Health Care Today | Health Law Blog

Oklahoma is making history in its pending multi-billion-dollar opioid case against Johnson & Johnson, in which the state is accusing the drug manufacturer of irresponsible marketing practices that allowed it to profit from the opioid crisis. The parties await a final decision from Oklahoma Circuit Judge Thad Balkman after a seven-week bench trial that concluded July 15.

Starting on Jan. 1, 2020, Illinois residents and visitors over age 21 are allowed to purchase, possess, use, or transport cannabis for recreational purposes. Illinois’ legalization of recreational cannabis under state law will impact Illinois and Missouri employers because the drug will be more accessible to their employees.

Certain treatments for chronic conditions can now be covered by high deductible health plans (HDHPs) as preventive care before the deductible is met. Pursuant to an executive order, a new IRS notice will allow individuals with certain conditions, such as asthma or diabetes, to obtain coverage for treatments and medications, such as inhalers and insulin, without first meeting their high deductible.

This is Part 1 in a two-part series. Part 1 will focus on employee non-compete assignability in asset purchase transactions, and Part 2 will address stock purchase or merger transactions.

Health care employers such as medical groups or hospitals have a valuable stake in protecting their businesses interests by having covenants not to compete in place for important employees such as physicians. Whether these non-competes are assignable by a seller to a buyer can be an important consideration in structuring a business transaction involving the purchase of a health care business enterprise.

The Office of Civil Rights (OCR) within the Department of Health and Human Services (HHS) has been able to hold “business associates” directly liable for certain HIPAA violations since 2009, with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Under HIPAA, a “business associate” is an entity that receives protected health information (PHI) in order to provide services to a “covered entity” (such as a health care provider, a health plan, or a heath care clearinghouse).

There has been a lot of movement throughout the country on the state level to prevent patients from receiving surprise medical bills when they receive unanticipated care from out-of-network providers while seeking care from in-network providers. For example, in 2018, Missouri passed such legislation, which banned surprise medical bills for patients who are treated by an out-of-network physician at an in-network emergency room.

The expansion of telehealth is changing the landscape of health care. This is the final installment in a four-part series exploring what providers should know about this growing area.

There are many business models and provider arrangements for the provision of telehealth. Given the regulatory climate and increasing use of telehealth by health care providers and patients, these business models and provider arrangements are continuing to change.

On May 24, 2019, the U.S. Department of Health & Human Services (HHS) announced that it is issuing proposed revised regulations under Section 1557 of the Affordable Care Act that remove the redefinition of “sex” and certain regulatory burdens, including language taglines. The changes substantially roll back the original Obama-era regulations.

Health care transactions can be complex, given the regulatory maze of health care laws and regulations applicable to the entities involved. One way to help mitigate the risks inherent in such transactions is through representations and warranties insurance (“R&W insurance”), which can be purchased by a buyer or seller. R&W insurance is becoming more common in health care transactions as a means to provide buyer and seller more financial certainty in finalizing a deal.

The expansion of telehealth is changing the landscape of health care. This is the third in a four-part series exploring what providers should know about this growing area.

Medicaid programs pay for telemedicine, telehealth and telemonitoring services delivered through a range of interactive video, audio or data transmission (telecommunications). Various state Medicaid programs are experiencing a significant increase in claims for these services and expect this trend to continue.