The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Transparency and the Open Payments Program
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Behind the Curtain: Enhanced Provider Enrollment Oversight
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Inflation Reduction Act’s Drug Price Negotiation Provisions – What Now? – Diagnosing Health Care Podcast
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Podcast: Inflation Reduction Act’s Drug Price Negotiation Provisions – What’s Next? - Diagnosing Health Care
Quick Takeaways From the 2024 Proposed Hospice Wage Index Rule
Public companies should take note of several recent developments, including: ..Reversal of the Pegasystems trade secrets lawsuit that nevertheless preserves guidance to take care when describing litigation as “without...more
The House of Representatives aims to keep the U.S. at the leading edge of AI policy and innovation with a bipartisan task force while the FTC considers expanding a rule to crack down on AI impersonation. Meanwhile, a recent...more
After the Department of Justice (“DOJ”) announced its Civil Cyber-Fraud Initiative in October 2021, many in the False Claims Act (“FCA”) bar expected an onslaught of enforcement actions and qui tam cases. The initiative...more
This newsletter provides updates employers should be aware of heading into 2024, including an outline of the updated 2024 retirement and welfare plan limits, instructions related to the “gag order” attestation requirements...more
The Cozen Lens- • Members of Congress have returned to Washington with a lengthy to-do list. Most pressing is appropriations given the potential for a government shutdown at the end of this month. Lawmakers will address...more
DOJ Enters Into DPAs with Former Deerfield Traders and CMS Consultant - On July 24, 2023, the US Department of Justice (DOJ) entered into deferred prosecution agreements with Theodore Huber and Robert Olan, former traders...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for June 2023. We discuss several civil enforcement actions involving false claims, the Anti-Kickback Statute (AKS) and...more
I. WHY THIS CASE MADE THE LIST - A highly publicized and long-running multi-agency action against the former Chief Executive Officer and the former Chief Operating Officer of Theranos Inc. resulted in criminal convictions...more
On December 27, 2022, the Second Circuit called into question the government’s theory of insider trading of confidential government agency information, potentially undercutting the DOJ’s enforcement of various white-collar...more
On December 27, 2022, in United States v. Blaszczak (“Blaszczak II”), the U.S. Court of Appeals for the Second Circuit called into question what constitutes “property” in cases of securities fraud, wire fraud and theft of...more
A divided panel of the U.S. Court of Appeals for the Second Circuit held, on December 27, 2022, in United States v. Blaszczak (“Blaszczak II”) that an agency’s confidential, pre-decisional information did not count as...more
The Cozen Lens- •Governor Ron DeSantis (R-FL) is running for reelection this year. But all eyes are on what he does two years later, as DeSantis presents the most formidable challenge to a third presidential election cycle...more
Two separate, recent lines of cases have continued to shape the circumstances under which insider trading prosecutions can be brought, and as a result, the insider trading compliance risks faced by companies. First, the...more
Where’s the Beef? Two Charged with $650 Million Cattle Ponzi Scheme - On May 12, the Department of Justice (DOJ) announced that a federal district court in Colorado unsealed an indictment alleging that two individuals ran...more
The question of what constitutes insider trading has been litigated for decades. Many thought that a series of Supreme Court cases such as Dirks v. SEC, 462 U.S. 646 (1983) and its progeny had largely resolved the question...more
On January 11, 2021, the U.S. Supreme Court vacated the 2019 decision of the U.S. Court of Appeals for the Second Circuit in United States v. Blaszczak, which substantially broadened the scope of criminal insider trading...more
The COVID-19 pandemic has stressed the M&A market at every stage of the deal-making process – from complicating on-site visits and intensifying the diligence process to introducing valuation gaps (relative to pre-COVID-19...more
Below, please find a summary of the federal government’s response to the COVID-19 pandemic since our last update (Thursday, June 18) – including today’s proclamation by President Trump to extend and expand COVID-19 related...more
Below, please find a summary of today’s federal government activities in response to COVID-19. Congress - During today’s Senate Small Business Committee hearing on CARES Act small business lending programs, Ranking...more
The CARES Act adds $100 billion to the “Public Health and Social Services Emergency Fund” to reimburse “eligible health care providers” for “health care-related expenses or lost revenues that are attributable to Coronavirus.”...more
The CARES Act establishes a $500 billion loan program accessible by cities, states, and businesses, while also providing for more than $250 billion in direct funding to state and local governments. The majority of the direct...more
On April 10, the Internal Revenue Service published responses to frequently asked questions with respect to the payroll tax deferral provisions of the CARES Act, including clarification that employers that take loans under...more
With the passage of the CARES Act, $100 billion has been appropriated to the Public Health and Social Services Emergency Fund (“PHSSEF”), to be administered by a small agency within the Department of Health and Human Services...more
In this time of crisis, nonprofits of all shapes and sizes have been scrambling to obtain assistance under the federal CARES Act. Sheppard Mullin’s Nonprofit Team is grateful for the special opportunity to help by partnering...more
On March 27, 2020, Congress passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, which authorized $2.2 trillion to, among other things, help companies and individuals mitigate the financial repercussions...more