Podcast - The New Rules of Healthcare Fraud Enforcement
The Down-Low on Data for Value-Based Enterprises and Their Participating Providers – Diagnosing Health Care Video Podcast
What's New with the False Claims Act?
AGG Talks: Home Health & Hospice Podcast - Episode 9: The Impact of AI and Prior Authorizations on Home Health and Hospice
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Business Better Podcast Episode: 2024 Advance Notice: Proposed Changes to the Medicare Advantage Risk Adjustment Model
Video: Record-Shattering Year for FCA Recoveries in Health Care - Thought Leaders in Health Law
Hooper, Kearney and Macklin on Cutting Edge Topics in the False Claims Act
Hospice Audit Series: The Latest Developments and Strategies for Success in the Ever-changing Audit Landscape
Podcast: IP(DC): Drug Prices, Political Pressures & Patents
Reforming prior authorization processes has been on the regulatory menu for a while. Both patients and providers have argued that prior authorization is a complex and burdensome process that too often results in patients...more
2026 has opened with unmistakable signals that False Claims Act (“FCA”) enforcement in the health care sector is accelerating. On January 16, 2026, the Department of Justice (“DOJ”) announced a record-breaking $6.8 billion in...more
I was sitting with a model of care (MOC) recently — not skimming it, actually reading it — and it brought back a conversation I had with a colleague that I have not been able to shake....more
False Claims Act (FCA) enforcement in healthcare is accelerating, and providers cannot afford to wait to react until after the government comes calling. In this episode of "Counsel That Cares," litigation attorneys Meredith...more
Few sectors are more consistently in the crosshairs of congressional oversight than healthcare. In the 119th Congress, Republican committee chairs have pursued investigations into group purchasing organizations (GPOs),...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
In last week’s Regs & Eggs post, we discussed one notable proposal from the Centers for Medicare & Medicaid Services’ (CMS’s) fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule: the proposed...more
On April 10, 2026, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule, setting out the agency's intent to expand the Hospital...more
UnitedHealthcare (UHC) promises to exempt roughly 1,500 rural hospitals and all critical access hospitals from most prior authorization requirements across all lines of business by the end of 2026. ...more
Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more
In a recent ruling out of the District of Minnesota, a federal magistrate judge directed UnitedHealthcare (UHC) to turn over an expansive set of documents in the class action Estate of Lokken v. UnitedHealth Group, Inc.,...more
On April 21, 2026, in a “Hearing on Protecting Patients and Taxpayers: Cracking down on Medicare Fraud,” the House Ways & Means Committee received testimony on hospice and home health fraud from Sheila Clark, President and...more
On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule that would require faster prior authorization (“PA”) decisions, expand electronic PA to drugs, and increase transparency...more
On April 10, 2026 (and officially published in the Federal Register on April 14, 2026), CMS published a proposed rule that would expand electronic prior authorization requirements, modernize HIPAA transaction standards, and...more
The Centers for Medicare & Medicaid Services (CMS) has been busy lately serving up regs. Regs & Eggs certainly has a lot to chew on going forward as, just last week, the agency released new proposed rules around the Medicare...more
A panel of former federal prosecutors and current health care law practitioners identified key trends in health care enforcement by the Trump administration at the ABA White Collar Crime Institute in March 2026. These trends...more
In anticipation of the CY2027 bid deadline, CMS released both the CY2027 final rule for Medicare Advantage (“MA”) and Medicare Part D (the “Final Rule”) as well as the CY2027 MA Capitation Rates and Part C and Part D Payment...more
Two recent announcements from the Centers for Medicare & Medicaid Services (CMS) continue to signal the Trump administration’s approach to the Medicare Advantage (MA) program, building on trends first seen in the Contract...more
Both the House and Senate have been in recess for the last two weeks. While lawmakers have been out of town, focus has remained on funding the US Department of Homeland Security....more
In February 2026, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) issued its highly anticipated Industry Compliance Program Guidance for Medicare Advantage (MA ICPG), the first such...more
Recent changes to the Medicare Diabetes Prevention Program (“MDPP”) are in sync with recent Centers for Medicare and Medicaid Services (“CMS”) initiatives to utilize technology to make healthcare services more accessible and...more
The Centers for Medicare & Medicaid Services (CMS) has issued its Advance Notice and related rulemaking for the Medicare Advantage (MA) and Part D programs for plan year 2027. ...more