This year’s Going Digital Health’s Behavioral Health Tech Conference (GDBH) was well-attended and rife with insightful panel presentations and discussions featuring key players from across the behavioral health and substance...more
A panel discussion moderated by Sofia Guerra of Bessemer Venture Partners aptly titled “The Great Leveling Out” provided some clear insights into how investors view the current state of play in digital health markets. Laura...more
A panel of top investors comprised of Nancy Brown, Managing Director at Oak HC/FT, Dan Gebremehdin, Managing Director at Flare Capital, and Laura Veroneau, Managing Director at Optum Ventures, convened in a webcast on January...more
With over 10,000 people in attendance, HLTH 2022 was inspiring and covered a wide range of subjects from health equity to the future of the digital health investment environment. Some sessions were laser-focused on current...more
Starting January 1, 2023, Medicare will expand and increase coverage of certain services and providers to advance access to prevention and treatment services for substance use disorders (SUD) and mental health services. These...more
Over the last two years, behavioral health (BH) has been one of the biggest growth areas in the health care ecosystem, fueled by the Public Health Emergency (PHE) but in many ways an ignored, overlooked, understaffed, and...more
4/1/2022
/ CMMI ,
Consolidated Appropriations Act (CAA) ,
DEA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Health Care Providers ,
Investors ,
Medicaid ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Out of Network Provider ,
Public Health Emergency ,
Reimbursements ,
Substance Abuse ,
Surprise Medical Bills
The traditional world of Medicare-certified home health and hospice is changing rapidly. To the surprise of many, though the pandemic has been an accelerant, the reasons are more fundamental, and at the core are forces...more
In the 12-month period starting in April 2021, over 100,000 people have died from drug overdoses, a 28.5% increase from the same period the year before. While the opioid crisis has been a declared public health emergency...more
In a Press Release issued on October 14 2021 by the Office of Massachusetts Attorney General Maura Healy, a potentially groundbreaking settlement was announced. Below is an excerpt from the release, followed by our takeaways....more
Hosted by the Health Plan Alliance, I was joined by Ken Barrette, Managing Director of Health Care at Alvarez and Marsal, and Marshall Votta, Operating Partner at Nautic Partners, to discuss the unique opportunities that...more
At the annual Home Care 100 Conference this past week, I had the pleasure of moderating a panel of top executives in the home health, hospice, palliative, and integrated primary care business models discuss leading trends in...more
Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms -
New opportunities for investor-backed behavioral health platforms in...more
3/3/2021
/ Biden Administration ,
Coronavirus/COVID-19 ,
Drug Treatment ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Part B ,
Medicare Part D ,
Mental Health Parity Rule ,
Opioid ,
Substance Abuse
California Senate Bill 977 (SB-977), entitled “Health care system consolidation: Attorney General approval and enforcement,” is set for a June 9 hearing before the Senate Appropriations Committee. The bill has two main...more
Since President Trump declared a national emergency concerning the Novel Coronavirus Disease (COVID-19) outbreak on March 13, 2020, the health care industry has witnessed increased focus by investors on sectors closely tied...more
Following the Eleventh Circuit’s and Third Circuit’s recent rulings in United States v. AseraCare and United States v. Care Alternatives, respectively, the Ninth Circuit Court of Appeals has now also addressed the question of...more
Between various blanket Section 1135 waivers and state specific waivers issued by CMS, provisions of the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) and numerous state, local and accreditation body...more
The Senior Housing Industry has been uniquely impacted by the coronavirus pandemic. In addition to the various logistical, practical, and educational measures senior housing communities should be taking to monitor, respond to...more
4/10/2020
/ Ambulatory Surgery Centers ,
Assisted Living Facilities (ALFs) ,
Certificate of Need ,
Dedicated Emergency Departments ,
Federal Funding ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Reform ,
Hospitals ,
Inpatient Rehab Facilities ,
Legislative Agendas ,
Long Term Care Facilities ,
Proposed Legislation ,
Regulatory Agenda ,
Reviewability Determinations
The United States Court of Appeals for the Third Circuit ruled last week that whistleblower relators need not show “objective falsity” to prove their claims, and that a dispute among physician experts about a clinical...more
3/12/2020
/ False Claims Act (FCA) ,
Health Care Providers ,
Hospice ,
Insurance Fraud ,
Life Sciences ,
Medicare ,
Objective Falsity ,
Physicians ,
Professional Liability ,
Qui Tam ,
Relators ,
Scienter ,
Triable Issue of Fact ,
Whistleblowers
Federal enforcers typically announce (formally as well as informally) work plans or focus areas for the upcoming year that can provide some guidance as to where providers might anticipate enforcement action and, where they...more
All hospice providers routinely should assess risk exposure under the False Claims Act — now with the benefit of the U.S. Court of Appeals for the Eleventh Circuit’s long-awaited decision in United States v. AseraCare Inc. ...more
2/4/2020
/ Appeals ,
Evidence ,
False Claims Act (FCA) ,
Health Care Providers ,
Hospice ,
Jury Verdicts ,
Medical Experts ,
Medical Records ,
Medicare ,
Objective Falsity ,
Physicians ,
Summary Judgment ,
Terminal Illness Treatments ,
Trial Court Orders ,
Vacated
Despite the pressure and turmoil going on in certain sectors of the health care continuum, both home health and hospice continue to shine as attractive investment and expansion opportunities for existing providers. Each...more
Big changes were announced this past week in what Health and Human Services (HHS) has labeled a “Regulatory Sprint to Coordinated Care.” Foley will be breaking down many of the areas of the proposed rule and the effects on...more
Welcome to Foley & Lardner LLP’s Health Care MarketTrends. In this issue, we examine private equity investment in specialty areas of the health care industry, specifically dermatology and orthopedics....more
9/17/2019
/ Anti-Kickback Statute ,
Audits ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Coding ,
Health Care Providers ,
Hospitals ,
Investors ,
Medicaid ,
Medicare ,
Private Equity ,
Private Equity Firms ,
Specialty Healthcare ,
Stark Law
Tuesday’s ruling by the United States Court of Appeals for the Eleventh Circuit in United States v. AseraCare is a win for hospice and other health care providers who have long argued that a mere difference of clinical...more
This conference season, private equity (PE) investors and provider compared notes on the current state of the markets, trends, opportunities and challenges...more
5/15/2019
/ Acquisitions ,
Capital Requirements ,
Corporate Financing ,
Healthcare ,
Hedge Funds ,
Industry Consolidation ,
Investment Funds ,
Mergers ,
Partnerships ,
Private Equity ,
Private Equity Funds ,
Underwriting ,
Valuation