The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-07 (the “Opinion”), to a nonprofit tax-exempt grant-making...more
In this episode, AGG Healthcare attorneys Lisa Churvis and Alan Horowitz discuss critical aspects of nursing home staffing requirements. Lisa and Alan delve into the implications of recent legislative proposals and regulatory...more
Ending 40 years of judicial deference to administrative agencies’ interpretations of ambiguous statutes governing them, the Supreme Court of the United States finally pulled the plug on this experiment that it, just five...more
7/23/2024
/ Administrative Agencies ,
Administrative Authority ,
Administrative Procedure Act ,
Affordable Housing ,
Chevron Deference ,
Chevron v NRDC ,
Fair Housing Act (FHA) ,
Government Agencies ,
HUD ,
Loper Bright Enterprises v Raimondo ,
SCOTUS ,
Statutory Interpretation ,
Urban Planning & Development ,
USDA
Ending 40 years of judicial deference to administrative agencies’ interpretations of ambiguous statutes governing them, the Supreme Court of the United States finally pulled the plug on this experiment that, just five years...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-02 (the “Opinion”) to a nonprofit organization that provides...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more
3/14/2024
/ Anti-Kickback Statute ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Hospitals ,
Insurance Industry ,
Medicare ,
Medicare Beneficiaries ,
Medigap ,
OIG ,
Preferred Hospital Networks Arrangement ,
Social Security Act
AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more
A New Jersey hospice provider must continue its long fight against whistleblowers alleging it violated the False Claims Act (“FCA”) by seeking Medicare reimbursement for patients whose documentation did not support hospice...more
The U.S. Centers for Medicare & Medicaid Services (“CMS”), the agency that administers the Medicare hospice benefit, has announced increased scrutiny of hospice programs in the wake of growing concerns over hospice service...more
AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more
Does legislation enacted pursuant to Congress’s Spending Clause power give rise to rights privately enforceable via 42 U.S.C. § 1983? If so, do provisions regarding medication and transfer in the Federal Nursing Home Reform...more
Over the last three decades, the OIG has developed a series of voluntary compliance program guidance documents (“CPGs”) directed at various segments of the healthcare industry, such as hospitals, nursing homes, and hospices....more
Texas Medical Association (“TMA”) and LifeNet Inc. are expanding their fight over the regulations implementing the No Surprises Act (“NSA”). The NSA protects patients from surprise medical bills when they receive...more
The Medicare Payment Advisory Commission (“MedPAC”) will hold a public virtual meeting on December 8, 2022, to assess payment adequacy and updating payments for hospice services. By law, each year MedPAC reviews Medicare’s...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 22-17, analyzing the proposed restructuring of financial relationships...more
The Eleventh Circuit recently clarified the standard for deciding whether a plaintiff has engaged in a protected activity for purposes of successfully pleading a False Claims Act (“FCA”) retaliation claim. In Simon ex rel....more
The Department of Health and Human Services, Office of Inspector General (OIG) recently released a favorable advisory opinion, OIG Advisory Opinion No. 22-11 (the “Opinion”), analyzing the proposed employment of an individual...more
AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics.
In this edition, we analyze a recent Eleventh Circuit decision addressing False Claims Act penalties and the...more
2/28/2022
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Discount Pricing ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Government Investigations ,
Healthcare ,
Healthcare Fraud ,
Infectious Diseases ,
OIG ,
Paycheck Protection Program (PPP)
On January 19, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) released a favorable advisory opinion, OIG Advisory Opinion No. 22-01 (the “Opinion”), analyzing a proposed expansion of...more
2/15/2022
/ Advisory Opinions ,
Anti-Kickback Statute ,
Beneficiary Inducement ,
Civil Monetary Penalty ,
Customer-Loyalty Programs ,
Discount Pricing ,
Food & Drug Regulations ,
Low-Income Issues ,
Medicaid ,
Medicare Advantage ,
Medicare Part B ,
Medicare Part D ,
OIG ,
Patient Access ,
Pharmacies ,
Prescription Drug Coverage ,
Prescription Drugs ,
Remuneration ,
Sanctions ,
Statutory Interpretation