Friday the 13th is not all bad luck. On September 13, 2024, the United States Court of Appeals for the Eighth Circuit’s published its much-anticipated decision in United States ex rel. Holt v. Medicare Medicaid Advisors,...more
In its November 2023 Proposed Rule and in its recently issued Final Rule that will be published in the Federal Register later this month, the Centers for Medicare & Medicaid Services (CMS) addressed concerns related to agent...more
4/23/2024
/ Brokers ,
Centers for Medicare & Medicaid Services (CMS) ,
Compensation ,
Contract Renewal ,
Enrollment ,
Fraud and Abuse ,
Health Insurance ,
Medicare Advantage ,
Medicare Part D ,
OIG ,
Proposed Rules ,
Public Health Insurance Marketplace ,
Risk Management
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
2/23/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Dispute Resolution ,
Enforcement ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Mental Health ,
No Surprises Act (NSA) ,
Physician Fee Schedule ,
Public Health Emergency ,
Risk Assessment
Based on recent changes and clarifications made by the Centers for Medicare and Medicaid Services (CMS) in the Federal Physician Self-Referral Law (commonly known as the “Stark Law”), hospitals and health systems need to...more
CMS made impactful changes to the Federal physician self-referral law’s (i.e., Stark Law’s) regulations in its Final Rule that were effective January 19, 2021 (with the exception of the changes to 42 C.F.R. § 411.352(i) that...more
CMS made impactful changes to the Federal physician self-referral law’s (i.e., Stark Law’s) regulations in its Final Rule that were effective January 19, 2021 (with the exception of the changes to 42 C.F.R. § 411.352(i) that...more
1/21/2021
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Commercially Reasonable Efforts ,
Compensation ,
Cybersecurity ,
Final Rules ,
Physicians ,
Remuneration ,
Stark Law ,
Value-Based Care ,
Value-Based Payments
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
As noted in previous Health Care Law Today blog posts, we have seen an uptick in private equity recapitalization transactions in orthopedics. We expect this trend to continue, and to pick up pace, as the economy remains...more
1/8/2019
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Homeland Security (DHS) ,
Health Care Providers ,
Hospitals ,
Joint Venture ,
Physicians ,
Private Equity ,
Private Equity Funds ,
Recapitalization ,
Stark Law