Jackson Kelly PLLC

Health Law Monitor

Reimbursement issues

Hospital Price Transparency is Coming

Three separate price transparency rules have been published or go into effect soon. Hospitals and insurers need to prepare for compliance and all of the legal issues that will arise during implementation of the rules.

The Hospital Price Transparency Rule

Beginning January 1, 2021, the Hospital Price Transparency Rule (“Hospital Transparency Rule”) goes into effect, requiring all hospitals, as…

At Long Last--CMS & OIG Issue Rules Embracing Value Based Payment Systems

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) issued their long-awaited final rules on November 20, 2020.  The final rules revise the Medicare Physician Self-Referral law (Stark law), the Federal Anti-kickback statute, and the Civil Monetary Penalties Rules.1  Each agency has issued a Fact Sheet highlighting the…

Update on HHS Recent Changes to the 340B Program’s Reimbursement Rates

A recent decision from the District of Columbia’s Court of Appeals has paved the way for the United States Department of Health and Human Services (“HHS”) to continue its policy of Medicare Part B reimbursement reductions for 340B covered entities.


Congress created the 340B drug pricing program in 1992, requiring certain pharmaceutical manufacturers to sell outpatient drugs at discounted…


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