Hospice Insights Podcast - What's Good and Bad in Hospice Right Now: A Conversation with Greg Grabowski, Partner at Hospice Advisors
Strategic Restructuring for the Future - Think Before You Sign: Five Key Insights for VBID and Managed Care Contracts
Health Care Enforcement: The Impact on Private Equity Investments
Why Health Care Providers Need A Managed Care Strategy
The Justice Department has increased False Claims Act prosecutions, reflecting a continued focus on healthcare fraud and a new initiative on trade fraud....more
Healthcare fraud continues to plague providers, managed care, and drug companies. $5.7 billion of the $6.8 billion recovered by DOJ was generated from the healthcare industry. There is a bottomless pit of possible targets....more
Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more
The Superior Court of Delaware, applying Delaware law, has held that a federal civil investigative demand (“CID”) issued by the Department of Justice (“DOJ”) qualified as a “Claim” under a managed care errors and omissions...more
Insight, innovation, and practical strategy for professionals in the managed care space - Compliance professionals in managed care face an ever-changing landscape shaped by evolving regulations, emerging risks, and...more
The New York Attorney General’s Office imposition of a $250,000 penalty on MVP Health Care for maintaining an inaccurate mental health provider directory riddled with “ghost” providers. The problem, however, extends beyond...more
Navigate the current enforcement landscape with expert guidance - The Healthcare Enforcement Compliance Conference brings together experienced attorneys and consultants, compliance professionals, and leading experts in...more
On September 9, 2025, CMS issued a guidance letter on Section 71116 of the One Big Beautiful Bill Act, which became effective for Medicaid managed care rating periods beginning on or after July 4, 2025. The provision requires...more
For over a decade, the two-midnight rule has served as an important determinant of whether a hospital inpatient stay is reimbursable by Medicare, as well as a measure of protection for hospitals that treat patients over...more
Among the many sweeping changes to the Medicaid program included in the One Big Beautiful Bill Act (“OBBBA”), Congress established new statutory caps on state-directed payments (“SDPs”) in Medicaid managed care. SDPs have...more
The healthcare mergers and acquisitions (M&A) market remained active in Q2 2025, with several sectors including physician practice management (PPM), clinical research, and digital health experiencing continued investment and...more
The One Big Beautiful Bill Act (P.L.119-21) (the “OBBB”) passed by slim margins in the U.S. Senate (51-50) and U.S. House (218-214) and was signed into law by President Trump on July 4, 2025....more
Within the first six months of President Trump’s second term, his Administration and the GOP have already implemented significant policies that are reshaping health care in the United States. Through his Administration’s...more
The healthcare mergers and acquisitions (M&A) market began 2025 with a slower start than expected given the easing headwinds and building momentum at the end of last year, with the number of deals reported in Q1 lower than...more
Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more
In a significant development for fiscal intermediaries (FIs) and the Consumer Directed Personal Assistance Program (CDPAP), a New York Supreme Court Justice ruled on March 20, 2025, that the New York State Department of...more
Bass, Berry & Sims is pleased to announce the release of the 13th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2024. Compiled by the firm's Healthcare Fraud & Abuse Task Force,...more
Greenbaum healthcare attorneys Neil M. Sullivan and Jennifer A. Belardo analyze the CMS’s Medicaid and Children’s Health Insurance Program (CHIP) Managed Care final rule – and its impact on states, healthcare providers, and...more
In this episode, Husch Blackwell’s Meg Pekarske is joined by long-time hospice friend and industry guru Greg Grabowski. They turned the microphone on their usually private (but always lively) discussions on what’s going on in...more
The Centers for Medicare & Medicaid Services (CMS) on Sept. 20, 2024, released the Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program (CMS-2434) Final Rule....more
Focused education for compliance professionals in the managed care space - If your role involves compliance for a health plan provider, don’t miss our annual education and networking opportunity devoted specifically to...more