Affordable Care Act, Enforcement

CMS Audits on the Horizon: Prepare for Increased CMS Audits Under the Sunshine Act

Gardner Law on 5/15/2024

Historically, the Centers for Medicare and Medicaid Services (“CMS”) has not aggressively pursued enforcement activity under the Sunshine Act. However, this may change in 2024. Late last year, CMS updated its Open Payments...more

Highlights from the Inaugural Hot Topics in Health Care Law

Miles & Stockbridge P.C. on 3/4/2024

The Miles & Stockbridge Health Care Practice Group hosted its inaugural Hot Topics in Health Care Law seminar last month for clients from Maryland and beyond. Miles & Stockbridge health care lawyers kicked off the seminar...more

HHS Publishes Final Rule Governing Healthcare Conscience Protections

Holland & Knight LLP on 3/1/2024

On Jan. 11, 2024, the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) published its 2024 Final Rule governing healthcare conscience protections, "Safeguarding the Rights of Conscience as...more

Enforcement Back On: Departments Rescind Enforcement Relief for Machine Readable File Requirements under Transparency in Coverage...

Snell & Wilmer on 10/6/2023

On September 27th, the Departments released FAQs about Affordable Care Act Implementation Part 61 (“FAQ 61”), announcing that the Departments are rescinding prior-issued enforcement relief for certain machine-readable file...more

Whither Insurance Coverage for Preventive Health Services? District Court Decision Striking Down Affordable Care Act’s Preventive...

Zuckerman Spaeder LLP on 5/22/2023

On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more

Federal Judge Blocks Preventive Care Mandates Under the Affordable Care Act and Enjoins Further Enforcement of Special Task...

King & Spalding on 4/5/2023

On March 30, 2023, the U.S. District Court for the Northern District of Texas vacated actions taken by HHS to implement provisions of the Affordable Care Act (ACA) that require health insurance plans to include coverage for...more

HHS Issues Proposed Rule Under Section 1557 of the Affordable Care Act: Nondiscrimination in Health Programs and Activities

McDermott Will & Emery on 8/5/2022

On August 4, 2022, the US Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking (NPRM or proposed rule) to reinterpret section 1557 of the Affordable Care Act (ACA), which prohibits...more

Investigations Newsletter: New DC Circuit Ruling Impacts Medicare Advantage Plans and FCA Enforcement

ArentFox Schiff on 8/23/2021

In a unanimous opinion, the DC Circuit reversed a successful challenge brought by UnitedHealth (United) and other Medicare Advantage insurers to vacate a Medicare Advantage Overpayment Rule. The Overpayment Rule requires that...more

The Ongoing Saga of the CMS Hospital Price Transparency Rule

Bradley Arant Boult Cummings LLP on 5/13/2021

The Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule went into effect on January 1, 2021, but whether it will succeed in making prices readily comparable for healthcare consumers remains to be...more

[Webinar] Healthcare Anti-Discrimination Litigation: What Payors Need to Know - May 13th, 1:00 pm - 2:00 pm ET

McDermott Will & Emery on 4/29/2021

As we continue our three-part webinar series, McDermott’s litigation and healthcare lawyers will focus on how payors can actively prepare for possible enforcement and litigation stemming from recent and potential changes to...more

The State of Competition in the U.S. Healthcare Industry

Sheppard Mullin Richter & Hampton LLP on 3/31/2021

The U.S. healthcare system has been undergoing significant changes since the passage of the Affordable Care Act in 2010, which helped precipitate a wave of hospital and healthcare system consolidation, as providers sought out...more

FDA Publishes Enforcement Policies to Address Coronavirus Personal Protective Equipment Shortages

Foley & Lardner LLP on 4/7/2020

In the wake of the COVID-19 pandemic, the FDA has sought to expand the availability of needed personal protective equipment (PPE) for the general public and healthcare professionals. Recently, for example, FDA published two...more

Federal Courts Vacate the New HHS “Conscience Rule” Two Weeks Before it was to Take Effect

Miles & Stockbridge P.C. on 11/21/2019

A November 6, 2019 decision by the United States District Court for the Southern District of New York vacated new rules promulgated by the Department of Health and Human Services (HHS) intended to protect medical providers...more

Healthcare Law Update: May 2018

Holland & Knight LLP on 5/30/2018

Enforcement - OIG Issues Advisory Opinion on Provision of Samples by a Device Distributor - On April 30, 2018, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a...more

Northern District of Texas Blocks Enforcement of the Non-Discrimination Regulations of the ACA

McDermott Will & Emery on 1/10/2017

On December 31, 2016, the US District Court for the Northern District of Texas issued an opinion and order in Franciscan Alliance, Inc. et al v. Burwell, which preliminarily enjoins the US Department of Health and Human...more

Health Update - November 2016

Manatt, Phelps & Phillips, LLP on 11/23/2016

Post-Election Analysis: Healthcare Antitrust in a Trump Administration - In a Republican sweep of all the elected branches of the federal government, Donald Trump won the presidential election and Republicans retained...more

The Time is Right for Hospitals to Ensure 501(r) Compliance

Cozen O'Connor on 9/15/2015

Updated requirements for hospitals to maintain their tax-exempt status under Section 501(r) of the Internal Revenue Code are nothing new. They were enacted as part of the Affordable Care Act in 2010. However, at the end of...more

Proposed Rule's Medicaid Managed Care Medical Loss Ratio Requirement Will Likely Impact Plans, Providers and Patients in New York

Proskauer Rose LLP on 6/4/2015

On June 1, 2015, the Department of Health and Human Services Center for Medicaid and Medicare Services (CMS) published a proposed rule at 80 Fed. Reg. 31097 (Proposed Rule) that will fundamentally change state Medicaid...more

Health Care Enforcement: The Impact on Private Equity Investments

Mintz on 4/29/2015

Brian Platton provides an overview of enforcement trends that private equity investors should be aware of before entering into the health care space....more

2014 – The Health Law Year in Review

Bradley Arant Boult Cummings LLP on 12/31/2014

Each year brings significant changes and challenges in the laws governing the health care industry, and 2014 proved to be no exception. What the year may have lacked in the high drama that accompanies comprehensive health...more

Government demonstrates willingness to enforce Affordable Care Act provision that could cost providers millions of dollars

Saul Ewing Arnstein & Lehr LLP on 11/5/2014

Under a little-known provision of the Patient Protection and Affordable Care Act (“ACA”), healthcare providers could face millions of dollars in liability for failing to reimburse the government for overpayments in a timely...more

Patient Protection and Affordable Care Act (PPACA) › Enforcement