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Foley & Lardner LLP

Health Care Enforcement: “Tea Leaves” in the 2024 National Health Care Fraud Summer Takedown

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Each summer in recent years, the U.S. Department of Justice (DOJ) and associated fraud enforcement partners have indicted many health care defendants, in multiple cases across the country. This summer continued the tradition....more

Ankura

Will Regulatory Scrutiny Impact Private Equity Investment in Healthcare?

Ankura on

Private Equity in Healthcare - Over the past decade, private equity investors have shown a particular interest in acquiring or investing in various healthcare providers and services. This includes physician practices across...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

ArentFox Schiff on

With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more

ArentFox Schiff

Coordinated Agency Activities: FTC, DOJ, and HSS Launch Cross-Government Inquiry on Effect of Transactions in Health Care

ArentFox Schiff on

On March 5, the Federal Trade Commission (FTC), the US Department of Justice (DOJ) Antitrust Division, and the US Department of Health and Human Services (HHS) launched a cross-government inquiry into the role private equity...more

McDermott Will & Emery

Top Takeaways | FTC Hosts Workshop, Solicits Public Comments on Private Equity in Healthcare

McDermott Will & Emery on

On March 5, 2024, the Federal Trade Commission (FTC) hosted “Private Capital, Public Impact: An FTC Workshop on Private Equity in Health Care” to examine the role of private equity investment in healthcare markets. The same...more

NAVEX

Addressing Cybersecurity Expectations in Healthcare

NAVEX on

2024 is shaping up to be a very active year for regulatory and enforcement developments in the healthcare industry – developments that concern not just hospitals and nursing facilities, but many non-healthcare companies as...more

McDermott+

McDermottPlus Check-Up: March 8, 2024

McDermott+ on

Appropriations Update. On March 3, Congress released bill text for the CAA, 2024, which includes funding for six of the 12 appropriations bills: Agriculture-FDA, Military Construction-VA, Energy-Water, Transportation-HUD,...more

Troutman Pepper

FTC Workshop Argues That Private Equity Incentives Are Not Aligned With Quality Health Care

Troutman Pepper on

On March 5, the Federal Trade Commission (FTC) hosted a public workshop titled “Private Capital, Public Impact: An FTC Workshop on Private Equity in Health Care.” The event is part of the agency’s effort to publicize and...more

Mintz

EnforceMintz — Artificial Intelligence and False Claims Act Enforcement

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Like most industries, the health care sector is grappling with the uses of artificial intelligence (AI) and what AI means for the future. At the same time, many health care companies already have integrated algorithms and AI...more

Bass, Berry & Sims PLC

OIG Approves the Use of Gift Cards to Reward Customers' Marketing Efforts

Bass, Berry & Sims PLC on

On January 3, the U.S. Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion 23-15, approving a physician practice consultant’s proposal to offer gift cards to its customers when...more

Foley & Lardner LLP

Biden Administration Announces New Efforts to Promote Competition in Health Care

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On December 7, 2023, the Biden Administration announced several new initiatives intended to “promote competition” in the health care sector. These initiatives reflect a broad range of concerns about rising costs in health...more

Bass, Berry & Sims PLC

HHS Releases Groundbreaking General Compliance Program Guidance, Setting New Standards for Healthcare Entities

Bass, Berry & Sims PLC on

On November 6, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released the most up-to-date, comprehensive, and practical general compliance guidance in decades. The new...more

The Volkov Law Group

DOJ Declines Prosecution Applying Corporate Enforcement Program in Healthcare Fraud Case

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The Justice Department’s Corporate Enforcement Policies and Program applies to prosecutions outside of the FCPA context.  The impact of DOJ’s new approach, encouraging voluntary disclosures, applies to other federal criminal...more

Manatt, Phelps & Phillips, LLP

Access to Care for Justice-Involved Pregnant People With a Substance Use Disorder

There is a critical need to increase access to evidence-based care for justice-involved pregnant people with a substance use disorder (SUD)—and connect them to continued coverage and care upon release—according to national...more

Health Care Compliance Association (HCCA)

News Briefs: August 14, 2023

Report on Medicare Compliance Volume 32, no 29 (August 2023) In a new Medicare transmittal (12,202), CMS introduced a new place of service (POS) code (27) for “Outreach Site/Street.” POS 27 is defined as “a non-permanent...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | June 2023 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for June 2023. We discuss several civil enforcement actions involving false claims, the Anti-Kickback Statute (AKS) and...more

Health Care Compliance Association (HCCA)

FCA Lawsuit Alleges Three Hospitals Were Overpaid PRF ‘High-Impact’ Money and Kept It

Report on Medicare Compliance Volume 32, no 25 (July 2023) The former chief hospital executive of Bayonne Medical Center (BMC) in New Jersey has filed a False Claims Act (FCA) lawsuit alleging the hospital and two others...more

Paul Hastings LLP

Finance in Five Minutes: Healthcare Finance Checkup

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While mergers and acquisitions, and attendant financings may not be at a blistering pace globally, the prognosis for deal activity in the healthcare sector remains healthy, in particular as the consolidation of providers, the...more

Troutman Pepper

DOJ's New Voluntary Self-Disclosure Policy Raises More Questions Than It Answers

Troutman Pepper on

On February 22, 2023, the Department of Justice (DOJ) issued a press release highlighting the new Voluntary Self-Disclosure (VSD) Policy for U.S. Attorney’s Offices (USAOs). The DOJ developed this policy, which is applicable...more

Kohn, Kohn & Colapinto LLP

The Government’s Ability to Combat Fraud is on the Line in False Claims Act Supreme Court Case

Oral arguments are scheduled for April 18, 2023, in the Supreme Court case combining two Seventh Circuit Court of Appeals cases U.S. ex rel. Schutte v. SuperValu, Inc. (“SuperValu”) and U.S. ex rel. Thomas Proctor v. Safeway,...more

Bradley Arant Boult Cummings LLP

Second Circuit Limits Use of Confidential Government Agency Information as Basis for Securities Fraud Prosecutions

On December 27, 2022, the Second Circuit called into question the government’s theory of insider trading of confidential government agency information, potentially undercutting the DOJ’s enforcement of various white-collar...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

ArentFox Schiff

10 Legal Challenges for the Health Care Industry in 2023

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With the new year underway, the ArentFox Schiff Health Care team highlights 10 of the most pressing legal issues facing the industry in 2023. End of the COVID-19 Public Health Emergency. After being in effect for more than...more

King & Spalding

Group of Agency Inspectors General Publishes Report on Program Integrity Risks Across Certain Health Care Programs During the...

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On December 1, 2022, the Pandemic Response Accountability Committee (PRAC) Health Care Subgroup published a report about the use of telehealth in selected health care programs across six federal agencies during the first year...more

ArentFox Schiff

Pharmacy Benefit Manager Reform Remains Legislative Priority

ArentFox Schiff on

The 2022 midterms have concluded, but the Republican underperformance is not expected to dampen Congressional enthusiasm for Pharmacy Benefit Manager (PBM) reform. The issue remains at the forefront of the healthcare pricing...more

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