News & Events

COVID-19 and Hospital Financial Performance

KaufmanHall, a consulting services and software provider to 80 of the 100 largest health systems in the United States, recently published an article entitled, “The Effect of COVID-19 on Hospital Financial Health.” “For any organization, a posit… Read More
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New Provider COVID-19 Reporting and Testing Requirements

On August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) promulgated regulatory changes via an interim final rule dated August 21, 2020, requiring nursing homes to test staff and offer testing to residents for COVID-19. Laboratories… Read More
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The Time is Now for Reference-Based Pricing Plans

As if the standard issues facing businesses related to healthcare were not enough, businesses now have to deal with the COVID-19 pandemic. As it was, annual premiums were on the rise – increasing 5% in 2019 and predicted to increase 6% in 2020. The… Read More
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Section 1332 Waivers-Reinsurance

Section 1332 of the Affordable Care Act (ACA) allows states to apply for a State Innovation Waiver to pursue innovative strategies for achieving high quality, affordable health insurance and to to alter key ACA requirements in the individual and smal… Read More
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U.S. District Court Holds Department of Health and Human Services’ Price Transparency Rule is Constitutional

In November 2019, the Centers for Medicare and Medicaid Services (CMS), an agency within the Department of Health and Human Services, issued a Rule entitled Medicare and Medicaid Programs: CY 2020 Hospital Outpatient PPS Policy Changes and Payment Ra… Read More
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Looking for an Exit?

Before the onset of COVID-19, there existed a seller’s market for businesses. Clean, profitable businesses were in short supply. An abundance of private equity and historically low interest rates drove multiples to levels this author had not previo… Read More
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Surprise Medical Billing Statutes Ignore Fundamental Right

Surprise medical billing has been a key issue targeted by legislators across the country, including by the U.S. House and Senate. Surprise medical bills arise when a patient inadvertently receives care from an out-of-network provider, such as when a… Read More
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Balance Billing and COVID-19

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). The CARES Act has many components, one of which was to make $175 billion in Provider Relief Funds available to hospital fac… Read More
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Data and More Data; Good Data or Not so Good Data?

Good reliable data is necessary for public authorities, aided by medical professionals, to formulate sound strategies for dealing with COVID-19. An understanding of the progression of the pandemic, infection rates, death rates, and other data points… Read More
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Tossing Aside the Rule of Law, an "Op Ed" By James F. Koehler

Are we tossing aside the rule of law as we respond to the COVID-19 pandemic? I’m beginning to wonder. I can’t help but think the state-by-state designations of essential businesses have been arbitrary, inconsistent, and in some instances driven b… Read More
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