On February 24, 2022, the Centers for Medicare & Medicaid Services (CMS) announced a new accountable care organization (ACO) model, called ACO REACH. REACH stands for “Realizing Equity, Access, and Community Health.” ACO REACH will replace the current Global and Professional Direct Contracting (GPDC) model, and terminate the current Geographic Direct Contracting (Geo Model) model, a subset of the GPDC model. This Health Capital Topics article will discuss the new ACO REACH model and its implications for existing ACOs. (Read more...)

In 2020, special purpose acquisition companies (SPACs) began tremendous growth and looked to be a new mainstream avenue of investing. Two years later, the growth of SPACs across all industries, including healthcare, has plateaued and appears to be dropping in some industries. This Heath Capital Topics article will examine how SPACs grew to their 2021 height in popularity and their future in a post-COVID world. (Read more...)

On February 28, 2022, President Joe Biden announced during his State of the Union address that the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) will establish increased standards in nursing homes to improve equality and safety. In his address, President Biden cited the poor performance of nursing homes across the U.S. and the toll that the COVID-19 pandemic has had on them, particularly with regard to financial and personnel losses. (Read more...) 

Home healthcare in the U.S. is highly regulated, creating a complex system, especially for home health agencies (HHAs) that operate across multiple states. HHAs face a range of federal and state legal and regulatory constraints, which affect their formation, operation, procedural coding and billing, and ability to engage in transactions. The second installment of this home health valuation series will discuss the regulatory environment in which these organizations operate. (Read more...) 

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This one-hour webinar provides legal and valuation perspectives on the finalized changes to the Stark Law and the Anti-Kickback Statute. Specific issues covered include:

  • The changes to the “big three” requirements – Fair Market Value, Commercial Reasonableness, and the Volume or Value Standard;
  • The new exceptions and safe harbors for value-based arrangements, including where the Stark Law and Anti-Kickback Statute final rules differ; and
  • Other new and modified exceptions and safe harbors included in the final rules.