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Three Days Left to Request 2019 MIPS Targeted Review
Waller, October 2020

Individuals who participated in the Centers for Medicare and Medicaid (“CMS”) Quality Payment Program Merit-based Incentive Payment System (“MIPS”) in 2019 may request a Targeted Review of their performance feedback, including their MIPS final score and payment adjustment factor at the Quality Payment Program website. In July, CMS released the MIPS Performance Feedback and scores for eligible providers...

Continuing Resolution Delays Repayment of Accelerated Advanced Payments by Healthcare Providers and Suppliers
Waller, October 2020

President Trump today signed a continuing resolution that will fund the federal government until December 11, 2020. The continuing resolution (the “CR”) also grants relief to the providers and suppliers that were preparing to repay the Medicare accelerated or advance payments they received in response to the COVID-19 pandemic...

HHS Issues Rules for New ESRD Treatment Choices Payment Model
Waller, September 2020

The Department of Health and Human Services (HHS) has implemented a new Medicare payment model, the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. The ETC Model was developed to test whether the greater use of home dialysis and kidney transplantation for Medicare beneficiaries with ESRD will reduce Medicare expenditures, while also preserving or enhancing the quality of care furnished to beneficiaries with ESRD...

SEC Adopts Significant Amendments to Regulation S-K and Accredited Investor and Qualified Institutional Buyer Definitions
Waller, September 2020

The U.S. Securities and Exchange Commission (SEC) has adopted several significant amendments affecting disclosure requirements under Items 101, 103 and 105 of Regulation S-K and also expanded the definitions of “Accredited Investor” and “Qualified Institutional Buyer” under Rule 501(a) and Rule 144A, respectively. As SEC Chairman, Jay Clayton, announced in the press release, Items 101, 103 and 105 have not undergone significant revisions in over 30 years...

Five Practical Tactics for Large Hospital Systems
Waller, September 2020

While the pandemic and subsequent economic downturn are creating unprecedented challenges for health systems across the country, opportunities for collaboration remain as strong as they had been pre-COVID, and large health systems are well positioned to take advantage of new opportunities. In light of this, Waller has partnered with Kaufman Hall to develop a guide for health system leaders, The Health System Growth Imperative: Charting Opportunities During the Pandemic and Beyond...

HHS Implements New Radiation Oncology Payment Model
Waller, September 2020

Details regarding a new Medicare payment model for radiation oncology care have been released by the Department of Health and Human Services (HHS). The new Radiation Oncology Model (RO Model) qualifies as an Advanced Alternative Payment Model (APM) and a MIPS APM under the Quality Payment Program. According to this release from HHS, the RO Model aims to “promote quality and financial accountability for providers and suppliers of radiotherapy...

DOJ Clarifies Guidelines on Settling Cases Based on Ability to Pay
Waller, September 2020

In early September, the Department of Justice issued additional guidance that the Commercial Litigation Branch can consider when settling cases for less than the full amount of the claim based on the defendant’s inability to pay. Under its statutory authority, the Civil Division has the ability to settle claims for less when an entity offers the maximum amount that it is able to pay and the federal government is acting as plaintiff...

Department of Labor Issues Updated and Revised Regulations for the Families First Act
Waller, September 2020

The Families First Coronavirus Response Act (FFCRA) was enacted on March 18, 2020, creating additional leave rights for employees in response to the COVID-19 pandemic through two provisions: the Emergency Family and Medical Leave Expansion Act (EFMLA) and the Emergency Paid Sick Leave Act (EPSLA). Since then, however, the exact contours of employee rights and employer obligations under the FFCRA have been the subject of some debate and disagreement...

Definition of Healthcare Provider Narrowed in revised FFCRA regulations
Waller, September 2020

The U.S. Department of Labor (DOL) announced Friday Friday that it had revised the Families First Response Act (FFCRA) in response to a recent ruling by a federal court in New York. The new regulations are effective September 16 and represent a significant change for healthcare entities who previously (and correctly) used “blanket” denials of FFCRA requests for all of their employees...

6 Ways Independent Hospitals can get Stronger Amid the COVID-19 Pandemic
Waller, September 2020

The impact of COVID-19 and the economic downturn has pressured independent hospitals, rural hospitals and smaller health systems in particular. Despite the immense challenges, independent facilities and their Boards should take this time to best position for the near- and long-term. In light of this, Waller partnered with Kaufman Hall to develop a guide for healthcare leaders, The Health System Growth Imperative: Charting Opportunities During the Pandemic and Beyond...

Alternative Financing Solutions: Intellectual Property-Backed Loans
Waller, September 2020

As the world begins to adjust to the short and long-term impact and implications of the COVID-19 pandemic, many companies are seeking ways to preserve cash on their balance sheets while simultaneously raising funds to ensure a continuation of operations. One option to consider is using the company’s intellectual property (IP) portfolio as collateral for funding...

That Was Then and This Is Now: How the COVID-19 Crisis Changed Telehealth Services
Waller, September 2020

Historically, telehealth services were limited both in reimbursement and location. Most encounters took place for purposes of rural health treatment and in underserved areas as a way to get specialized treatment to patients in geographic locations where they would not otherwise have treatment options. The use of telehealth services has increased in recent years...

Alternative IPO Methods Gain Traction as NYSE Direct Listings are Approved by the SEC
Waller, August 2020

In a year that has already seen explosive growth in the alternative initial public offering space, the New York Stock Exchange (NYSE) has gotten approval to allow companies to raise capital through a primary direct listing on the NYSE. The NYSE submitted its proposal relating to direct primary listings in November 2019, and had amended the proposal twice in an effort to satisfy the United States Securities and Exchange Commission (SEC), which is the NYSE's primary regulator...

Get Your Drinks To Go or Delivered to Your Home
Waller, August 2020

Tennessee Gov. Bill Lee has extended the executive order allowing carryout and delivery of beer, wine and spirits for restaurants. Restaurants, limited-service restaurants and wine-only restaurants can continue to sell carryout and deliver alcoholic beverages and beer. There is no additional license or permission needed to deliver. Lee extended the privilege through to 11:59 pm September 30, which brings welcome certainty to an industry battered by the pandemic...

The Health System Growth Imperative Charting Opportunities During the Pandemic and Beyond
Waller, August 2020

Executive summary The COVID-19 pandemic has created significant challenges for smaller hospitals and health systems. It has presented significant challenges to smaller, less capitalized and otherwise distressed healthcare providers. In terms of operating performance, half of our country’s hospitals reported negative margins as Q1 of 2020...

Tennessee enacts COVID-19 Recovery Act
Waller, August 2020

Tennessee Governor Bill Lee has signed into law the Tennessee COVID-19 Recovery Act which provides liability protection from claims related to the COVID-19 pandemic. The Waller Government Relations team worked closely with the Tennessee Chamber of Commerce and Industry and various stakeholders in recent months to achieve passage of the Tennessee COVID-19 Recovery Act...

CMS Announces Initiative to Transform Rural Health
Waller, August 2020

A new reimbursement model intended to address healthcare access and availability in rural communities was introduced by The Centers for Medicare & Medicaid Services (CMS) Innovation Center. The Community Health Access and Rural Transformation (CHART) Model will “provide up-front investments and predictable, capitated payments that pay for quality and patient outcomes,” according to CMS...

Physician Practice M&A: A Pandemic-Inspired 6-Step Checklist for Sellers
Waller, August 2020

As healthcare providers pursue transactions during and in the wake of COVID-19, both buyers and targets should prepare for heightened scrutiny during the due diligence process. Getting organized ahead of a sale can dramatically expedite timelines and reduce deal fatigue for all parties, particularly in light of the heavier-than-normal due diligence process as a result of the pandemic. Click here for a full PDF of this report...

Office of the Future: COVID-19 is Changing How and Where we Work
Waller, August 2020

COVID-19 is having a transformational impact on American workplaces, which has short- and long-term consequences. Waller partners Bo Campbell and Aron Karabel join this episode to address the transformation. Campbell, a leader on Waller's real estate team, discusses the impacts on commercial leasing and how the work-from-home phenomenon will impact office trends and future development projects. Here is a transcript of the conversation: Morgan Ribeiro, Host Welcome to PointByPoint...

HHS Commits to Release Reporting Requirements for Provider Relief Funds on August 17
Waller, July 2020

Since the Department of Health and Human Services (HHS) Provider Relief Funds (PRF) first started arriving in provider bank accounts on April 10, 2020, HHS has stated that it will issue additional guidance “soon” on mandatory reporting requirements on how use of funds must be reported. The PRF funds are among the funds Congress appropriated to reimburse eligible healthcare providers for healthcare-related expenses or lost revenues attributable to COVID-19...

Virginia Becomes First State to Enact COVID-19 Occupational Safety Requirements
Waller, July 2020

Virginia is now the first state in the nation to enact mandatory occupational safety standards regarding COVID-19. The Virginia Department of Labor and Industry’s health and safety board voted 9-2 on July 15 to adopt an “Emergency Temporary Standard” which requires employers to implement measures to protect employees from COVID-19...

Reflections on the Supreme Court — Past and Present
Waller, July 2020

When I became a judicial law clerk right out of law school, my boss, a federal judge in Houston, Texas, explained to me that the goal of his job (and therefore mine) was to find the right answer and do the right thing. That was, in a sense, easy enough. Research the law, and figure out how it applies to the particular facts of each case — because following the law is the right thing to do. Of course, judges will disagree about how the law should apply...

Loosening of Volcker Rule Gives Banks Flexibility with Hedge, Private Equity Funds
Waller, July 2020

On June 25, five federal regulatory agencies, including the federal banking agencies,[1] finalized changes to the Volcker rule that reduce margin requirements for derivatives trades and loosen restrictions on banking entities’ ability to invest in, sponsor or maintain certain relationships with hedge funds and private equity funds — known as “covered funds” under the Volcker rule...

Medicare May Permanently Allow Some Home Health Visits to Occur via Telehealth but it Could Cost You
Waller, July 2020

The impacts of COVID-19 appear set to permanently expand telehealth and fundamentally transform how and where providers practice. Shortly after the start of the pandemic, CMS made major temporary federal policy changes in response to the pandemic, including expanding access to telehealth services for people with Medicare, such as home health visits, and reimbursement for additional services when furnished via telehealth...

Could Telehealth Expansion be an Area of Healthcare Reform with Bipartisan Support?
Waller, July 2020

The use of telehealth skyrocketed during the COVID-19 public health emergency, as many regulatory barriers restricting its use were temporarily removed at the federal and state level and by private payors. Providers and patients adapted to the changes and are now relying on these flexibilities to deliver and receive high quality virtual care. This rapid expansion of the use of telehealth has ignited the need for permanent telehealth reform...

 

 

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