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Byline: Lisa Schencker The pharmaceutical industry notched another win in its campaign to rein in the federal 340B drug pricing program. Last week, a federal judge struck down the Obama [...]

Byline: Lisa Schencker Many state medical boards may find themselves on the wrong side of the Federal Trade Commission's new guidelines laying out how groups consisting of active members of [...]

Byline: Lisa Schencker The House's lawsuit against the Obama administration over the Affordable Care Act will likely move forward despite Speaker John Boehner's surprise announcement last week that he would [...]

Byline: Lisa Schencker In another setback for California advocates of physician aid in dying, a California Superior Court judge indicated last week he would dismiss a case challenging the state's [...]

Byline: Lisa Schencker The U.S. Supreme Court's 6-3 decision upholding premium subsidies for Americans in all states puts to rest months of fretting over the immediate future of the Affordable [...]

Byline: Lisa Schencker If House Republicans win legal standing in their lawsuit challenging the Affordable Care Act's cost-sharing subsidies, their case could pose another serious threat to the law's coverage [...]

Byline: Lisa Schencker The Obama administration this week hopes to block yet another lawsuit that could disrupt the Affordable Care Act, arguing that the plaintiffs lack standing to sue. Administration [...]

Byline: Lisa Schencker The American Orthotic & Prosthetic Association is proposing a change to Medicare's recovery audit contractor program that it contends would keep providers from suffering devastating financial losses [...]

Byline: Lisa Schencker State professional regulatory boards may seek more state supervision or change their membership makeup because of a U.S. Supreme Court decision last week involving a North Carolina [...]

Byline: Lisa Schencker The two federal antitrust enforcement agencies will scrutinize provider competition and payment models during a two-day workshop this week in Washington. The event, 'Examining Healthcare Competition,' will [...]

Byline: Lisa Schencker A new brief filed by those asking the U.S. Supreme Court to strike down the Obamacare premium subsidies focuses on what they fear are the government's strongest [...]

Byline: Lisa Schencker EXCELLENCE IN GOVERNANCE 2015 MIDSIZE PROVIDER ORGANIZATIONS Erica Ward Gerson Chair Board of trustees Detroit Medical Center's Children's Hospital of Michigan The first week of 2011 was [...]

Byline: Lisa Schencker Republicans and Democrats will face off in the courtroom this week in yet another challenge to the Patient Protection and Affordable Care Act. Oral arguments are scheduled [...]

Byline: Lisa Schencker A $389 million civil settlement announced last week between DaVita HealthCare Partners and the federal government over allegations of Medicare fraud is the latest example of the [...]

IT'S BEEN YEARS since the incident, but Bishop V. Gene Robinson's heart still races when he sees it on film. Robinson, the Episcopal Church's first openly gay bishop, was preaching [...]

Ryan and Kristy Buescher, of Neoga, Ill., have driven for hours to learn about the culture of South Korea. They've learned to cook South Korean food, and their two young [...]

Like many Americans, Damon Williams joined a stock investment club to eventually put his children through college. But unlike most of those others, he is just 11 years old. After [...]

The article presents the list of the 100 Most Influential People in Healthcare in the U.S. including U.S. President Barack Obama, Stephen Hemsley, chief executive officer (CEO) of UnitedHealth Group and Kent Thiry, CEO of DaVita Healthcare Partners.

The article reports that the end-of-life care has become important in healthcare in the U.S. with a greater focus on open communication, advance directives and avoiding overtreatment of dying patients. Topics including the debate surrounding assisted suicide, both supporters and opponents of aid in dying stating that palliative care may reduce some patients' desire to receive physician assisted suicide, and findings of a Gallup poll related to the same.

The article reports on patient assistance programs (PAP) that keeps the drug prices high and also discusses the contribution of drugmakers in the PAP and its impact on the residents under medical coverage by citing the reference of Andre Rucker, a heavy equipment mechanic, who was suffering from multiple myeloma. Topics discussed include impact of independent PAPs on the health insurers, views of Clare Krusing, a spokeswoman for America's Health Insurance Plans, and Affordable Care Act.

The article discusses the growing number of lawsuits filed against Medicare Advantage plans in the U.S. Topics highlighted include plans' violation of False Claims Act, lawsuit's claim that health care providers and Advantage plans exaggerated diagnoses to obtain bigger payments, estimated overpayments and underpayments made by Medicare due to risk adjustment errors, and examples of increased average risk scores offered by several Medicare plans such as XL Health Corp. and Emblem Health.

The article discusses the efforts being made by Dr. Charles Sorenson, chief executive officer (CEO) of Intermountain Healthcare, with Dr. Brent James, chief quality officer at Intermountain, to improve quality, efficiency and controlling the overall cost of the system. It mentions that Sorenson also asked the board of trustees of Intermountain to improve the care long before the passage of the Patient Protection and Affordable Care Act.

The article reports on U.S. Supreme Court case King v. Burwell challenging the legality of subsidies in the U.S. Affordable Care Act along with the views of U.S. Department of Health & Human Services (HHS) Secretary Sylvia Mathews Burwell. Topics discussed include views of U.S. Solicitor General Donald Verrilli Jr., on the same, doubts raised by justice Anthony Kennedy on the petitioner's attorney Michael Carvin's statement, and Thomas Miller, a resident, favoring elimination of subsidies.

The article discusses the U.S. Supreme Court's hearing for the court case King v. Burwell, which discusses whether the language of Affordable Care Act (ACA) allows Americans to receive premium tax credits under federal insurance exchange. Topics discussed include support of U.S. Internal Revenue Service for subsidies in all states, allegation of plaintiffs regarding lack of clarity in ACA language and views of Tim Jost, a law professor at Lee University, on the same.

The article discusses the opposition of the Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative, California Proposition 46 by Molly Weedn, a spokeswoman for the California Medical Association. According to the 2014 Medical Liability Monitor's annual rate survey, rates for common specialties across the country has declined from 2013 to 2014. It informs about the argument of physician, insurance and business groups on increase healthcare costs in the U.S.

The article discusses mixed results of U.S. Supreme Court decisions on healthcare industry cases in the last term that are deemed affected by the midterm death of Justice Antonin Scalia. Topics include decisions on cases including Whole Woman's Health v. Hellerstedt on the Texas abortion law and Gabrielle v. Liberty Mutual Insurance Co. Also cited are the False Claims Act case of Universal Health Services v. U.S. ex rel Escobar and the case Friedrichs v. California Teachers Association.

The article focuses on efforts to change the Stark law or the physician self-referral statute led by U.S. Senate Finance Committee chair Orrin Hatch. Topics covered include criticisms on the complexity of the statute as designed during the Medicare fee-for-service era that outdated barriers should be updated. Also cited are medical sector experts who will testify at the senate hearing including Dr. Ronald Paulus, Troy Barsky and Johns Hopkins Health System Corp. general counsel Peter Mancino.

The author discusses possible ruling of the U.S. Supreme Court on the abortion access case Whole Woman's Health v. Hellerstedt. Topics explored include the arguments raised by abortion clinics involved in the lawsuit, the observed handling of controversial cases by Supreme Court justices following the February 2016 death of Associate Justice Antonin Scalia, and the outlook issued by Robin Fretwell Wilson of the University of Illinois at Urbana-Champaign for the outcome of this case.

The article discusses electronic health records (EHR) adoption and patient safety-related lawsuits in the U.S. healthcare sector. Topics explored include the breach-of-contract lawsuit filed by health information technology solutions provider Cerner Corp. against hospital system PinnacleHealth, the patient safety concerns raised by professional medical associations which involve EHR systems use, and the handling of these lawsuits as malpractice cases by U.S. courts.

The article reports on the ruling by the U.S. Supreme Court in the case Universal Health Services vs. U.S. ex rel Escobar that a legal theory called implied certification may be used to bring False Claims Act cases against healthcare providers and others.

The article reports that more hospital deals could arise from the decision by U.S. District Judge Jorge Alonso to refuse to grant the U.S. Federal Trade Commission (FTC) a preliminary injunction to temporarily stop a merger between Advocate Health Care and NorthShore University HealthSystem. Topics covered include the FTC's intent to appeal the ruling, the claim by the FTC that the merger would lead to increased prices, and the two systems' plan to offer a low-cost insurance product.

The article reports on the lawsuit filed against Carolinas Healthcare System for illegal requirements on contracted insurers in the U.S. as of June 18, 2016. It states that insurers are being forbidden from offering tiered networks including competing hospitals, and from offering of narrow networks only for competitors. The article notes that the practice supports Carolinas's charging of high medical costs and suppression of competition.

The article reports on the decision of U.S. Supreme Court justices to hear a case dealing with a Washington state regulation which states that pharmacies cannot refuse to fill prescriptions because of their owner's religious beliefs. It highlights the reaction of national and state pharmacy associations, including the Washington Board of Pharmacy, to the rule. It also warns about the potential of abortion rights groups to pursue similar regulations.

The article discusses the federal government lawsuit against Prime Healthcare Services (PHS) that could delay its merger and acquisition (M&A) program. Topics covered include allegations of a whistle-blower about fraudulent Medicare billing of admitted patients who should be outpatients by PHS founder Prem Reddy in 14 PHS hospitals in California. Also cited are the rise of Medicare claims after hospital acquisition of PHS and its Prime Health Foundation operating 43 acute-care hospitals.

The article discusses the balanced approach on the investigation of a complaint filed by whistle-blowers Thomas Schuhmann and Leatrice Ford alleging Medicare billing of 1,300 hospitals for implantable cardioverter defibrillators (ICDs). Topics include federal prosecutors Jeffrey Dickstein and Amy Easton issuing investigative demands and retaining an expert review team of electrophysiologists, cadiologists and heart failure specialists. Also cited are hospital settlement at 280 million dollars.

The article reports on the scheduled arguments between the U.S. Federal Trade Commission (FTC) and NorthShore University Health System and Advocate Health Care in May 2016. Topics covered include the focus of the conflict on the merger of the health care systems and the impact of the deal on care quality and costs. Also mentioned is the attempt of the hospitals to negotiate with insurers.

The article reports that the decision of a federal judge that the administration of U.S. President Barack Obama unconstitutionally spent money to pay for part of the Affordable Care Act may not immediately disrupt beneficiaries or health plans. Topics covered include the cost-sharing provisions of the Affordable Care Act (ACA) such as reduced deductibles and the coinsurance and copayments that many U.S. citizens receive.

The article reports on the allegations of fraud, waste and abuse in Broward Health, the public healthcare system in Broward County, Florida. Topis covered include the amount the system agreed to settle allegations that it gave physicians excessive salaries in exchange for referrals, the operating revenue of Broward health system and a statement from Patrick Burns of the not-for-profit group Taxpayers Against Fraud Education Fund about the state of Broward Health.

The article reports on a hospital leader's push for more protection for healthcare providers against frivolous fraud lawsuits in the U.S. as of May 2016. Topics discussed include the proposal that whistle-blowers should bring allegations directly to providers before filing lawsuits, and the opposing view that the move would only weaken the False Claims Act. Also noted is the Act's allowance for providers to reduce liability by self-reporting fraud within 30 days of its discovery.

The article talks about the U.S. Supreme Court and its hearing of arguments for the Universal Health Services v. United States ex. rel. Escobar case, which involves the validity of a legal theory and its applicability under the False Claims Act. Topics include the theory of implied certification, its application for whistle-blowers alleging false claims by providers, and the opposition against allowing implied certification by U.S. hospital organizations like the American Hospital Association.

The article reports on the decision of the U.S. Supreme Court to hear the lawsuit filed by industry groups opposing a federal rule that mandates home health care agencies to offer higher wages to employees.

The article reports on the hearing scheduled in Chicago, Illinois April 2016 over the U.S. Federal Trade Commission's (FTC) request to pause a merger between Advocate Health Care and NorthShore University HealthSystem. Topics covered include the allegation that the deal would create a system that controls general acute-care inpatient hospital services, the arguments presented by the systems in response to the allegation and the stance of antitrust expert Jeff Miles on the case.

The article discusses issues concerning U.S. President Barack Obama's nomination of Merrick Garland to the U.S. Supreme Court. Topics covered include Senate Majority Leader Mitch McConnell's pledge not to confirm a nominee before the next president takes office, analysis of the decisions made by Garland related to health care, and the opinion of constitutional law professor Stephen Wermiel.

The article reports that a federal jury has ruled that health care company Johnson and Johnson must pay damages worth 502 million dollars to five patients in Texas who suffered injuries due to the company's Pinnacle Ultamet metal-on-metal hip replacements, as of March 2016.

The article discusses the ruling of the U.S. Court of Appeals for the 7th Circuit that Advocate Health Care's pension plan cannot be considered a church plan just because the health systems is religiously affiliated. Topics covered include the decision that the plan is subject to the federal Employee Retirement Income Security Act (ERISA) and criticisms on the exemption of church plans from ERISA.