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Category Archives: Health Care

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Report Regarding Drug Purchasing in Ohio

Posted in Access, Drug Pricing, Health Care, Medicaid, Pharmaceuticals

Today Ohioans Against the Deceptive Rx Ballot Issue announced opposition to the ballot issue on drug pricing in Ohio. More than 30,000 doctors, nurses and pharmacists, business and labor and the state’s largest organization serving individuals with AIDS/HIV announced their opposition to the proposal. A policy report was released in September 2016, providing an analysis… Continue Reading

New Report Regarding Drug Purchasing in Ohio

Posted in Access, Drug Pricing, Health Care, Medicaid, Pharmaceuticals

A proposed initiated statute to change state prescription drug purchasing in Ohio would be difficult if not impossible to implement, according to a new report issued by Ohio public health policy experts. The report, released today from Vorys Health Care Advisors (VHCA) and Health Management Associates (HMA), analyzes the proposed initiated statute to change state… Continue Reading

Date Nears for States to Implement CMS Access Rule

Posted in Access, CMS, Health Care, Medicaid, Regulations

On January 4, 2016, the Center for Medicare and Medicaid Services (CMS) implemented sweeping new requirements for ensuring access to specific categories of Medicaid services. The final rule, released on November 2, 2015, and titled Medicaid Program; Methods for Assuring Access to Covered Medicaid Services, creates a very important vehicle for beneficiaries, service providers, their… Continue Reading

CMS Final Rule on Reporting Overpayments

Posted in CMS, Health Care, Overpayments, Regulations

Yesterday, the Centers for Medicare and Medicaid Services (CMS) published a final rule regarding health care providers’ duty to report and return self-identified Medicare Part A and Medicare Part B overpayments to CMS.  The purpose of this final rule is to provide clarification of the meaning of overpayment identification and the required look-back period for… Continue Reading

VHCA Webinar on New Medicaid Managed Care Rules

Posted in Behavioral Health, CMS, Health Care, Managed Care, Medicaid, Regulations

CMS recently proposed regulations regarding Medicaid managed care.  The proposed rule, which was released on June 1, offers the fist major update to Medicaid and CHIP managed care regulations since 2002 – in many ways, this update and modernization of the regulations is overdue.  In general, the proposal takes a big step toward aligning Medicaid and CHIP managed… Continue Reading

Governor Kasich Proposes Numerous Tax Changes in 2016-2017 State Budget

Posted in Articles, Health Care

Ohio Governor John Kasich recently outlined the tax changes he will include in his 2016-2017 biennial state budget.  The governor’s proposal is a mixture of cuts, increases and elimination of taxes which he says will result in a net $500 million tax cut for Ohioans. The taxes included in his package are: sales tax, commercial… Continue Reading

Payment Reform and Maryland’s All Payer Agreement with CMS

Posted in Articles, Health Care, Health Care Reform

Payment reform is considered essential to the transformation underway across the United States. Catalyst for Payment Reform (CPR) indicates that almost 90% of all private sector payments are still provided on the basis of fee-for-service. CPR defines payment reform as “payment methods that reflect or support provider performance, especially the quality and safety of care that… Continue Reading

Is One Brand of Medicaid Expansion Waiver Better than Another?

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Different strokes for different folks as the old adage goes.  This saying, however, is particularly true when you look at the states that have chosen to expand their Medicaid programs under the Affordable Care Act (ACA) through waivers. States do not have to seek a waiver from the federal government in order to expand their… Continue Reading

New York State’s Budget Relies on Federal Medicaid Money –Expecting an Answer from CMS Soon

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In 2012, New York Governor Andrew Cuomo submitted to the federal Centers for Medicare & Medicaid Services (CMS) an amendment to New York’s existing Partnership Plan 1115 waiver that sought to “redesign” the state’s Medicaid program.  The amendment proposed to reinvest $10 billion of the $17 billion in savings the state anticipated it would achieve… Continue Reading

The Governor’s Big Play: Pushing Ahead on Medicaid Expansion

Posted in Affordable Care Act, Behavioral Health, Health Care, Health Care Reform, Medicaid

By Sylvia Brown and Former State Senate President Tom Niehaus Anticipation is building as the battle over Medicaid expansion moves to the unlikely arena of the state Controlling Board. On Monday, October 21 at 1:30 p.m., Governor John Kasich will try to make good on his promise to take whatever action within his power to… Continue Reading

Health Insurance Options in 2014

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

In a recent post, we discussed the insurance mandate itself.  That is, the requirement that most people have health insurance beginning in 2014 or face a financial penalty.  We also briefly mentioned the insurance options that will be available to you in order to fulfill this requirement.  They are— Have employer-sponsored insurance Be covered by… Continue Reading

False Claims Act Webinar

Posted in Health Care

Join Vorys attorneys Matt Albers and Michael Bronson for a complimentary webinar on Tuesday, June 25th, 12:00 – 1:00 p.m. (Eastern Time). The presentation will discuss: Overpayments not reported or returned within 60 days constitute “obligation” under reverse False Claims Act provisions When is an overpayment “identified” for purposes of the 60-day deadline? Requirements for reporting… Continue Reading

CMS Addresses DSH Cuts; Impact on States That Do Not Expand Medicaid Remains Unclear

Posted in Affordable Care Act, Health Care, Health Care Reform, Medicaid

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that cuts federal payments to hospitals for uncompensated care.  What still remains unclear, however, is how these cuts will impact states that do not expand their Medicaid programs. The Affordable Care Act (ACA) requires significant cuts to Disproportionate Share Hospital… Continue Reading

Webinar – HIPAA Privacy and Security Rules: Updated Privacy Rule Changes

Posted in Health Care

Join Vorys attorneys Lisa Reisz and J. Liam Gruzs on Tuesday, March 19th, noon-12:30 p.m. (Eastern Time) for a complimentary webinar to further discuss the release of the final omnibus HIPAA rule by the U.S. Department of Health and Human Services. The new rule includes sweeping changes to the HIPAA Privacy and Security Rules. This… Continue Reading

MetroHealth Launches Comprehensive Health Care Coverage for Thousands of Uninsured Adults In Cuyahoga County

Posted in Health Care

The MetroHealth System announced on Tuesday that the federal government has approved its plan to provide a medical home and health coverage for up to 30,000 uninsured residents of Cuyahoga County. The program, called MetroHealth Care Plus, is designed to provide the high-quality services people need to maintain their health, while also reducing health care spending. The… Continue Reading

Changes to Federal EHR Rule Will Likely Benefit Medicaid Providers

Posted in Health Care, Medicaid

Vorys’ HealtHITech Law blog recently shared news regarding two key changes to federal rules related to implementation of electronic health records (EHR) for Medicaid providers.  These two changes are likely to benefit providers seeking Medicaid incentive payments for EHR. Read about these changes and others included in the Medicare and Medicaid EHR Incentive Programs Stage… Continue Reading

Webinar: Recent Labor Law Developments for the Health Care Employer

Posted in Health Care

Join Vorys for a complimentary webinar, Friday, October 26 from 12:00 – 1:00 p.m. (Eastern Time). Recent Labor Law Developments for the Health Care Employer Vorys partner Nelson Cary will discuss the following in his presentation: Update on Status of National Labor Relations Board (NLRB) and Department of Labor Rulemaking Activities The NLRB’s Relentless Focus on Employer Handbooks… Continue Reading

Some Health Care Providers Left Out of HITECH Incentive Framework

Posted in Health Care

Our colleague, Liam Gruzs, recently shared information on fedeal incentive payments made available to health care providers that adopt certified Electronic Health Records (EHRs) and demonstrate meaningful use of the EHRs.  Read Liam’s post to find out why many types of medical professionals may not become eligible for incentive payments, even if they do become “meaningful… Continue Reading

Webinar – The U.S. Supreme Court Decides on the Affordable Care Act: What Happens Now?

Posted in Health Care, Health Care Reform

The U.S. Supreme Court is expected to announce on Thursday, June 28th, its decision on the Affordable Care Act. Vorys Health Care Advisors and a panel of Vorys, Sater, Seymour, and Pease attorneys will be available Monday, July 2 at 2:30 p.m. (ET) for a complimentary webinar. To RSVP or for more information, please contact Cindy… Continue Reading

Health Care Reform: Count Down to Decision Day (Part II)

Posted in Health Care, Health Care Reform, Medicaid

In our last post, we discussed the practical impact on the American public of the Affordable Care Act’s Medicaid expansion.  There are also significant repercussions for states, as described below. What does the Medicaid expansion really mean for States?  For Ohio, specifically? • States will be responsible for up to 10% of the cost of the… Continue Reading

Health Care Reform: Count Down to Decision Day

Posted in Health Care, Health Care Reform, Medicaid

Conventional wisdom holds that the U. S. Supreme Court is likely to render a decision on the fate of the Affordable Care Act (ACA) near the end of its term concluding on June 30th.  Four separate issues are under review: 1. The so-called “individual mandate” that all Americans have health insurance 2. The Medicaid expansion to low-income… Continue Reading

Ohio Makes Medicaid Eligibility Easier for Children and Pregnant Women

Posted in Health Care, Medicaid

The Ohio Department of Job and Family Services this week announced an initiative that will have a profound impact on Ohio’s most vulnerable citizens. In collaboration with Ohio Medicaid’s ongoing effort to simplify and streamline the eligibility process for all Medicaid-eligible individuals, the State is implementing presumptive eligibility for certain groups of individuals.  Presumptive eligibility… Continue Reading