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The Physician Payment Sunshine Act, which was incorporated into Section 6002 of the Affordable Care Act, requires pharmaceutical, medical device, biological and medical supply manufacturers to file annual reports on payments to physicians and teaching hospitals. Despite the requirement in the law that manufacturers submit their first report in March 2013 disclosing payments made during…

On May 22, 2012, the Patient-Centered Outcomes Research Institute (“PCORI”), a private nonprofit entity established by the Patient Protection and Affordable Care Act of 2010, announced that it will be seeking applications to fund an initial $96 million in grants for innovative research projects in clinical effectiveness research. These grants will be awarded in four areas recently identified in PCORI’s National Priorities Research Agenda.
Continue Reading Patient-Centered Outcomes Research Institute Begins Process to Fund Clinical Effectiveness Research Grants

Back in 1996, the Federal Trade Commission and Department of Justice, in providing antitrust guidance for multi-provider networks, considered financial integration and clinical integration as separate pathways for such networks to avoid per se violations of the antitrust laws and, instead, to be treated under the rule of reason, allowing for an assessment of their…

As the health care world awaits the Medicare Shared Savings Program regulations expected to be issued soon by CMS, below is a wish list for key attributes that I hope the regulations evidence:

 

 

1. Flexibility. 

 

 "Transforming health care everywhere starts with transforming it somewhere." I hope that CMS takes Atul Gawande’s advice and …

Now that we have sweeping new health care legislation, the Patient Protection and Affordable Care Act ("the Act"), let’s look at the rollout of the accountable care provisions–i.e., those changes to the payment and delivery system that hold the most long-term promise of improving quality and cost-efficiency. They are discussed in my most recent article: "The…

In my most recent article in the series I have been writing for the BNA’s Health Law Reporter on payment and delivery system reform, accountable care organizations and bundled payments, I comment on where things are now that federal reform has stalled. The article, titled "Payment and Delivery System Reform: It’s Only a Matter of Time," argues that changes in …

In addition to the many hotly contested insurance and access-related provisions in the America’s Healthy Future Act of 2009, the Chairman’s Mark from Senator Baucus on behalf of the Senate Committee on Finance, released Wednesday, there is in the bill a section that addresses in a substantive way reform of the health care delivery

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