Some Wins, Some Losses, and a Proposed Rule on Value-Based Payments for Prescription Drugs

Price Transparency Rule Upheld

In  November 2019, the Department of Health and Human Services (“HHS”) published a transparency rule in the Federal Register requiring hospitals to disclose pricing information.  The American Hospital Association and many other associations and hospital systems sued HHS arguing that HHS lacked statutory authority to require public disclosure of individually negotiated rates between commercial insurers and hospitals. 

HHS Changes Reporting Requirements Under the Provider Relief Fund, Direct Contracting Is Open, and New York Expands Telemedicine

HHS Says Health Care Providers Will Not Have to Submit Report on How They Spent COVID-19 Relief Grants by July 10

Many providers have received funds pursuant to the Provider Relief Fund and executed the terms and conditions, which require providers to issue reports to the Department of Health and Human Services (“HHS”).   However, HHS has recently announced in its FAQ, under Reporting Requirements, that recipients do not need to submit a separate quarterly report to HHS or the Pandemic Response Accountability Committee, as initially required.

New Jersey Department of Health Modifies Guidance on the Resumption of Elective Surgeries in Ambulatory Surgery Centers to Address Issues That Were Preventing Surgeries

Late Tuesday, the New Jersey Department of Health modified its previous guidance on the resumption of elective surgeries in ambulatory surgery centers.  One of the most significant changes was to extend the time for COVID-19 testing.   Under the initial guidance that was issued on May 19, 2020, patients had to undergo COVID-19 testing and receive results within four days before the scheduled surgery.

New Jersey Waives Certain Regulations Applicable to Collection Stations

In an effort to increase testing capacity in New Jersey, the Department of Health waived certain regulations applicable to collection stations, which is when a licensed clinical laboratory occupies office space in a physician’s office for the purpose of collecting specimens on the physician’s patients.   According to a June 5, 2020 Notice of Waiver, New Jersey licensed clinical laboratories may open collection stations to collect specimens for COVID-19 testing without completing the collection station licensing process or paying the required fee.

New Jersey Considers Delaying Assessment for Ambulatory Surgery Centers and CDC Issues Guidance on Antibody Testing

New Jersey and the Federal Government continue to revise statutes and regulations to address COVID-19. Our updates continue to focus on these revisions. For example, New Jersey is currently considering a law that delays, for nine months, the assessment that Ambulatory Surgery Centers must pay by June 15. Any Center, however, should not wait until June 15 to determine if the law passes. Call the Department of Health and ask for an extension to pay the assessment.

A Non-COVID-19 Update . . . Yes . . . You Read That Correctly

Although everyone’s attention has been focused on COVID-19, other aspects of health care continue to move forward.  This update focuses on non-COVID-19 issues like five recent federal proposed payment rules, the recent Medicare Advantage Rate Announcement, and critical federal litigation.

New Jersey Department of Health Issues Guidance on the Resumption of Elective Surgeries

As a follow-up to yesterday’s blog post, the New Jersey Department of Health (“NJDOH”) issued its guidance on the resumption of elective surgeries in hospitals and licensed ambulatory surgery centers.  As we mentioned yesterday, the Division of Consumer Affairs (“DCA”) issued guidance addressing the resumption of (1) medically necessary or therapeutic services and (2) elective procedures in the office setting. 

New Jersey’s Division of Consumer Affairs Issues Order on the Resumption of Elective Surgeries

On Friday, May 15, 2020, Governor Phil Murphy executed Executive Order No. 145, which allows for the resumption of elective surgeries, both medical and dental, starting Tuesday, May 26 at 5:00 a.m. The Order required the New Jersey Department of Health (“NJDOH”) and the Division of Consumer Affairs (“DCA”) to issue policies by Monday, May 18, to address where, when and how these surgeries can resume.