Health Capital Topics 2016

 This book is a compilation of excerpts from articles originally published in the newsletter, Health Capital Topics, which have been organized by topic in relation to the Four Pillars concept.

Health Capital Topics is a monthly e-newsletter, which has been published by Health Capital Consultants since 2007, featuring timely topics related to the regulatory, reimbursement, competition, and technology aspects of the U.S. healthcare delivery environment. It is sent monthly to over 12,000 healthcare executives, physicians, attorneys, accountants, and other professionals in the healthcare industry. Copies of past Health Capital Topics newsletters, as well as special alert issues, can be found at

Some of the articles represent a retrospective look at a topic as noted by the date of original publication that appears following the article title. The intent of this book is to serve as an (admittedly abridged) brief annual primer and reference source for these issues. In the months and years ahead, we will strive to continue staying on top of key issues in the healthcare industry and presenting them in the monthly e-publication issues of Health Capital Topics and special alert issues.

Table of Contents


Tax-Exempt Status Two-Part Series

Pharmacy Benefit Management Two Part Series

Regulatory Scrutiny for Physician Compensation Continues

ACO Waivers Final Rule Issued

2016 Stark Law Changes Issued

FTC Issues Guidance Regarding Antitrust Scrutiny of State Medical Boards

OIG Releases 2016 Work Plan

Updated Two-Midnight Rule Released

SCOTUS to Weigh in on Definition of "False" Under FCA

HCA Hit with $400 Million Judgment by Missouri Court

Distribution of Medical Malpractice Claims - Implications for Healthcare Organizations

2016 Supreme Court Healthcare Cases: Post Scalia

Fraud and Abuse in Healthcare: CMS Extends Moratorium on the Certification of New Home Health Agencies in Certain Areas

CMS Issues MACRA Proposed Rule One Year After Passage

FTC v. Pinnacle: Antitrust Concerns vs. Reform-Based Consolidation

Practice Loss Postulate: Regulatory Trend Misapplies Theory to Healthcare Integration

Cost of Patient Access to Medical Information: Recent HHS Guidance

Stark Law Reform Debated by Senate Committee 


Value-Based Reimbursement Three-Part Series

ICD-10 Rollout Relatively Smooth, Insurers Say

Congress Changes Reimbursement Rules for Off-Campus Facilities

CMS Releases Comprehensive Care for Joint Replacement Model

Medicare Physician Fee Schedule 2016 Updates

The Re-Emergence of Provider-Sponsored Plans

ACA's Cadillac Tax Delayed Until 2020

Reputable Hospitals Score Low in CMS Hospital Rankings


ACA CO-OP Closures Two-Part Series

Patient Wait Times for Medical Care Often Excessive

Great Variability in Geographic Access to Primary Care Facilities

Disruptive Innovation in Healthcare

Rural Hospital Closure Rates Higher in Non-Medicaid Expansion States

"Implied False Certification" Theory Under False Claims Act Upheld by Supreme Court


Telemedicine Four-Part Series

CMS Delays Enforcement of Stage Three Meaningful Use Requirements

New Electroceutical Technologies May Revolutionize Medical Care

"Pharmacy on Demand" To Revolutionize Drug Manufacturing

Pharmaceutical Pay-for-Delay Agreements in Decline Since 2013



Firm Background

HCC Leadership