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McBrayer Blogs
Anne-Tyler Morgan
Showing 24 posts by Anne-Tyler Morgan.
Should Health Care Providers Pay Attention to the Seventh Circuit’s New Definition of “Referral”? - Part Two
Tuesday’s post discussed the Seventh Circuit’s holding in United States v. Patel, broadly expanding the definition of “referring” under the Anti-Kickback Statute. Today’s post turns to the question of how other circuits have dealt with the issue. More >
Should Health Care Providers Pay Attention to the Seventh Circuit’s New Definition of “Referral”? - Part One
The Seventh Circuit Court of Appeals, in the case of United States v. Patel[1], just expanded the definition of “referring” under the federal Anti-Kickback Statute[2] (“Statute”). In light of this case, health care providers should again review any arrangements with their peers and colleagues, as previous arrangements may now be considered illegal under the Statute. More >
What the Anthem Cyberattack Means for the Health Care Industry
Unfortunately, account hacks and data breaches are nothing new. Every day, we hear reports of hackers compromising networks and their protected data. When it happens on a massive scale to a powerful player in the health insurance industry, however, all health care entities should sit up and take note. On February 4, 2015, Anthem Inc. (“Anthem”), the second largest health insurance company in America, admitted that hackers compromised the company’s network and stole the information of up to 80 million customers. This may be the largest health-related data breach in history. More >
Quality Over Quantity: The Shift from Fee-for-Service to Value-Based Payment Systems
The United States Department for Health and Human Services (“HHS”) recently announced its intention to tie thirty percent of fee-for-service Medicare payments to alternative and value-based payment models by 2016. HHS hopes to increase that amount to fifty percent by the end of 2018. Currently, up to twenty percent of payments are made through alternative models, a substantial increase in a short amount of time since almost no payments were made through alternative models as recently as 2011. Two days after HHS’ announcement, a group of key health care industry stakeholders announced the formation of the Health Care Transformation Task Force, a new industry consortium making a public commitment to transition seventy-five percent of its business between now and 2020 to value-based arrangements. These developments demonstrate the shift from fee-for-service payments based on quantity of work regardless of outcome and signals a larger trend to seek quality over quantity. With the seemingly meteoric rise of value-based care, it is important to understand the ramifications of alternative payment models within the health care industry as a whole. More >
