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The Volkov Law Group

DOJ Announces New West Coast Health Care Fraud Strike Force

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The Department of Justice (“DOJ”) continues to expand its aggressive health care fraud enforcement efforts with the announcement of a new West Coast Health Care Fraud Strike Force....more

Mintz - Health Care Viewpoints

OIG Focuses on Prevention in New Medicare Advantage Risk Adjustment Report

The Office of the Inspector General (OIG) continues to focus on Medicare Advantage (MA) risk adjustment payments, issuing a report this week detailing its audit of MA risk adjustment payments based on acute stroke diagnosis...more

King & Spalding

Department of Justice Announces FCA Settlement with Psychiatric Hospital Operator

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On May 27, 2026, the Department of Justice (DOJ) announced a False Claims Act settlement with psychiatric hospital operator Oglethorpe Inc. (Oglethorpe) and three executives resolving allegations that they violated the False...more

Skadden, Arps, Slate, Meagher & Flom LLP

MFN Drug Pricing and Impact on International Life Sciences Licensing Deals

The current U.S. administration’s most-favored-nation (MFN) drug pricing initiative raises numerous legal questions for life sciences companies that intend to sell drugs in the U.S. and abroad....more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - May 2026 #4

News Briefs - March Hospital Operating Margins Rebounded, Data Show - Hospitals are showing signs of stronger operational discipline in early 2026, but those gains have yet to translate into meaningful financial growth. While...more

King & Spalding

CMS Finalizes Updates to the Increasing Organ Transplant Access Model Ahead of Its Second Year in Operation

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On May 28, 2026, CMS published a final rule (Final Rule) updating and revising the Increasing Organ Transplant Access Model (the IOTA Model) for Performance Year (PY) 2 (and future performance years). The Final Rule, which...more

King & Spalding

CMS Finalizes Updates to the Increasing Organ Transplant Access Model Ahead of Its Second Year in Operation

King & Spalding on

On May 28, 2026, CMS published a final rule (Final Rule) updating and revising the Increasing Organ Transplant Access Model (the IOTA Model) for Performance Year (PY) 2 (and future performance years). The Final Rule, which...more

King & Spalding

CMS Finalizes Updates to the Increasing Organ Transplant Access Model Ahead of Its Second Year in Operation

King & Spalding on

On May 28, 2026, CMS published a final rule (Final Rule) updating and revising the Increasing Organ Transplant Access Model (the IOTA Model) for Performance Year (PY) 2 (and future performance years). The Final Rule, which...more

Fisher Phillips

Hospital Operator Agrees to Pay $32M Due to Medicare Overpayments: Here’s How Healthcare Companies Can Curb False Claims Liability

Fisher Phillips on

The Department of Justice recently ramped up healthcare fraud investigations and prosecutions and shows no intention of slowing down. Indeed, the DOJ’s recent settlement with Oglethorpe, Inc. and its top executives offers key...more

Sheppard

HHS Expands Use of AI in Detection of Healthcare Fraud

Sheppard on

The United States Department of Health and Human Services (“HHS”) announced at the end of May that it is expanding its use of AI to analyze the audit reports of states and other recipients of federal healthcare funding. This...more

Proskauer - Health Care Law Brief

West Coast Fraud and AI: DOJ Expands Healthcare Fraud Enforcement into Technology-Driven Markets

On April 30, 2026, the Department of Justice (“DOJ”) announced the creation of the West Coast Health Care Fraud Strike Force, a coordinated enforcement initiative focused on healthcare fraud in Arizona, Nevada, and Northern...more

Latham & Watkins LLP

Healthcare Life Sciences Drug Pricing Digest - June 2026

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Our Drug Pricing and Market Access team tracks recent developments in healthcare reform, the Medicaid Drug Rebate Program, the 340B Program, Medicare, and state law....more

Bass, Berry & Sims PLC

OIG Advisory Opinion 26-11: HHS Inspector General Approves Free Multi-Cancer Screening Report Under Anti-Kickback Statute and...

On May 20, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 26-11, concluding that it would not impose administrative sanctions against a precision oncology company...more

Holland & Knight LLP

H.R. 1 and Beyond: The CMS Proposal to Cap Medicaid State-Directed Payments at Medicare Rates

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President Donald Trump signed into law H.R. 1 on July 4, 2025, major budget reconciliation legislation often referred to as the "One Big Beautiful Bill Act" (Pub. L. 119-21), but which the Centers for Medicare & Medicaid...more

Foley & Lardner LLP

DMEPOS Competitive Bidding Structures: CMS Confirms Important Flexibility for Round 2028

Foley & Lardner LLP on

The Centers for Medicare & Medicaid Services’ (CMS) guidance issued on April 2, 2026, addressing the Round 2028 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Guidance)....more

Benesch

Dialysis & Nephrology Digest - May 2026

Benesch on

The LEAD Model-Kidney Care’s Value-Based Care Journey LEADs Here - CMS’s LEAD Model marks the next evolution in valuebased kidney care, integrating CKD and ESRD patients into a primary care-centered ACO framework. As CKCC...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - May 2026 #3

News Briefs - High Court Won't Hear Drug Manufacturer Price Negotiation Appeal - The Supreme Court declined to hear an appeal from six drug manufacturers that wanted the court to reject the Medicare Drug Price Negotiation...more

Seyfarth Shaw LLP

The Week in Weed: May 2026 # 4

Seyfarth Shaw LLP on

Welcome back to the Week in Weed, your Friday look at what’s happening in the world of legalized marijuana. This week, we find out Virginia Governor Spanberger’s reasons for vetoing the retail cannabis market bill. A hemp...more

Morgan Lewis - Health Law Scan

DOJ Forms West Coast Strike Force to Combat Health Care Fraud

The US Department of Justice (DOJ) has announced a significant expansion of its health care fraud enforcement efforts with the formation of the West Coast Health Care Fraud Strike Force. This initiative is spearheaded by the...more

McDermott+

CMS releases first serving of Medicaid regs: Medicaid state directed payments proposed rule

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We are about to sit down to a large meal of Medicaid regs, many of which stem from requirements included in the One Big Beautiful Bill Act (OBBBA)....more

Goodwin

2026 OIG Advisory Opinions: What Healthcare, Life Sciences, and Medtech Companies Need to Know

Goodwin on

There have been a number of notable developments coming out of the U.S. Department of Health and Human Services Office of Inspector General (OIG). So today, we wanted to take a step back and do a 2026 look back on some of the...more

King & Spalding

OIG Report Finds Ambiguous Medicare Requirements for Inpatient Rehabilitation Facilities Led to Noncompliance and Overpayments

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On May 14, 2026, the HHS Office of Inspector General (OIG) published a report finding that unclear Medicare requirements led to differing interpretations of inpatient rehabilitation facility (IRF) documentation, coverage, and...more

Shumaker, Loop & Kendrick, LLP

Client Alert: The Next Era of GLP-1s: Three Market Shifts to Note

In 2026, the U.S. prescription drug market is predicted to exceed $1 trillion for the first time, and the growth of glucagon-like peptide-1 (GLP-1) drugs are one of the primary reasons. Driven by new regulatory changes and...more

Mandelbaum Barrett PC

New Medicaid Work Requirements: What Older Adults and Families Need to Know

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In 2025, Congress passed a sweeping federal spending law widely referred to as the “One Big Beautiful Bill Act” (H.R. 1). Among its many provisions are significant changes to the Medicaid program, including the introduction...more

Husch Blackwell LLP

Hospice Insights Podcast - Bottom Line, Top of Mind: Compliance Checklists for Hospice and Home Health

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In hospice and home health, certain compliance problems can have a big impact on the organization’s bottom line—and ability to keep operating. Even seemingly minor issues can affect whether the organization will be fully paid...more

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