Mark Lutes Quoted in “Health and Life Sciences Policy to Watch in 2020”


Mark E. Lutes, Chair of the firm’s Board of Directors and Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in Law360, in “Health and Life Sciences Policy to Watch in 2020,” by Jeff Overley. (Read the full version – subscription required.)

Following is an excerpt:

An extraordinary feud among the Trump administration’s top health care officials will serve as a riveting backdrop in 2020 to contentious debates over hospital reimbursement and drug prices. Here, Law360 gets you up to speed on the biggest health care and life sciences policies to watch this year. …

Value-Based Medicare Pay Will Keep Expanding

In a continuation of an Obama administration priority, the Trump administration has been gung-ho about value-based Medicare reimbursement — pay that’s linked to quality and efficiency — and attorneys expect that enthusiasm to continue in 2020 on multiple fronts.

In perhaps the most prominent example for 2020, regulators could cement new safe harbors for value-based reimbursement that implicates the Anti-Kickback Statute, or the so-called Stark Law, which restricts physician referrals.

But the safe harbors mostly only cover health care providers, and some observers say the potential of value-based care can only be fully realized if drugmakers are invited to the party. …

Another example of the value-based trend’s evolution could emerge when regulators in early 2020 unveil their annual set of policy tweaks for Medicare Advantage, the privately administered alternative to traditional Medicare. Among other things, regulators may allow Medicare Advantage insurers to more widely incentivize healthy behaviors by policyholders.

“I think there will be lots of little things, [and] they’re consistent with this trend of letting Medicare Advantage be all that it can be,” Mark Lutes, board of directors chairman at Epstein Becker Green, told Law360.

Part of the idea, Lutes added, is for Medicare Advantage to serve as a “surrogate for CMS to deploy the value-based purchasing incentives that need to be deployed.”