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Focus on Regulation

Tag Archives: healthcare

CMS Proposes Network Adequacy Standards for 2017 as State Regulators Approve Network Access and Adequacy Model Law

On November 22, 2015, the National Association of Insurance Commissioners (NAIC) approved new standards designed to ensure that consumers have adequate access to doctors, hospitals, and other healthcare providers under health benefit plans that use provider networks. Read More: CMS Proposes Network Adequacy Standards for 2017 as State Regulators Approve Network Access and Adequacy Model

OIG Issues Supplemental Special Advisory Bulletin Expanding Guidance on Independent Charity Patient Assistance Programs

Likely in response to recent controversy and public scrutiny, on 21 May 2014, the Office of Inspector General issued a supplemental Special Advisory Bulletin regarding independent charitable organizations that provide cost-sharing assistance for prescription drugs, including to federal healthcare program beneficiaries. Read More: OIG Issues Supplemental Special Advisory Bulletin Expanding Guidance on Independent Charity Patient

FTC issues advisory opinion approving physician hospital organization’s clinical integration model

On February 13, 2013, the FTC staff issued a favorable Advisory Opinion to the Norman Physician Hospital Organization (Norman PHO) allowing it to move forward with its clinical integration plan. The Norman PHO, an affiliation of the Norman Regional Health System and approximately 280 participating physicians, seeks to transition from a messenger model when dealing