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Tiffany A. Hetland

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Tiffany’s practice touches all aspects of the rapidly changing healthcare delivery system, from medical care providers to hospitals, pharmaceutical manufacturers and insurance plans.

Mental Health Family

We continue to see an increase in fiduciary litigation involving employer-sponsored group health plans, particularly litigation involving mental health.  A recent New York Federal District Court case, Collins et al. v. Anthem, Inc. & Anthem UM Services, Inc., Case No. 1:20-cv-001969, is one example that may have wide-ranging impact. This case caught our attention because of its potential impact on plan design and plan administration of its mental health and substance use disorder (collectively “behavioral health”) benefits.

Colorful of oral medications on dark background.

Since mid-2020, many pharmaceutical manufacturers have introduced policies that scope their offering of 340B pricing, including limiting contract pharmacy arrangements and requiring covered entities to submit claims data. These policies have generated a good deal of attention generally, and a significant number of covered entities have made attendant complaints to the Health Resources and Services Administration (HRSA).

Virtual Series

Hopefully you had an opportunity to attend our recent Health Law & Innovation Virtual session titled “Stimulus Relief Funds: Strings Attached.” Here are program materials that will be helpful to you:

Cheat Sheet for CARE’s Act Provider Relief Funds
PowerPoint Presentation
Provider Relief Fund General Distribution FAQs (As of 10/28/2020)
U.S. Department of Health & Human Services | CARES Act Provider Relief Fund

If you miss some of the webinar, want to review some of the material or have a colleague who missed the program? The webinar recording is now available for viewing at your convenience. Simply register using the following link and you will have access to the recorded webcast. https://event.on24.com/wcc/r/2637091/918529162DBD1A80B6B8A27F1431372C

Virtual Series

Please join Husch Blackwell as we go virtual with our Health Law Conference. The series will include a range of important topics relevant to the healthcare industry and will be moderated by Curt Chase, leader of the firm’s Healthcare, Life Sciences and Education team; Hal Katz, American Bar Association, Health Law Section, Chair; and Tom Shorter, American Health Law Association, President-Elect Designate. The webinar programs will be offered every Thursday through November 19.

On July 13, the Centers for Medicare & Medicaid Services (“CMS”) put out its 2018 Medicare Hospital Outpatient Prospective Payment System Proposed Rule. The Rule proposes, among other things, to dramatically reduce Medicare Part B reimbursement of drugs procured by hospitals at 340B prices—from the current rate of Average Sales Price (“ASP”) plus 6 percent to ASP minus 22.5 percent.  By CMS’s estimate, this could result in savings to the Part B program of $900 million and a corresponding cut to the 340B hospitals which currently receive those payments (and ostensibly use them in furtherance of the 340B program’s goal of assisting safety net providers in stretching their scarce resources).  

The U.S. Department of Health & Human Services Office of Inspector General (“OIG”) issued a proposed rule Oct. 2 that would add new safe harbors to the Anti-Kickback Statute (“AKS”) regulations and interpret existing, statutory safe harbors. The rule would also amend the Civil Monetary Penalties (“CMP”) regulations by adding statutory exceptions to the regulatory definition of “remuneration” and codifying the so-called “gainsharing CMP” found in the Social Security Act.