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Search OptionsHealth CareWith SEA 140, Indiana Joins Other States in Limiting Pharmacy Benefit Manager Vertical Integration
Indiana recently enacted Senate Enrolled Act 140 (SEA 140), a significant overhaul of pharmacy reimbursement practices intended to greatly impact pharmacy benefit manager (“PBM”) vertical integration. SEA 140 introduces multiple changes to how pharmacy benefits are managed and delivered in Indiana,… The End of Physician Noncompetes in Indiana Hospitals: A Look into Indiana Senate Enrolled Act No. 475
In a significant development for healthcare employment law, Indiana’s Senate Enrolled Act No. 475 (“SEA 475”) broadens existing restrictions on physician noncompete agreements to include nearly all physician types—not just primary care providers. Building on Senate Enrolled Act No. 7, which took… Tele-prescribing Here to Stay? HHS Signals Commitment to COVID-19 Era Telemedicine Prescribing Expansions
After months of back and forth, with the fate of tele-prescribing in limbo, the Department of Health and Human Services (“HHS”) signaled its continued commitment to some COVID-19 era telemedicine expansions by the recent issuance of two final rules: (1) Expansion of Buprenorphine Treatment via… Clearing the Path to Care: OIG Continues to Approve Modest Patient Incentives to Accessing Health Care Services
A recent advisory opinion from the Office of Inspector General (“OIG”) provides welcome clarity and encouragement to community health centers looking for ways to incentivize patient access to care. Advisory Opinion 25-02 continues the OIG’s favorable support of strategies designed to connect… OIG Signals Potential Approval of Prescription Drug Assistance Programs
Non-profit healthcare entities may soon have greater flexibility when it comes to patient assistance programs that subsidize the cost of prescription drugs for their patients residing in rural areas. Generally, such programs risk violating the patient remuneration prohibition under the federal… Massachusetts to Require Licensure for Non-Resident Pharmacies in 2025
The Massachusetts Board of Registration in Pharmacy (the “Board”) announced, via updated Non-Resident Licensure FAQs on November 19, 2024, that it will now require non-resident pharmacies to be licensed in order to dispense prescription products into the state. Massachusetts has historically… Approaching Deadline to Submit HIPAA Breach Notifications to HHS
Under the HIPAA Breach Notification Rule, entities regulated under HIPAA must report breaches affecting less than 500 individuals to the Department of Health and Human Services (“HHS”) within sixty days following the end of each calendar year. Therefore, the deadline to report 2024 breaches… HIPAA Wrapped: OCR’s 2024 HIPAA Highlights
OCR Director Melanie Fontes Rainer released an announcement on January 7, 2025 recapping OCR’s HIPAA accomplishments and enforcements in 2024. (“Announcement”). In the Announcement, Rainer highlights new rules implemented and enforcement actions taken by her agency in 2024. Covered entities should… CMS Reporting Requirements for Nursing Facilities: Fast Tracking the Start Line
As we previously reported, CMS issued a Final Rule implementing certain requirements in the Affordable Care Act regarding the disclosure of ownership, managerial and other information for Medicare and Medicaid participating nursing facilities. Most notable and complicated of these new requirements… Is the Heyday of Whistleblowers Coming to a Close?
Under the False Claims Act (“FCA”), whistleblowers (known as qui tam relators) are able to initiate and direct the litigation of cases that seek recovery for alleged injuries to the federal government. 31 U.S.C. § 3730(b). The penalties for FCA violations are astronomical – with penalties up to… Physician Non-Competes in Indiana – The Old, the New, and the Future
Restrictive covenants in Indiana have long been a topic of litigation and debate for health care providers, private practices, and health systems. Historically, and before there were statutory restrictions for physician non-competes, there is a long line of cases that have required physician… HHS Finalizes Enforcement Stick For Health Care Providers Committing Information Blocking
Effective July 31, 2024, health care providers will be subject to “disincentives” for committing information blocking. As codified under the 21st Century Cures Act, information blocking is when an “actor” (e.g. health care provider) interferes with the access, exchange, or use of electronic health… |
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