Hospitals with off-campus provider-based departments may want to rethink their end of summer vacation plans in order to focus on a recent slate of proposed regulations from the Center for Medicare and Medicaid Services that seek to rein in Medicare reimbursement for outpatient hospital services – including at excepted/grandfathered off-campus locations.

The Deputy Secretary of the Department of Health and Human Services (HHS) recently testified before congress that HHS is reviewing both the Stark Law and the Anti-Kickback Statute (AKS) in order to remove some “regulatory barriers” that burden providers. 

On February 26, 2018, twenty states jointly filed a lawsuit in the U.S. District Court for the Northern District of Texas requesting that the court strike down the Patient Protection and Affordable Care Act as amended by the Tax Cuts and Jobs Act of 2017 as unconstitutional. 

President Trump recently revealed his strategy to lower drug prices, a 44-page document titled “American Patients First.” The plan details changes to the Medicare program that could potentially lower pharmaceutical prices.  

During a speech at the World Health Care Conference, Tom Price, former Secretary of the Department of Health and Human Services under the Trump administration, stated that repealing the individual mandate of the Affordable Care Act would drive up consumer costs.

In an announcement on Monday, April 23, the Centers for Medicare and Medicaid Services proposed a new model which would allow beneficiaries of the Medicare program to directly contract with physicians. This comes in an effort to allow physicians more autonomy in their practice to control cost and manage quality.

States have recently become larger players in the world of HIPAA, with the Attorney Generals’ offices in both New Jersey and New York taking action against health care companies for alleged HIPAA violations.

The Centers for Medicare and Medicaid Services announced last month that it would be sending out new Medicare identification cards to all beneficiaries in April of 2019, designed to protect beneficiaries against fraud. However, a report by Bloomberg Law cautions that these cards could cause issues with physician billing and may even result in more fraud.

In its most recent omnibus bill draft, Republican House lawmakers stated that they have removed provisions to help stabilize the ACA, such as cost-sharing subsidies and reinsurance.

The House recently rejected an experimental drug “Right to Try” bill which would allow very ill patients to avoid standards of the FDA in order to use experimental treatments.