Hurricane Harvey. On August 26, 2017, the Secretary of Health and Human Services (HHS) issued a waiver of certain compliance requirements, retroactive to August 25, 2017, for providers in areas of Texas affected by Hurricane Harvey.  A similar waiver was issued August 28, 2017, for providers in Louisiana, retroactive to August 27, 2017.  Along with these waivers, the Secretary of HHS issued disaster declarations for the states of Texas and Louisiana pursuant to section 319 of the Public Health Service Act, and the President issued disaster declarations for the states of Texas and Louisiana pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act.

Continue Reading CMS Grants Providers Compliance Flexibility in Areas Affected by Hurricane Harvey or Irma

The weather has cleared and SXSW is well underway! The HBInnovate team has been sharing its experiences via Twitter and blog, keeping everyone up-to-date on the innovations and creative ideas on display.

Hot at SXSW continues to be healthcare products and services that rely upon a phone or tablet. Everyone sees the tremendous potential phones and tablets have in supporting our health and wellness.  One of the most common concerns from healthcare startups has been how to do roll-out products and services compliant with The Food and Drug Administration (FDA).

Continue Reading SXSW 2017 –Dare Enter the World of the FDA?

Texas_157051216In addition to H.B. 307 (discussed in a prior post), H.B. 1566 and its companion bill, S.B. 507, propose to expand the requirement for mediation of balance bills.

Currently, Chapter 1467 of the Texas Insurance Code requires a facility-based physician to mediate balance bills upon the request of the patient if the patient is responsible to a facility-based physician, after copayments, deductibles, and coinsurance, including the amount unpaid by the administrator or insurer, for an amount greater than $500 and either (i) the facility-based physician fails to disclose projected amounts for which the patient may be responsible and the circumstances under which the enrollee would be responsible for those amounts; or (ii) the facility-based physician makes the disclosures but the amount billed is greater than the maximum amount projected in the disclosure. Continue Reading Texas 85th Legislature (2017) Legislation Update: Out-of-network billing limitations

flag_160540827This is the fifth article in our series on the effect of the “slow repeal” of the Affordable Care Act (ACA). This week’s article focuses on the potential impact of the slow repeal of the ACA on rural communities and healthcare.

Continued Fragile System Leads to Uncertainty or Closure Causing Economic Ripple Effect Throughout Rural America

There are nearly 5,000 short-term, acute care hospitals in the United States, half of which are in rural areas. About four in 10 rural hospitals are located in the South. More than half of rural hospitals are Critical Access Hospitals (CAHs) (53.5%); a smaller share of rural hospitals are designated as Sole Community Hospitals (SCHs) (13%), Medicare Dependent Hospitals (MDHs) (8%), and Rural Referral Centers (RRCs) (11%). All of these designations provide enhanced or supplemental reimbursement under Medicare, using different formulas. Rural hospitals that do not qualify for these Medicare programs are reimbursed as standard Medicare Prospective Payment System (PPS) hospitals. Continue Reading Slow Repeal of the ACA and Its Impact on Rural Healthcare and Communities

dollar-signiStock_000013001848_LargeNote: this guidance is now outdated. Please refer to this blog for current guidance.

On February 15, 2017, the IRS announced on its website that, based upon its review of the White House’s January 20, 2017, executive order, it would continue to accept returns filed by taxpayers that do not report whether the taxpayer has complied with the individual mandate of the Affordable Care Act. Individual taxpayers are required to report on their returns whether they have health insurance coverage, qualify for an exemption to the coverage requirement, or are making a shared responsibility payment. Previously, the IRS had made changes to its software that processes tax returns so that returns filed without these sections completed would be automatically rejected and treated as not filed. Now, those returns will be treated as filed, and the missing information will be addressed by the IRS. Continue Reading IRS announces changes to individual mandate enforcement

A stethoscope and American money on a white background - HealthcEven without potential changes to the Medicare program, MACRA poses a significant challenge for any clinician trying to determine the best strategy to maximize Medicare reimbursement – there are hundreds of pages of guidance in the proposed and final regulations to review and understand. But, at this point, clinicians attempting to assess MACRA must also deal with uncertainty about changes to the Medicare program. A significant source of uncertainty is the Trump administration’s stated intent to repeal the Affordable Care Act (“ACA” and also known as Obamacare), which is being implemented by current legislative efforts. Uncertainty about the ACA should be considered in developing a strategy to comply with MACRA. Continue Reading Managing MACRA – Part VII: What happens to MACRA if the Affordable Care Act is repealed?

gavel-scales2013%20052[With the nomination of Judge Neil Gorsuch of the United States Court of Appeals for the Tenth Circuit to the United States Supreme Court, much of the conversation in coming days and weeks will be about his views on abortion, free speech, and his stated skepticism regarding the Chevron doctrine. But his opinion in a recent tax case allows a glimpse into his views on another issue that may come before the Court – the split between the growing number of states which have legalized marijuana and the its continued illegality under federal law. Continue Reading Gorsuch, marijuana and taxes

749231-F-DHB23-060The 2017 National Defense Authorization Act, Pub. L. No. 114-328 (Dec. 23, 2016), introduces major changes to the Defense Department healthcare program known as TRICARE. By this time next year, we’ll see a new program to contain the cost of prescription drugs at retail pharmacies, contractual incentives for improving the quality of healthcare and reducing “per-capita cost,” and the first major step toward privatizing the delivery of healthcare to military members.

Read more.

pills-colorful492864587This is the third article in our series on the effect of a “slow repeal” of the ACA. This week’s discussion focuses on the potential impact of a slow repeal of the ACA on the pharmaceutical industry (Pharma).

Unlike many of the players detailed in our prior articles on the slow repeal of the ACA, Pharma has not made a lot of noise regarding a repeal of the ACA. In fact, Pharma and biotech stocks soared—generally 3 percent to 10 percent—on November 8, 2016, largely because the industry had been preparing for a Clinton victory. A recent quote attributed to one Pharma industry official—“I actually think the Republican Party is a far less certain bet for the pharmaceutical industry”—reflects some of the unease surrounding the change in administration, and the likely repeal of the ACA. Continue Reading Slow Repeal of the ACA and Its Effect on the Pharmaceutical Industry

flag_160540827This is the second article in our series on the effect of a “slow repeal” of the ACA, which began January 3, 2017, when Senate Budget Committee Chairman Mike Enzi introduced a budget resolution with instructions to the relevant Senate and House committees to develop a plan to repeal the ACA. The four committees that control healthcare policy have until January 27, 2017, to draft reconciliation bills, which will address the important details, likely including how long it will take to replace the ACA, and which parts of the ACA will be repealed through a budget reconciliation process. On January 4, 2017, the Senate promptly voted (51-48) to begin debate on the procedures to repeal the ACA. Continue Reading Slow Repeal of the ACA and Its Effect on Physicians