Category Archives: Accounting and Regulatory Technical Updates

11th Circuit: Difference in Opinion Not Enough for FCA Liability

By | October 14, 2019

The 11th Circuit’s long-awaited AseraCare opinion requires more than mere disagreement regarding clinical judgment to prove falsity under the False Claims Act. The 11th Circuit rejected the government’s theory of falsity in its long-running False Claims Act (FCA) case against long-term care provider AseraCare Inc. The 11th Circuit affirmed the lower court’s ruling that mere clinical disagreement was… Read More »

Sponsored Post: Reasons to Be Hopeful About the US Health Industry in 2019

* * * * * This post sponsored by PwC. * * * * * The US health industry is showing signs of modernizing along the lines of tech, retail and hospitality, changes that should benefit consumers and the healthcare system overall. Once thought to operate outside the greater US economy, the industry—with its byzantine payment system, complicated… Read More »

Smile for the camera!

By | October 30, 2018

Between the New to Healthcare and the Accounting and Regulatory Technical Update, we’ve had two wonderful educational events in the past few weeks. Below are some pictures from these two events. If you have photos from HFMA that you’d like featured on the blog, please email them to admin@ma-ri-hfma.org. New to Healthcare Seminar & Networking:     Accounting… Read More »

Trump Administration Proposes Requiring Disclosure of Drug Prices in TV Ads

The Trump Administration is moving full speed ahead with its proposals under the Blueprint to Lower Drug Prices (the “Blueprint”).  Earlier this week, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule that would require pharmaceutical manufacturers to disclose the list price of their pharmaceutical products in direct-to-consumer (“DTC”) television ads (the “Proposed Rule”).  This comes only a week… Read More »

Are you a Knowledge Worker?

By | October 2, 2018

Many of the HFMA members reading this blog post are likely defined as “knowledge workers” – a term coined by management guru Peter Drucker back in the mid-20th century. Knowledge workers are individuals who work with their heads, not their hands (maybe other than to utilize Excel and PowerPoint to the point of exhaustion) to plan, contribute, and… Read More »

Evolving Healthcare Strategy

By | September 25, 2018

CVS Health announced its intention to purchase Aetna. Cigna Corp. has announced an agreement to buy Express Scripts. Amazon, JPMorgan Chase & Co., and Berkshire Hathaway have joined forces on healthcare. Partners HealthCare is in talks with Harvard Pilgrim Health Care, and recently closed its purchase of Massachusetts Eye and Ear. Beth Israel Deaconess Medical Center, Lahey Health… Read More »

Nothing better than learning live! Join us for networking and knowledge!

By | September 11, 2018

Accounting and Regulatory Technical Update:  Evolving Strategy in a Dynamic Healthcare Environment On Friday, October 19th, spend the day at the Doubletree by Hilton in Westborough engaging in an interactive learning experience.  Network with colleagues, ask your questions to experienced panelists on Cybersecurity and Evolving Healthcare Strategy, and learn the latest on tax reform and accounting and financial… Read More »

Evolving Strategy in a Dynamic Healthcare Environment – Registration Open

By | August 15, 2018

This year’s Accounting & Regulatory Update brings together a variety of healthcare professionals to offer their perspectives on the shifting American healthcare landscape, including industry consolidation, enhanced use of digital technology and evolving reimbursement and regulatory developments, and what it portends for healthcare providers and payers in Massachusetts and Rhode Island.  This seminar will also explore the growth… Read More »

August 2018: Where Are We Now With 340B?

By | August 1, 2018

It seems like every week, there are multiple new developments in the 340B Drug Discount Program. In just the last few weeks, we have seen a new Senate hearing, a new GAO Report, a new House hearing, and introduction of more than a dozen new bills in Congress that would impact 340B. To understand where things may be… Read More »

Value in Managing Chronically Ill Patients

By | July 18, 2018

The Center for Medicare and Medicaid Services (CMS) launched the Chronic Care Management (CCM) program in January 2015. The introduction of CPT code 99490 allowed provider led teams to remotely manage the health of their sickest patients. Medicare fee-for-service beneficiaries with two or more chronic conditions among the twenty seven outlined by CMS (source) may be enrolled, after… Read More »