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Government Investigations Team Insights - July 2024

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more

Healthcare Providers Could Finally Have Their Day in Court: Supreme Court Holds That Defendants Are Entitled to Jury Trials When...

On June 27, 2024, the Supreme Court of the United States released its opinion in SEC v. Jarkesy, a case involving a Securities and Exchange Commission (“SEC”) enforcement action for civil penalties against an investment...more

AGG Talks: Home Health & Hospice - Lessons Learned From ALJ Hospice Audit Appeals [Audio]

In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring is joined by Megan Turby and Lisa Barker, MD, of Gulfside Healthcare Services in Land O' Lakes, Florida. AGG represented Gulfside in a series of hospice...more

Momentum is Building: Another Federal Court Stops Recoupment During a ZPIC Appeal, Citing Backlog in Medicare Appeals Process as...

Medicare’s implementation of post-payment review through overly aggressive zone program integrity contractors (ZPICs) and unified program integrity contracts (UPICs), combined with an ineffective review process at the first...more

What’s Past Is Prologue: District Court Halts Medicare Recoupments After Fifth Circuit Rules That Courts Are Empowered to Halt...

Medicare’s implementation of post-payment review through overly aggressive private contractors, combined with an ineffective review process at the first two levels of the administrative appeal process (redetermination and...more

Fifth Circuit: District Courts Have Jurisdiction to Halt Medicare Recoupments Pending Administrative Appeal to Prevent Procedural...

Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with an ineffective review process at the first two levels of administrative appeal...more

AGG Helps Hospice Weather the Perfect Storm of Aggressive Medicare Payment Denials and Administrative Appeal Backlog

Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with a severe backlog of cases in queue for hearing before an Administrative Law Judge...more

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