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FAQs: An Essential Guide for Healthcare Leaders Navigating FTC’s Non-Compete Ban

The Federal Trade Commission’s April 23 final rule banning most non-competes for workers in the United States, including clinical and non-clinical employees in the healthcare industry, undoubtedly will raise questions from...more

A View From the Top: Brent Korte of Frontpoint Health

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

CMS Again Settles Record Stark Self-Disclosures in 2023

The Centers for Medicare & Medicaid Services (CMS) recently released data on its 2023 settlements of voluntary self-disclosures related to past violations or potential violations of the physician self-referral law (the Stark...more

OIG Plans New Guidance for Medicare Advantage and Nursing Homes

In its General Compliance Program Guidance (GCPG) issued in November 2023, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) announced its intent to publish industry segment-specific...more

Indiana Becomes Latest State to Enact Mandatory Reporting of Healthcare Transactions

On March 13, 2024, Indiana Gov. Eric Holcomb signed into law Senate Bill No. 9, which requires Indiana healthcare entities and private equity firms to notify the Office of the Indiana Attorney General of qualifying...more

A View From the Top: Joel Theisen of Lifespark

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

Ounce of Prevention: Are Independent Contractor Agreements Signed?

Applicable Provider Types: All - Is Your Entity in Compliance? Financial relationships with an independent contractor in a position to make or influence referrals of federal healthcare program business can implicate...more

A View From the Top: Cara Reymann of First Fertility

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

A View From the Top: Teira Gunlock of First Stop Health

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

OIG’s New Compliance Guidance: 10 Action Items and Six Themes for Providers

On Nov. 6, 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued the General Compliance Program Guidance (GCPG) for healthcare providers and other industry stakeholders. The GCPG...more

A View From the Top: Peter McCann of Growth Orthopedics

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

A Failed Constitutional Challenge to the AKS Safe Harbor Provision – More to come?

This past summer, in United States v. Booker, a North Carolina district court ruled against a challenge to the constitutionality of Congress’s delegation of authority to promulgate safe harbors to the Anti-Kickback Statue...more

The Growing Causal Divide: But-For Causation in AKS/FCA Actions

In United States v. Regeneron, the District of Massachusetts Court recently joined the Sixth and Eighth Circuits in requiring the government to show a direct tie between kickbacks and referrals that proximately caused claims...more

$12M Default Judgment Results from Purchasing Prescriptions

A large damage award serves as a significant reminder to file an appearance in a False Claims Act (FCA) case. In late August of 2022, the Government filed suit against AZ Diabetic and the owner, Hisham Zaghal (Zaghal),...more

A View From the Top: Rich Goode of Urology America

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

Lessons for Providers and Practice Entities: Ophthalmology Groups Pay Millions to Settle Co-Management, Optometrist Relationship...

Recently, two ophthalmology practice groups — Kleiman Evangelista Eye Centers of Texas (KEEC) and SouthEast Eye Specialists, PLLC (SEES) — reached large settlements with the U.S. government over allegations that the groups’...more

HHS Advisory Opinion Approves Profit-Based Bonus Plan for Bona Fide Physician Employees

On Oct. 13, 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 23-07 approving a multispecialty physician practice’s proposal to pay bonuses to each of its...more

A View From the Top: Scott Mayer and Josh Gantz of Ambulatory Management Solutions

The interview below is part of a McGuireWoods series featuring interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future interview, email Holly Buckley at...more

DOJ Settles Self-Reported Referral Incentives With Dermatology Practice Manager

On Sept. 13, 2023, the U.S. Attorney’s Office for the Northern District of Texas announced a settlement with Oliver Street Dermatology Management LLC. Oliver Street agreed to pay the United States $8.892 million to resolve...more

CMS Settles Record Number of Stark Self-Disclosures

The Centers for Medicare & Medicaid Services (CMS) recently released data on its 2021 and 2022 settlements of voluntary self-disclosures related to past violations or potential violations of the physician self-referral law...more

Private Equity in Healthcare – An Updated Review of Selected Niche Investment Areas

Since mid-2022, the macro acquisition environment has faced the challenges of inflation and increasing interest rates, among a variety of other headwinds. Global deal flow is down from its 2021 peak. Yet, as this white paper...more

Eleventh Circuit Affirms Order for $1.195 Million in Restitution and 48 Month Sentence in Commercial Insurance Healthcare Fraud...

Last month, the Eleventh Circuit upheld a $1.195 million restitution order and 48-month sentence against Carlos Verdeza for three counts of healthcare fraud. See United States v. Verdeza, No. 21-10461, 2023 WL 3728960 (11th...more

Regional Hospital System and Two Physicians Pay More Than $69 Million to Settle False Claims Act, Involving Allegations of...

On March 29, 2023, the U.S. District Court for the Eastern District of Michigan granted the parties’ joint stipulation for dismissal in U.S. ex. rel. Godsholl v. Covenant Healthcare, following three settlements of the...more

HHS Language Access Progress Report – OCR Will Hold Providers to the “Highest Bar”

On May 24, 2023, the U.S. Department of Health and Human Services (HHS) released its first Language Access Annual Progress Report (the Report) reflecting on its advancements since the 2022 HHS Equity Action Plan (Equity Plan)...more

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