Affordable Care Act, Healthcare, Department of Justice (DOJ)

Navigating the Wild West of the New ACA Preventative Care Ruling

Sheppard Mullin Richter & Hampton LLP on 5/12/2023

On March 30, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a decision in Braidwood Management Inc. v. Becerra (“Braidwood”), invalidating the Affordable Care Act’s (“ACA’s”) mandate...more

DOJ Antitrust Division and HHS OIG Enter into Partnership to Increase Coordination and Enforcement in Health Care

Foley & Lardner LLP on 12/14/2022

On December 9, 2022, the U.S. Department of Justice Antitrust Division (DOJ) and Office of Inspector General of the U.S. Department of Health and Human Services (OIG) announced they had entered a Memorandum of Understanding...more

Pandemic and Political Shifts in Section 1557 of the Affordable Care Act

Dentons on 9/24/2021

As part of the Affordable Care Act (ACA), Section 1557 is a multilayered approach to prohibit discrimination based on color, national origin, sex, age, and disability in health programs or “activities that receive federal...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

What is the Fate of ACA? No Answers Yet from the Fifth Circuit.

Snell & Wilmer on 1/15/2020

Background - As noted in our previous December 2018 blog post, “Texas Judge Declares the Affordable Care Act Unconstitutional – What’s Next?,” and our October 2019 newsletter, “2019 End of Year Plan Sponsor “To Do” List...more

Update to Texas v. United States

Sheppard Mullin Richter & Hampton LLP on 4/5/2019

In our December blog post, we discussed Texas v. United States, No. 19-10011 (5th Cir.), a Texas federal district court decision which struck down the entirety of the Affordable Care Act (“ACA”). The case is being appealed to...more

Texas Judge Declares the Affordable Care Act Unconstitutional – What’s Next?

Snell & Wilmer on 12/19/2018

As reported in our “2018 End of Year Plan Sponsor “To Do” List (Part 1) Health & Welfare,” the Tax Cuts and Jobs Act repealed the individual mandate, which spawned a lawsuit challenging the whole of the Affordable Care Act...more

Is the Affordable Care Act a House of Cards? If Yes, What Does the Recent Texas Court Decision Mean for the US Health Insurance...

Epstein Becker & Green on 12/19/2018

In an unexpectedly broad ruling issued December 14, 2018, the U.S. District Court for the Northern District of Texas declared the Affordable Care Act (“ACA”) as unconstitutional in its entirety. This decision, if ultimately...more

What's Next After the Texas vs. Azar Ruling?

Mintz - Health Care Viewpoints on 12/19/2018

On Friday, December 14th, Judge Reed O’Connor, a Texas Federal District Court Judge, ruled on the case Texas vs. Azar. As background, Texas vs. Azar was filed by 20 Republican state attorneys general and governors. The...more

2016/2017 Labor & Employment Observer

Cozen O'Connor on 1/12/2017

Activist NLRB Created More Problems For All Employers in 2016 - What Happens Under President Trump? During 2016, the National Labor Relations Board (NLRB or the Board) maintained its generally pro-union, anti-employer...more

The AHA’s Letter to Santa Claus

Akerman LLP - Health Law Rx on 1/10/2017

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...more

White Collar Crime Law Enforcement in a Trump Justice Department - 8 Predictions

Cadwalader, Wickersham & Taft LLP on 11/30/2016

After a conventional presidential campaign, determining the policy priorities and direction of the incoming administration with respect to the Justice Department’s white collar law enforcement responsibilities can be a...more

DOJ Antitrust Head Remains Focused on Health Care in Era of Consolidation

Faegre Drinker Biddle & Reath LLP on 11/17/2015

Speaking at an industry conference on November 13, U.S. Assistant Attorney General Bill Baer reiterated the government’s focus on competition concerns in the health care industry. According to Baer, head of the Department of...more

Health Care Update - November 2015

Mintz - ML Strategies on 11/4/2015

Ways & Means Leadership Changes – Health Policy Implications Looming: As Congress pushes forward with a two-year budget deal, and new Speaker Paul Ryan begins his tenure as the top Republican in the House of...more

Skeletons in the Closet? Beware of Potential Enforcement Actions

Mintz - Health Care Viewpoints on 10/29/2015

With Halloween looming, a discussion of skeletons that may be lurking in a health care provider’s closet is timely. Many of our previous posts, as well as the monthly Qui Tam Updates published by our Health Care Enforcement...more

OMB Receives Final Medicare Parts A and B 60-Day Overpayment Rule from CMS

King & Spalding on 10/28/2015

On October 21, 2015, the Office of Management and Budget (OMB) received the Medicare Parts A and B overpayment final rule from CMS which is the last phase before the rule is issued in the Federal Register. While the text of...more

Kmart Settlement Shows Breadth of Healthcare Practices Government Says Violate False Claims Act

Saul Ewing Arnstein & Lehr LLP on 9/30/2015

A recent settlement by retailer Kmart Corp. illustrates the breadth of practices in the healthcare space that the government considers to be illegal kickbacks that violate the False Claims Act (FCA). The U.S. Department of...more

Washington Healthcare Update

McGuireWoods LLP on 9/15/2015

This Week: House Energy and Commerce Subcommittee Holds Hearing on Legislation to Strengthen Medicaid Program Integrity and Fraud Controls... Bipartisan Senate Bill Introduced to Stop Anti-Competitive “Pay-For-Delay”...more

Health Insurers Announce Merger Plans; Congress Announces Intention to Review

Baker Donelson on 9/2/2015

In the last few months, several of the largest commercial health insurers in the nation have announced their intentions to merge. First, Aetna (currently the nation’s third largest health insurer by revenue) announced its...more

Kane and the “60-Day Rule”: The Unforgiving World of Medicare and Medicaid Overpayments

BakerHostetler on 8/14/2015

The Southern District of New York has spoken on one of the first issues to confront those seeking compliance with the new “60-day rule” under the Affordable Care Act (ACA), and it does not bode well for defendant hospitals...more

First Court Opinion on When an Overpayment is “Identified” for Purposes of the 60-Day Repayment Law

Morgan Lewis on 8/6/2015

The court’s interpretation complicates the already difficult task providers face in having sufficient time to assess and quantify potential overpayments. An August 3 decision in United States v. Continuum Health Partners...more

SDNY Issues Groundbreaking Decision On False Claims Act Sixty-Day Rule

Polsinelli on 8/6/2015

Medicare and Medicaid providers have an obligation to refund overpayments from federal health care programs. The False Claims Act (“FCA”) imposes liability for any person who “knowingly conceals or knowingly and improperly...more

Health Update - July 2015

Manatt, Phelps & Phillips, LLP on 7/23/2015

Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace - Editor's Note: As marketplaces prepare for the third open enrollment period, consumers are...more

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

Epstein Becker & Green on 4/15/2015

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

DOJ and FTC Announce Proactive Approach to Monitoring Post-Affordable Care Act Antitrust Compliance at Joint Workshop

Patterson Belknap Webb & Tyler LLP on 3/4/2015

On February 24 and 25, the DOJ and FTC held their second joint workshop to examine the state of health care competition in the United States. The workshop explored five main themes: early observations regarding accountable...more

Patient Protection and Affordable Care Act (PPACA) › Healthcare › Department of Justice (DOJ)

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