BRG Quarterly Compliance and Program Integrity Developments

The BRG Healthcare Transactions and Strategy quarterly compliance bulletin compiles noteworthy developments in the healthcare sector related to compliance, program integrity, and enforcement activities. In the fourth quarter of 2020, we have taken particular note of: DOJ/HHS activity Two OIG reports Two Comparative Billing Reports Four GAO reports OCR activity Proposed and approved additions to the RAC audit list Click to read more.

Managed Care Friday

20: Number of primary care centers Humana opens in four states this year, including Atlanta, New Orleans and Las Vegas. Leaning on Humana as your major Medicare payer for your primary care operation brings upside given the company’s investment in risk-based models and in some cases elevated PMPMs, but it also brings this evolving dynamic of competition from Humana’s Partners in Primary Care owned practice. Staff Boom Or Zoom? Two companies merged in January to become the biggest healthcare staffing firm in Washington state. The joint company, now known as Actriv Healthcare, will employ over...

Weekly Medicaid Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: FL:   Gov. DeSantis releases FY22 budget proposal MN:  Gov. Walz releases FY22-23 biennial budget proposal MO:  Gov. Parson releases FY22 budget proposal WA:  State delays Consumer Directed Employer model for individual providers of HCBS WI:   State expands coverage for residential SUD treatment Click to read more.

Biden Administration Health Agenda

The Biden-Harris Administration faces a global health pandemic and a precarious economic situation. U.S. health policy topics will largely be overshadowed by Administration actions to address climate change, racial equity, and other deferred policy goals like immigration, leading to relative stability in healthcare and only incremental change. Click to read more.

Managed Care Friday

29: Percent of primary care practices “hiring” mental health staff in 2021 according to our poll of 567 PCPs, pediatricians, internists and specialty doctors who manage conditions in which depression and anxiety are common, like asthma, crohn’s, cancer, pregnancy and rheumatoid arthritis. Landing Home: Landmark Health, which focuses on in-home medical care to frail populations, formed a value-based care partnership with Southwestern Health Resources, a clinically integrated network. Through this partnership, the pair will offer multidisciplinary medical care at patients’ homes for...