Download Presentation Materials

  • COVID-19: KL Gates Triage: Responding to the Unimaginable: Legal Challenges for Nursing Homes  Long-Term Care Facilities in a COVID-19 Enforcement Environment

    COVID-19: K&L Gates Triage: Responding to the Unimaginable: Legal Challenges for Nursing Homes & Long-Term Care Facilities in a COVID-19 Enforcement Environment

    09/06/2020 Duração: 24min

    On this week’s episode, John Lawrence, Myla Reizen and Mark Rush discuss the devastating effects COVID-19 has had on nursing homes and long term care facilities in the United States and potential civil and criminal liability that may stem from how nursing homes and long term care facilities have responded. In particular, the presenters discuss guidance the United States government has provided to nursing homes and long term care facilities for handling the COVID-19 pandemic, areas of potential exposure to criminal and civil actions for nursing homes and long term care facilities related to their response to the pandemic, and what protective measures such facilities can take to prevent or defend against such civil and criminal actions.

  • COVID-19: KL Gates Triage: Considerations for Behavioral Health Providers in the COVID-19 Environment and Beyond

    COVID-19: K&L Gates Triage: Considerations for Behavioral Health Providers in the COVID-19 Environment and Beyond

    04/06/2020 Duração: 16min

    In this week’s episode, Carla Dewberry, Sarah Carlins, and Cheryl Choice discuss the ways in which the COVID-19 emergency has changed the landscape of behavioral health in the United States. The presenters address the ways in which the COVID-19 emergency has affected behavioral health providers and the ways in which they offer behavioral health services, as well as how some of these changes may continue to affect the field of behavioral health into the future. Presenters: Carla Dewberry, Sarah Carlins, Cheryl Choice

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