Policy & Medicine – Legal, Regulatory, and Compliance Issues
WEBHHS OIG Issues Report on Two Midnight Rule in Medicare. CMS estimates that between 2017 and 2021, Medicare Part A improperly paid $23.9 billion for inpatient hospital stays, with $7.8 billion attributable to short stays that did not qualify for Medicare Part A. On June 13, 2024, the U.S. Department of Health and Human Services’ Office of ...
Biden Administration Rescinds Trump Administration Insulin …
WEBOct 26, 2021 · One of the final healthcare actions made by the Trump Administration has been rescinded by the Biden Administration. On December 23, 2020, the Trump Administration finalized a rule that directed the Department of Health and Human Services (HHS) to take action to require that federally qualified health centers (FQHCs) make insulin and injectable epinephrine available to certain patients at 340B ...
PhRMA Announces Updated Code on Interactions with Health …
WEBOn August 6, 2021, the Pharmaceutical Research and Manufacturers of America (PhRMA) released its updated Code on Interactions with Health Care Professionals, a voluntary code of ethics that applies to pharmaceutical company interactions with United States health care professionals. As a member of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the PhRMA ...
CMS Updates Guidance on Sunshine Act Reporting Thresholds for …
WEBJan 25, 2021 · At the end of 2020, the Centers for Medicare and Medicaid Services (CMS) issued updated guidance on the thresholds that require an Applicable Manufacturer or Group Purchasing Organization to report under the Sunshine Act. Under the new guidance, if an Applicable Manufacturer or Group Purchasing Organization spends $11.05 or more on a “Reportable Activity” for any Covered Recipient from ...
Institute of Medicine Report – The Future of Nursing: Leading …
WEBFeb 17, 2011 · As the current debate surrounding the Affordable Care Act (ACA) continues in Congress, a number of strengths and weaknesses of the legislation are being emphasized. One specific issue is how the American …
FDA Issues Draft Guidance on Proprietary Names
WEBFeb 2, 2021 · The U.S. Food and Drug Administration (FDA) issued a pair of draft guidance documents aimed at guiding the selection of proprietary names for prescription and non-prescription drugs. The best practices set forth in the guidances are designed “to help minimize proprietary name-related medication errors and otherwise avoid adoption of ...
Prescription Copays More Expensive Than Full Price?
WEBSep 7, 2018 · A study published this year by the University of Southern California’s Schaeffer Center for Health Policy and Economics, Overpaying for Prescription Drugs: The Copay Clawback Phenomenon, found that insurance copays can occasionally be higher than the cost of the actual drug.. A PBS article brought the study to a brighter light, citing the case of Gretchen Liu and her husband Z. Ming Ma.
Physician Payments Sunshine Act Final Rule: Quick Reference Guide
WEBFeb 13, 2013 · The total amount of civil money penalties will not exceed $150,000. Knowingly failing to submit payment information will result in a civil money penalty of not less than $10,000, but not more than $100,000, for each payment. The penalty will not exceed $1,000,000. Combined, penalties may not exceed $1,150,000.
Rockpointe Celebrates 25 Years as a Leader in CME and Compliance
WEBOct 2, 2020 · Since that time, Rockpointe received Accreditation with Commendation in 2012 and has been listed by the ACCME as one of the top 30 overall providers of CME credit in the US. In 2008, Rockpointe launched Policy and Medicine (www.policymed.com) and since that time, has provided daily legislative, regulatory, and …
Prior Authorization Changes Driven by the COVID-19 Pandemic
WEBJul 15, 2020 · Below is a chart summarizing key policy changes major insurance companies have implemented related to PA in response to the COVID-19 pandemic. · PA waiver effective March 24, 2020 – May 31, 2020. · Improved patient access by allowing members to call and speak to a pharmacist. PA: Prior Authorization. UnitedHealthcare.