Medicaid

By: Sunita Desai & Kyle Smith (Washington Center for Equitable Growth) In this article, authors Sunita Desai & Kyle Smith shed light on the significant role of the U.S. healthcare...

On August 17, Mylan and federal investigators finalized a US$465 million settlement of charges the drugmaker overcharged the government for the injection allergy medication EpiPen. Resolving an issue that fueled nationwide debate over soaring drug costs, the agreement ends an investigation that found Mylan avoided paying state Medicaid programs higher EpiPen rebates by improperly catagorizing […]

New York health-care providers are working together under a Medicaid waiver program that looks to improve care, reduce costs and potentially provide cover from federal antitrust laws. Just how much the health of Medicaid beneficiaries will be improved and how much antitrust law protection the providers will enjoy remains to be seen. Early indications, however, […]

Lona Fowdur, John Gale, Jul 17, 2012 The Accountable Care Act (“ACA”) has brought to the fore the concept of Accountable Care Organizations (“ACOs”). These organizations comprise networks of otherwise unaffiliated providers that can obtain approval from the Centers for Medicare & Medicaid Services (“CMS”) to become jointly responsible for the coordinated care of an assigned […]

David Pearl, Toby Singer, May 12, 2011 On March 31, 2011, the Federal Trade Commission and the Antitrust Division of the Department of Justice (the “FTC and “DOJ” or the “Agencies”) issued a Proposed Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program. (“Proposed Statement). The Proposed Statement offers […]

Gregory Pelnar, Mar 30, 2011 An Accountable Care Organization (“ACO”) is “an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.” The Affordable Care Act of 2010 (“ACA”) encourages the formation […]