- Hypertrophic Cardiomyopathy (HCM)
- Eyecare
- Urothelial Carcinoma
- Hemophilia
- Heart Failure
- Vaccines
- Neonatal Care
- NSCLC
- Type II Inflammation
- Substance Use Disorder
- Gene Therapy
- Lung Cancer
- Spinal Muscular Atrophy
- HIV
- Post-Acute Care
- Liver Disease
- Asthma
- Atrial Fibrillation
- COVID-19
- Cardiovascular Diseases
- Prescription Digital Therapeutics
- Reproductive Health
- The Improving Patient Access Podcast
- Blood Cancer
- Ulcerative Colitis
- Respiratory Conditions
- Multiple Sclerosis
- Digital Health
- Population Health
- Sleep Disorders
- Biosimilars
- Plaque Psoriasis
- Leukemia and Lymphoma
- Oncology
- Pediatrics
- Urology
- Obstetrics-Gynecology & Women's Health
- Opioids
- Solid Tumors
- Autoimmune Diseases
- Dermatology
- Diabetes
- Mental Health
P4P arrangements can carry legal issues
As with any compensation arrangement between providers and health plans involving federal healthcare programs, parties to a pay-for-performance arrangement need to be mindful of possible fraud and abuse, according to Kathryn A. Roe, of Neal, Gerber & Eisenberg LLP in Chicago.
Chicago - As with any compensation arrangement between providers and health plans involving federal healthcare programs, parties to a pay-for-performance arrangement need to be mindful of possible fraud and abuse, according to Kathryn A. Roe, of Neal, Gerber & Eisenberg LLP in Chicago.
"That means asking whether the contemplated arrangement implicates the federal anti-kickback or Stark laws or their state counterparts, and if so, whether there is an available safe harbor or exception," Roe says.
Interference issues. Another consideration might be claims that pay-for-performance results in plan interference with the patient-provider relationship. "That was a common concern in the '90s with the rise of plan utilization management and other similar programs," Roe says. "Health plans responded by adding the managed care contracts provider acknowledgments of their ultimate responsibility for care rendered to patients. Such clauses could have equal application to pay-for-performance arrangements."
- Tracey Walker
Bridging the Diversity Gap in Rare Disease Clinical Trials with Harsha Rajasimha of IndoUSrare
November 8th 2023Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare.
Listen
Managing Editor of Managed Healthcare Executive, Peter Wehrwein, had a discussion with William Shrank, M.D., a venture partner with Andreessen Horowitz, a venture capital firm in Menlo Park, California, about how artificial intelligence's role is improving healthcare, where we are today with value-based care and the ongoing efforts of reducing waste in the healthcare space for this episode of the "What's on Your Mind" podcast series.
Listen
Air Pollution May Negatively Affect Male Reproductive Health
November 30th 2023A potential mechanism by which air pollutants may affect reproductive health is by endocrine disruption. Air pollutants are made up of mixtures of particulate matter that may include endocrine disruptors, such as polycyclic aromatic hydrocarbons (PAHs) and heavy metals.
Read More
35th World AIDS Day Marks 20 Years of PEPFAR: Challenges and Strategies to Combat HIV/AIDS
November 29th 2023PEPFAR, having invested $100 billion and saved 25 million lives in the global fight against HIV/AIDS, faces Congressional hurdles in its reauthorization due to abortion debates. Despite widespread support and no evidence of abortion-related activities, the legislative process is at a standstill. Members of PEPFAR and authors of a recent editorial stress the significance of PEPFAR and advocate for integrating behavioral and social science into healthcare programs to achieve UNAIDS targets and address barriers in HIV/AIDS testing and treatment.
Read More
