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The Changing Landscape of Prior Authorization for Medicare

On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a rule—the Interoperability and Patient Access final rule—that introduces new requirements for health care payers aiming to enhance patient data sharing and streamline the prior authorization process. The rule would require certain payers to digitize their prior authorization process, shorten the timeline […]

Proposed Rules to Enhance Access and Quality for Medicaid HCBS and Strengthen the HCBS Workforce

On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released proposed rules that, if finalized, would reshape Medicaid’s federal regulatory landscape in several ways, including with respect to home and community-based services (HCBS). The proposed rule most relevant for HCBS—titled Ensuring Access to Medicaid Services—includes measures to increase transparency, oversight and public engagement […]

No Surprises Act Update: The Latest Litigation, Enforcement and Implementation Challenges

The No Surprises Act (NSA), which went into effect January 1, 2022, was designed to protect patients from surprise medical bills when they are treated in out-of-network emergency departments or by out-of-network providers at in-network facilities. It represents a massive change in health patient financial practices—and controversy continues to surround its implementation, particularly around the […]

Augmenting Behavioral Health Treatment With Telehealth: New Research Findings

Catalyzed by the COVID-19 pandemic, many behavioral health care providers have implemented telehealth services to augment existing partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). In a new webinar—based on their just-released joint research study—Manatt Health and the National Association for Behavioral Health Education and Research Foundation (NABH) share how the growing use of telehealth is […]

Health Care Cybersecurity: Risks, Challenges and the Path Forward

Hospitals, health systems and providers are targets of cyberattacks, putting valuable patient data and, more importantly, patient lives at risk. The Department of Health and Human Services’ Office of Civil Rights reported an average of60 data breaches a month in the health care sector between January 1 and October 31, 2022. According to FBI data, 25% of […]

The NCATS Alliance: Speeding the Process of Bringing New Treatments to Patients

For the last decade, the National Center for Advancing Translational Sciences (NCATS), one of the 27 institutes and centers within the National Institutes of Health (NIH), has played a pivotal role in tackling ongoing challenges in research to deliver new and innovative treatments to patients faster. In a new webinar from Manatt Health, health care […]

TCPA Guide for Health Care: Trends, Requirements and Strategies to Mitigate Risk

Though its sponsors in 1991 intended it for small claims court, the Telephone Consumer Protection Act (TCPA) has turned into high-cost litigation with serious business, and even personal, consequences. The average cost of a TCPA settlement is estimated at more than $6 million—and health care is among the top three industries being targeted for litigation. […]

Webinar: Health Care Antitrust Policy Shifts: A New Look at Transactions & Competition

Shifts in Approach to Health Care Antitrust Since President Biden’s Executive Order in 2021 setting priorities for enforcing antitrust law, the Federal Trade Commission (FTC) and Department of Justice (DOJ) Antitrust Division have taken bold action to transform the landscape of health care compliance. Both have indicated that they are changing the lens through which […]

In the Shadow of Drug Pricing Reform: New Developments for Pharmaceutical Price Reporting

With the enactment of major drug pricing reform—including the Inflation Reduction Act (IRA), which arguably made the most significant changes to U.S. prescription drug pricing regulations in history—the reporting of drug prices is more critical than ever for determining reimbursement for drugs and establishing potential manufacturer payment obligations to various government agencies. In a new […]

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