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Ellee focuses her practice on healthcare regulatory law. Ellee has had experience representing hospitals, physicians and managed care companies with day-to-day compliance with various state and federal regulations.

On May 12, 2020 the Centers for Medicare & Medicaid Services (CMS) issued additional 1135 blanket waivers which are applicable to a wide variety of healthcare providers. These COVID-19 Emergency Declaration Blanket Waivers for Healthcare Providers are retroactively effective from March 1, 2020 through the end of the public health emergency (PHE). The waivers in this issuance do not require a request be sent or a notification be made to any of the CMS regional offices.  Each waiver must be consistent with the state’s emergency preparedness or pandemic plan.

Continue Reading CMS Adds Additional Blanket Waivers for Healthcare Providers

Within the vision space there has been some question regarding the authority of Texas Optometry Board (“TOB”) over retailers of ophthalmic goods and optometrists that are in business with or employed by a physician licensed by the Texas Medical Board. On March 30, 2020, the Texas Attorney General published an opinion that may impact retailers of ophthalmic goods and optometrists that are in business with or employed by a physician licensed by the Texas Medical Board (“TMB”). Ophthalmology practices should review the opinion to determine whether changes to their business relationships with optometrists are necessary.
Continue Reading Texas Attorney General Opinion KP-0297 Has Big Implications for Ophthalmologist/Optometrist Relationships

This is the third and final blog in our Surprise Billing series. Our first two blogs addressed legislation in Texas and California limiting “surprise” or “balance” billing. This article will briefly touch on surprise billing legislation that other states across the nation have implemented, and also look at proposed federal legislation that mirrors those state laws.

In today’s political climate, it is rare to have both sides of the aisle agree on the need to tackle a pressing issue. But leaders from both parties see eye-to-eye when it comes to ending surprise medical billing, a problem that arises in roughly 1 in 5 emergency department visits. However, agreeing that something needs to be fixed is only the first step—agreeing on how to fix it is another, much more difficult, issue. There have been proposals, from both the House and the Senate, with bipartisan support that are based on existing state legislation. Congressional legislation regarding surprise billing is imperative for many Americans, because state legislation does not protect patients enrolled in self-insured employer health plans due to preemption by the Employee Retirement Income Security Act (ERISA).
Continue Reading Proposed Federal Legislation Mirrors State’s Attempts to End Surprise Billing

This is the second blog of our Surprise Billing Series. This article will look at California’s Assembly Bill No. 72 which added sections to the California Health and Safety Code and to the California Insurance Code. This bill was one of the first to limit surprise billing and mandate a minimum re-payment amount from insurers for affected out-of-network services and as such has served as a case study for surprise billing legislation.

On September 23, 2016, the California Legislature passed Assembly Bill 72 (“the Law”). The Law applies to Health Care Service Plans regulated by the California Department of Managed Health Care (“DMHC”) and health insurers regulated by the California Department of Insurance (“CDI”) who have issued, amended, or renewed plans or policies after July 1, 2017. The Law has allowed other states across the US, as well as the Federal government, to observe how a change in handling surprise billing could affect patients and health care providers.
Continue Reading California Law Serves as a Case Study for Surprise Billing Legislation

This is the first of three blogs in a series discussing the shift many states are beginning to make towards limiting “Surprise” or “Balance Billing.” This first blog will focus on Texas Senate Bill 1264, which looks to end surprise billing in the State of Texas in certain circumstances. The second blog in this series will look at the similar law California passed in 2017 to see what kind of effects that law has had. The final blog in this series will discuss other proposed state and federal laws that look to continue the trend towards ending surprise billing.
Continue Reading New Texas Law Poses Limitations on Surprise Billing

On April 24-26, The National Association of Accountable Care Organizations held its semi-annual conference for members. NAACOS invites its business partner members, including Husch Blackwell, to attend their semi-annual meetings. Scott Loftin, a Healthcare Regulatory Associate in Husch Blackwell’s Denver office, and I were fortunate enough to attend the conference on behalf of the firm. This conference provided an opportunity for us to listen to the issues, challenges, concerns, and ideas ACO leadership are exploring and facing in today’s regulatory landscape. The presentations and conversations among the members provided us with a deeper understanding of our ACO clients’ business and legal needs.
Continue Reading Husch Blackwell at the NAACOS Conference

This is the third article in our series on the new “Pathways” rules for Accountable Care Organizations.  Our first two articles in the series can be found here.

The Centers for Medicare and Medicaid Services (CMS) issued its anticipated final rule revising the Medicare Shared Savings Program to improve cost savings and quality.

With the changes in the final rule, the revamped program, called “Pathways to Success,” is projected to save Medicare $2.9 billion over 10 years—that’s $0.7 billion more than projected in the proposed rule issued August 9, 2018.
Continue Reading The “Pathways to Success” Final Rule is Here: ACO’s Face Big Decisions