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Reporting Requirements False Claims Act (FCA)

WilmerHale

Cybersecurity in the First 100 Days

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This week, the Trump Administration reached the 100-day mark—a significant milestone in any presidential term wherein key administrative priorities and objectives are promulgated. Perhaps unsurprisingly, cybersecurity stands...more

Akin Gump Strauss Hauer & Feld LLP

Trump Administration Issues Executive Order Increasing Oversight of Foreign Funding at Universities

On April 23, 2025, President Donald Trump signed an Executive Order (EO) entitled “Transparency Regarding Foreign Influence at American Universities” and issued an accompanying Fact Sheet. The EO rekindles initiatives from...more

Frantz Ward LLP

Changes to Medicare Reporting Requirements for Workers’ Compensation Settlements

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Federal law requires employers to consider Medicare’s potential interests when settling a workers’ compensation claim with a Medicare beneficiary. The foregoing generally involves the use of a Workers’ Compensation Medical...more

Oberheiden P.C.

Serving as a Procurement Fraud Whistleblower: What Evidence Do You Need?

Oberheiden P.C. on

Whistleblowers play a key role in the federal government’s ongoing fight against procurement fraud. Government procurement fraud is extraordinarily costly; and, despite the government’s vast resources, detecting procurement...more

Lathrop GPM

Dept. of Education Certification Requirement Tied to “Antidiscrimination Obligations” for Continued K-12 Federal Funding

Lathrop GPM on

On April 3, 2025, the U.S. Department of Education (ED) issued a press release announcing the ED sent certification letters to state commissions that oversee K-12 State Education Agencies (SEAs), charging SEAs with the...more

Laughlin, Falbo, Levy & Moresi LLP

A NEW MEDIC-ERA; Changes to CMS Review Guidelines in 2025

Vast changes are swiftly approaching regarding the efforts Workers’ Compensation practitioners must make in protecting Medicare’s interests in future medical settlements. The Centers for Medicare/Medicaid Services (CMS) has...more

Foley Hoag LLP - White Collar Law &...

New Massachusetts Healthcare Law Targets Private Equity, REITs, and MSOs; Expands State False Claims Act

On January 8, 2025, Governor Maura Healey signed House Bill 5159 into law, toughening the rules and increasing the risks for private equity (PE) companies, real estate investment trusts (REITs), and management services...more

Seyfarth Shaw LLP

The New Administrative False Claims Act: Key Amendments and Implications

Seyfarth Shaw LLP on

On December 23, 2024, the Servicemember Quality of Life Improvement and National Defense Authorization Act (NDAA) for Fiscal Year 2025 (FY 2025 NDAA) (P.L. 118-159) was signed into law. Among its numerous provisions, the FY...more

Verrill

Massachusetts Enacts Largest Health Care Transactions and Financial Oversight Legislation In a Decade, Private Investors and...

Verrill on

Health care sector stakeholders take notice: On January 8, 2025, Massachusetts Governor Healy signed sweeping new health care legislation with transactional, financial, and ongoing operational compliance ramifications for...more

Kaufman & Canoles

Medicare’s 60-Day Rule

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The Centers for Medicare & Medicaid Services (CMS) finalized significant updates to the Medicare 60-Day Rule, which governs how providers and organizations must handle overpayments. Taking effect January 1, 2025, these...more

Proskauer - Health Care Law Brief

CMS Publishes Final Rule, Effective January 1, 2025, Addressing the Requirements for Reporting and Returning Overpayments

The standard for an “identified overpayment” under Medicare Parts A–D now aligns with section 1128J(d)(4)(A) of the Social Security Act, which incorporates by reference the Federal False Claim Act’s (the “FCA”) “knowledge”...more

Sheppard Mullin Richter & Hampton LLP

Massachusetts Expands Oversight of Private Equity Investment in Healthcare: Key Takeaways from House Bill 5159 Signed into Law by...

On January 8, 2025, Massachusetts Governor Maura Healey signed House Bill 5159 (“H.5159”) into law, marking a notable expansion of the regulation of private equity investments within the Massachusetts healthcare sector. The...more

McGuireWoods LLP

Massachusetts Tightens Healthcare Transaction Oversight, Focuses on Healthcare Investors

McGuireWoods LLP on

On Jan. 8, 2025, Massachusetts Gov. Maura Healy signed “An Act Enhancing the Market Review Process” (the Act). The Act increases regulatory reporting obligations and oversight of healthcare transactions involving private...more

Eversheds Sutherland (US) LLP

Unclaimed property hot topics: What to expect in 2025

Pivotal litigation, targeted legislation, and aggressive regulatory interpretations will reshape the unclaimed property landscape for US companies in 2025. States continue to expand the application and enforcement of their...more

Foley & Lardner LLP

Massachusetts: New Year, New Law — Governor Signs “An Act enhancing the market review process” (House Bill No. 5159)

Foley & Lardner LLP on

On January 8, 2025, Governor Maura Healey signed into law H.B. 5159, “an Act enhancing the market review process.” This new law promises sweeping reform to reshape how health care businesses operate and grow...more

McDermott Will & Emery

Massachusetts H.5159 Seeks to Reshape Private Equity in Healthcare

McDermott Will & Emery on

On December 30, 2024, both the Massachusetts House of Representatives and the Massachusetts Senate enacted House Bill 5159 (H.5159), and Governor Maura Healey signed it on January 8, 2025. The bill seeks to strengthen...more

Bass, Berry & Sims PLC

Athira Pharma Inc. Agrees to Settle False Claims Act Allegations

Bass, Berry & Sims PLC on

On January 6, the Department of Justice (DOJ) announced that Athira Pharma Inc., a Washington-based biopharmaceutical company, agreed to pay over $4 million to settle allegations it violated the False Claims Act (FCA). The...more

Burr & Forman

Failure to Return Credit Balances (Especially to Medicare and Medicaid) Can Create Significant Liability

Burr & Forman on

Every health care provider has “credit balances,” which occur when a provider receives more money than it is owed for services rendered. Credit balances can be caused by a number of factors, including incorrect coding,...more

Bass, Berry & Sims PLC

Massachusetts HB5159 Expands Oversight of Private Equity Investment in the Health Care Industry

Bass, Berry & Sims PLC on

On January 8, the governor of Massachusetts signed House Bill 5159 into law (Law). At a high level, the new Law expands Massachusetts’ existing health care transaction notice process and implements new reporting and oversight...more

Kilpatrick

Recent Changes in Appropriations Legislation May Have Given "Baby False Claims Act" New Teeth

Kilpatrick on

On December 23, 2024, President Biden signed into law H.R. 5009 - “Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025.” (2025 NDAA). First passed in 1961, the NDAA is a...more

Ropes & Gray LLP

Massachusetts Passes Act Implementing Broad Oversight into For-Profit Investment in Health Care

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On January 8, 2025, Massachusetts Governor Maura Healey signed House Bill 5159, An Act Enhancing the Market Review Process (the “Act”) into law, effective April 8, 2025. The Act is a compromise redraft of the separate health...more

Mintz - Health Care Viewpoints

It’s Been a Long Time Coming: Massachusetts Health Care Market Review 2.0

The latest entrant in a national wave of policymakers enacting health care market oversight laws that have a significant impact on providers and investors, Massachusetts Governor Maura Healey has signed into law House Bill...more

Troutman Pepper Locke

New Year, New Liability for Private Equity

Troutman Pepper Locke on

Private equity firms and health care companies operating in Massachusetts will now face enhanced liability risks following the recent passage and enactment of legislation regulating private equity investment in Massachusetts...more

Skadden, Arps, Slate, Meagher & Flom LLP

ESG: A Review of 2024 and Key Trends To Look for in 2025

In this article, we reflect on key trends in ESG over the second half of 2024 and look ahead at trends that may emerge in 2025. We analyze developments in the latter half of 2024, which were similar to those highlighted in...more

Whiteford

Navigating New Medicare Overpayment Rules and Practical Tips to Comply

Whiteford on

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the Medicare regulations interpreting the federal 60-day overpayment refund requirement (the Overpayment Statute) for Medicare Parts A and B as...more

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