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Newsletter

September 3, 2019

Health Headlines – September 3, 2019


CMS Announces New Market Saturation and Utilization Tool – In an August 30, 2019 press release, CMS announced the launch of a new tool, which CMS has titled the “Market Saturation and Utilization Data Tool.” The tool is available here through the CMS website. CMS’s stated purpose for the tool is to monitor market saturation to help prevent potential fraud, waste, and abuse. In its press release on the tool, CMS defines market saturation in this context as “the density of providers of a particular service within a defined geographic area.” The data can be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. CMS also stated that one objective of making these data public is to “assist health care providers in making informed decisions about their service locations and the beneficiary population they serve.”

The tool includes interactive data sets and maps that show national-, state-, county-, and Core-Based Statistical Area (CBSA)-level provider services and utilization data for selected health service areas and allow users to compare provider services and utilization data by geographic region. CBSAs are geographical delineations that encompass both metropolitan statistical areas and micropolitan statistical areas. A micropolitan statistical area is an urban cluster of at least 10,000 people but less than 50,000 people, while a metropolitan statistical area is an urban cluster of at least 50,000 people. CBSAs are Census Bureau-defined urban clusters of at least 10,000 people.

The new tool includes the following health service areas:

  • Home Health;
  • Ambulance (Emergency, Non-Emergency, Emergency & Non-Emergency);
  • Independent Diagnostic Testing Facilities (Part A and Part B);
  • Skilled Nursing Facilities;
  • Hospice;
  • Physical and Occupational Therapy;
  • Clinical Laboratory (Billing Independently);
  • Long-Term Care Hospitals;
  • Chiropractic Services;
  • Cardiac Rehabilitation Programs;
  • Psychotherapy;
  • Federally Qualified Health Centers;
  • Ophthalmology;
  • Preventive Health Services;
  • Dialysis; and
  • Telemedicine.

Additional information about the new tool and the methodology behind it can be found here.

Reporter, Elizabeth Han, Houston, +1 713 276 7319, ehan@kslaw.com.

Also in the News

Zuzana Ikels joins King & Spalding’s Healthcare Team – Last month, King & Spalding announced that Zuzana Ikels has joined the firm as a partner in the San Francisco office.  Her practice focuses on fraud and abuse litigation and commercial disputes for healthcare entities and healthcare technology companies. She has particular expertise in handling cases brought under the False Claims Act (FCA) and similar federal fraud and abuse statutes, as well as state law-based fraud and abuse statutes such as the California False Claims Act (CFCA) and the Insurance Frauds Prevention Act (IFPA).
Ikels joins King & Spalding from the healthcare-focused firm of Hooper, Lundy & Bookman, and adds to the existing Life Sciences expertise of the firm in San Francisco. Ikels will also join Northern California healthcare partners Stephen Goff, Marcia Augsburger, John Barnes and Leslie Murphy, as well as the firm’s strong healthcare presence in Los Angeles with healthcare partners Glenn Solomon, Daron Tooch, Torrey McClary, Travis Jackson, Gina Cavalier and Amanda Hayes-Kibreab. A press release on the addition of Ikels to King & Spalding’s Healthcare team is available here.

King & Spalding Webinar: Open Borders for Rx Drugs?  The Trump Administration’s Move to Authorize Prescription Drug Importation – Section 804 of the Federal Food, Drug, and Cosmetic Act authorizes the importation of certain prescription drugs from Canada but only if the HHS Secretary certifies that importation would “pose no additional risk” to U.S. consumers and “result in a significant reduction in the cost” of those prescription drugs.  Since enactment, no Secretary has made such a certification.  Nonetheless, on July 31, 2019, HHS released its “Safe Importation Action Plan,” designed to pave the way for the importation of select prescription drugs from foreign countries through two potential pathways.  King & Spalding will host a webinar on Thursday, September 12, 2019, from 1:00 p.m. ET until 2:00 p.m. ET that will outline the new policies, their broader policy implications, and the Secretary’s legal authority to enact the plan.

Click here to register. You do not have to be a client to attend, and there is no charge.

King & Spalding to Host 12th Annual Medical Device Summit in Chicago – King & Spalding, in conjunction with FDAnews, will host the 12th Annual Medical Device Summit in Chicago this week. The Summit will take place at The Ritz-Carlton on Thursday, September 5, 2019, with a reception the evening before. Alongside senior government officials, King & Spalding’s faculty will explore cutting edge issues facing the medical device industry. The Summit features three tracks of compelling and substantively diverse presentations from which attendees can build a program to suit their interests. This year, the Summit will include a medical device law fundamentals track of sessions, designed to introduce the core curriculum to lawyers new to the industry and provide refreshers for veterans. The Summit schedule is as follows:

Welcome Reception
Wednesday, September 4
6:00 P.M. – 9:00 P.M.

Medical Device Summit
Thursday, September 5
8:00 A.M. – 6:30 P.M.

For additional information about the Summit, please click here.