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Sheppard Mullin Richter & Hampton LLP

Special Fraud Alert: Suspect Payments in Marketing Arrangements Related to Medicare Advantage and Providers

Yesterday, the OIG released a Special Fraud Alert related to: (1) marketing arrangements between Medicare Advantage Organizations (“MAOs”) and health care professionals (“HCPs”), and (2) arrangements between HCPs and MA plan...more

K&L Gates LLP

RWI in Health Care M&A: Part 1

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In part one of this two-part series, Matt Miller and Andrew Lloyd analyze representations and warranties insurance (RWI) in the health care M&A landscape. They discuss the benefits of RWI for buyers and sellers, policy...more

Blank Rome LLP

Exploring Consolidation and Private Equity Investment in Physician Practice Management

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Episode 12: Exploring Consolidation and Private Equity Investment in Physician Practice Management - In this episode of BRight Minds in Healthcare Delivery, host Eric Tower interviews Robert Aprill, a partner at Physician...more

Ropes & Gray LLP

CMS Issues Final Rules for Medicare Parts A and B Overpayments: Key and Lingering Questions

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In November 2024, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule addressing, among other things, the Medicare Parts A and B overpayment provisions of the Affordable Care Act (the “Final Rule”). It...more

Ropes & Gray LLP

OIG Issues Special Fraud Alert on Medicare Advantage Marketing Arrangements

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On the heels of recent scrutiny of health care professional (“HCP”) arrangements with brokers and agents and Medicare Advantage Organization (“MAO”) arrangements with providers, including through the U.S. Department of...more

Goldberg Segalla

New York Enacts New Law for Workers Facing Job-Related Mental Injury

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Under S.6635/A.5745: Where a [worker] files a claim for mental injury premised upon extraordinary work-related stress incurred at [work], the board may not disallow the claim upon a factual finding that the stress was not...more

Orrick, Herrington & Sutcliffe LLP

The Sunshine Act: 10 Things to Know

For some companies that make and distribute medical devices and drugs, and for group purchasing organizations (GPOs), reporting financial information to the U.S. government has become a regular part of doing business. The...more

Dinsmore & Shohl LLP

Is the End Near? Medicare Telehealth Flexibilities Set to Expire at the End of the Year

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The temporary telehealth flexibilities that Medicare patients and providers have become accustomed to since the COVID-19 pandemic are set to expire December 31, 2024. The Consolidated Appropriations Act of 2023 extended many...more

Kerr Russell

New Michigan Legislation Aims to Unravel Medical Liability Reform

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Over the past 30 years, the Michigan legislature has enacted several tort reform laws affecting medical malpractice, wrongful death and other personal injury cases. The goals of these reform laws, and particularly those...more

Baker Donelson

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

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On December 9, 2024, the Centers for Medicare & Medicaid Services' (CMS's) Calendar Year 2025 Physician Fee Schedule Final Rule (the Final Rule) was published in the Federal Register. The Final Rule includes noteworthy...more

Arnall Golden Gregory LLP

OIG Updates Compliance Guidance for Nursing Facilities

In 1998, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services began issuing voluntary, compliance program guidance for various segments of the healthcare industry. Recently, the OIG has...more

Robinson+Cole Data Privacy + Security Insider

OCR Active with Settlements and Enforcement Actions in November and Early December

The Office for Civil Rights of the Department of Health and Human Services (OCR) was busy negotiating and settling enforcement actions in November and early December. Since October 31, 2024, the OCR has settled five separate...more

Dentons

Ep. 43 – Incorporating Routine Compliance Reports Into Your Board Meetings

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As the ultimate decision-maker for your organization, your governing body needs to understand compliance and appreciate the compliance risks facing the organization as well as what is needed to mitigate those risks. This...more

Stotler Hayes Group, LLC

Avoiding Transfer Penalties: How to Identify Successful Strategies to Remove Penalties on Medicaid Eligibility for the Skilled...

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Medicaid is the primary payer for 63% of nursing facility residents, propping up a large part of the industry’s funding. ...more

Foley & Lardner LLP

Antibody Drug Conjugates Keep Growing: What You Need to Know

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What Are ADCs and Why Are They Growing? Over the past few years economic headwinds have resulted in fewer deals, with companies and private equity firms alike reassessing where to spend money. But one portion of the...more

DLA Piper

CMS Releases New Proposed Rule for Medicare Advantage and Part D

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On December 10, 2024, the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule for revisions to the regulations governing the Medicare Advantage (MA) program, Medicare Prescription Benefit (Part D),...more

Bergeson & Campbell, P.C.

Senate Subcommittee Holds Hearing on Public Health Impacts of PFAS Exposures

On December 5, 2024, the Senate Environment and Public Works (EPW) Subcommittee on Chemical Safety, Waste Management, Environmental Justice, and Regulatory Oversight held a hearing on “Examining the Public Health Impacts of...more

Morgan Lewis - ML Benefits

Despite Challenges to Reproductive Healthcare Privacy Final Rule, Plan Sponsors Should Still Comply by December 23

The US Department of Health and Human Services’ (HHS) final rule on reproductive healthcare privacy is already subject to challenge even before its effective date. As described in our previous blog post, the HHS issued final...more

McDermott+

No Surprises Act Implementation Under the Trump Administration

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The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law passed...more

Steptoe & Johnson PLLC

Participation in Clinical Trial is FMLA-Protected, DOL Says

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On November 8, the Department of Labor (DOL) issued an opinion letter addressing an interesting question under the Family and Medical Leave Act (FMLA): Can an employee take FMLA leave to participate in a clinical trial for...more

Sheppard Mullin Richter & Hampton LLP

Is the Supreme Court Likely to Narrow Scope of Federal Fraud in Kousisis v. United States?

On December 9, 2024, the U.S. Supreme Court heard oral argument in Kousisis v. United States, a case that asks the Supreme Court to significantly narrow the scope of what behavior constitutes a federal criminal fraud....more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - December 2024 #1

News Briefs - FDA Guidelines Require TV Drug Ads to Be Simpler, More Direct - Those ever-present TV drug ads showing patients hiking, biking, or enjoying a day at the beach could soon have a different look: New rules require...more

Alston & Bird

2024 Health Benefits Year: A Year to Remember

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The year was packed with developments for health and welfare benefits plans. Our Health Benefits Team reviews 2024, from new data privacy rules to disaster tax relief....more

Cozen O'Connor

OSHA’s Safety and Health Tips for the Holiday Season

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OSHA’s website recently added advice to employers, particularly in retail and warehousing, to help keep their employees safe this holiday season and linked a video on the Department of Labor’s YouTube page containing nine...more

Array

This Week in eDiscovery: Data Growth Survey Findings | EDNY Refuses “Discovery on Discovery” | Cooperative eDiscovery

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Every week, the Array team reviews the latest news and analysis about the evolving field of eDiscovery to bring you the topics and trends you need to know. This week’s post covers the period of December 1-7. Here’s what’s...more

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