HEALTH & LIFE SCIENCES NEWS
HEALTH & LIFE SCIENCES NEWS
Exploring Critical Business and Legal Issues across the Healthcare and Life Sciences Industries
HEALTH & LIFE SCIENCES NEWS
Exploring Critical Business and Legal Issues across the Healthcare and Life Sciences Industries

Investing In a Healthier Future: The Investor’s Perspective On Value-Based Care

In this session, McDermott Will & Emery Partner Joel Rush moderated a discussion exploring investors’ interests in, opinions on and strategies for entering the value-based care (VBC) market. The panel discussed factors taken into consideration when choosing if and when to invest in VBC opportunities, issues that arise when collaborating with health systems, and ways to evaluate risk models and support improved care delivery.

Session panelists included:

  • Lauren Brueggen, Partner, Heritage Group
  • Devin Carty, Chief Executive Officer, Martin Ventures
  • Roger Kueny, Senior Vice President of Corporate Development, Alignment
  • David Pontius, Partner, WindRose Health Investors
  • Karey Witty, Managing Director, Valtruis

Top takeaways included:

  1. When it comes to investing in VBC, the tailwinds are just beginning to pick up after the COVID-19 pandemic reduced reimbursement volume. During that time, physician practices that were leaning on fee-for-service (FFS) reimbursements saw their volumes drop close to zero during the COVID-19 pandemic. Hospitals began to get crushed by the rates, and much of the volume has yet to return to normal. One way to solve this problem is by moving physician practices into VBC and to demonstrating that VBC is a bonus, not a penalty, and probably the only way to get back to the earnings they previously had. Also, when looking at hospital systems, investor-based hospitals performed significantly better during the pandemic. Innovative programs like the Accountable Care Organizations Realizing Equity, Access, and Community Health (ACO REACH) model are showing hospitals and physicians that the market is experiencing a technology shift, [...]

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This Week in 340B: September 6 – 11, 2023

This weekly series provides brief summaries to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation.

Issues at Stake: Contract Pharmacy

  • The government appellee in a contract pharmacy case filed a response to the trade association appellant’s Rule 28(j) letter.
  • The government defendant filed an answer in a state contract pharmacy case.

Get more details on these 340B cases with the 340B Litigation Tracker, a subscription product from McDermott+Consulting.




This Week in 340B: August 30 – September 6, 2023

This weekly series provides brief summaries to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation.

Issues at Stake:

  • The trade association appellant in a contract pharmacy case notified the court that the government appellee began enforcement of a state law that is the subject of their pending litigation.
  • The State of New York filed an antitrust case against a large retail pharmacy chain.

Get more details on these 340B cases with the 340B Litigation Tracker, a subscription product from McDermott+Consulting.




Top Takeaways | 2023 Physician Practice Management & ASC Symposium 2023 | Fraud & Abuse Risk Mitigation and Enforcement Trends

In this session, McDermott Will & Emery Partners Denise Burke, Tony Maida and Monica Wallace discussed top issues and enforcement trends that physician practice management companies (PPMs) and ambulatory surgery centers (ASCs) should watch to mitigate their fraud and abuse risk. The panel also discussed the potential impact of recent regulatory changes on future enforcement priorities.

Session panelists included:

  • Denise Burke, Partner, McDermott Will & Emery
  • Tony Maida, Partner, McDermott Will & Emery
  • Monica Wallace, Partner, McDermott Will & Emery

Top takeaways included:

  1. The federal government recently released False Claims Act recovery data for 2022. While the recovery amounts went down, the number of reported cases actually went up. We anticipate seeing more COVID-19-related enforcement actions. We are also seeing continued government focus on financial arrangements with physicians, including transactions involving physicians receiving preferential investment terms, such as below-fair-market-value purchase prices.
  2. In the most recent revision to the Stark rules, there is a new ability to cure compensation errors. Specifically, if a designated health services (DHS) entity has a compliant written compensation arrangement with a physician and discovers a payment error during the term of the arrangement or within 90 days of termination, the entity can correct or reconcile the compensation error and there is no need to submit a self-disclosure. The US Centers for Medicare & Medicaid Services (CMS) recently said that errors could even be fixed after 90 days from termination, but this requires a close analysis of the facts.
  3. The federal government has started [...]

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This Week in 340B: August 23 – 29, 2023

This weekly series provides brief summaries to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation.

Issues at Stake:

  • In a case involving the definition of “patient”, drug manufacturer amici filed reply briefs in support of their motions for leave to file amicus briefs and the court granted in part the manufacturers’ motions for leave to file amicus briefs.
  • The parties in a case related to the Administrative Dispute Resolution Rule filed a joint status report.

Get more details on these 340B cases with the 340B Litigation Tracker, a subscription product from McDermott+Consulting.




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