On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing efforts with respect to Medicare Advantage (“MA”) plans....more
Nearly two years ago, and as previously discussed in a Proskauer alert, New York enacted Public Health Law Article 45-A (the “Material Transactions Law”), which requires reporting of certain material health care transactions....more
4/9/2025
/ Acquisitions ,
Health Insurance ,
Healthcare ,
Healthcare Facilities ,
Hospitals ,
Mergers ,
New Guidance ,
New York ,
Physicians ,
Reporting Requirements ,
Threshold Requirements
SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management. As discussed in a...more
12/24/2024
/ Algorithms ,
Anti-Discrimination Policies ,
Artificial Intelligence ,
Audits ,
California ,
Centers for Medicare & Medicaid Services (CMS) ,
CMIA ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Medical History ,
Medicare Advantage Organizations (MAOs) ,
New Legislation ,
Personal Information ,
Physicians ,
Policies and Procedures ,
Software
On August 31, 2024, the California State Assembly and State Senate passed Assembly Bill 3129 (“AB 3129”). If signed by Governor Newsom, AB 3129 would establish a comprehensive transaction review law that (i) targets private...more
On April 22, 2024, the Office for Civil Rights (OCR) for the United States Department of Health and Human Services issued a Final Rule amending the Privacy Rule of the Health Insurance Portability and Accountability Act...more
6/24/2024
/ Attestation Requirements ,
Audits ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Dobbs v. Jackson Women’s Health Organization ,
False Claims Act (FCA) ,
Final Rules ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Privacy Rule ,
HIPAA Violations ,
Medicaid ,
Medicare ,
OCR ,
OIG ,
Patients ,
PHI ,
Popular ,
Reproductive Healthcare Issues ,
SCOTUS
As described in our blog post last year, an increasing number of states across the country are seeking to regulate physician practice management (“PPM”) and private equity transactions in the health care sector. As part of...more
On Tuesday, January 16, 2024, Governor Kathy Hochul released the SFY 2025 New York State Executive Budget (“Executive Budget”). While still subject to legislative approval, the Executive Budget incorporates the recently...more
2/5/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Health and Essential Rights (HERO) Act ,
Healthcare ,
Insurance Industry ,
MCOs ,
Medicaid ,
Mental Health ,
New Amendments ,
New York ,
Social Security Act ,
State Budgets ,
Value-Based Payments ,
Waivers
The U.S. Department of Health and Human Services (“HHS”) has expanded upon its recent Healthcare Sector Cybersecurity Concept Paper (which we covered in a prior blog post), issuing cybersecurity performance goals (“CPGs”) for...more
The U.S. Department of Health and Human Services (HHS) recently issued a strategy paper highlighting key aspects of its plan to revamp cybersecurity requirements in the healthcare industry. Citing a 93% increase in large data...more
12/8/2023
/ Cybersecurity ,
Department of Health and Human Services (HHS) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Legislative Agendas ,
National Security ,
New Guidance ,
OCR ,
Privacy Laws ,
Regulatory Agenda ,
Regulatory Requirements