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Is the Qui Tam A Sham?: Federal Judge Finds Qui Tam Enforcement of False Claims Act Unconstitutional

A recent federal court decision has the potential to significantly impact the future of False Claims Act (FCA) lawsuits initiated by whistleblowers and to upend the FCA. In United States of America ex rel. Clarissa Zafirov v....more

CMS Proposes Further Changes to Medicare Overpayment Rule

The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule, 89 FR 61596, that revives portions of a 2022 proposal to amend the Medicare Overpayment Rule. The 2024 proposed rule comes after...more

Washington DC Removes Collaboration Requirements for CRNAs

Certified registered nurse anesthetists (CRNAs) in Washington, DC can now practice without a collaborating physician following the DC legislature’s recent passing of Bill B25-0545, also known as the Health Occupations...more

Medicare Technology Standards for Prescribing Part D Drugs

The Centers for Medicare & Medicaid Services (CMS), the Office of the National Coordinator for Health Information Technology (ONC), and thr Department of Health and Human Services (HHS) published 89 FR 51238 (the Final Rule),...more

CMS Adopts New Age-Friendly Hospital Measure for Care of Older Adults for CY 2025 Reporting

The Centers for Medicare & Medicaid Services (CMS) has adopted an age-friendly quality hospital measure in its most recent final rule addressing prospective payment systems, policy changes, and quality program requirements...more

Privilege Denied When Facilities Fail To Comply With NJ Patient Safety Act

Two New Jersey healthcare facilities that violated the New Jersey Patient Safety Act, N.J.S.A. §§ 26:2H-12.23 to -12.25, (PSA), must provide plaintiff patients with internal reports and documents relating to adverse events,...more

CMS Updates Master List for DMEPOS

The Master List for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) comes from a November 2019 final rule that created the list to serve as a library of items that have been identified as potential...more

More Roadblocks For Information Blocking: HHS Finalizes Rule Establishing Disincentives for Hospitals, Clinicians, and ACOs

On July 31, 2024, the Department of Health and Human Services (HHS) final rule, 89 FR 54662, establishing disincentives for certain healthcare providers that have committed information blocking, will become effective. This...more

No Doubt, ‘Chevron’ Is Out; How Will This Impact Healthcare?

Through its recent decision in Loper Bright Enterprises v. Raimondo, No. 22-451 (S. Ct. June 28, 2024), the US Supreme Court overturned the landmark decision in Chevron U.S.A. Inc. v. Natural Resources Defense Council, Inc.,...more

New Jersey Statutory Update Part II

Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more

New Jersey Statutory Update Part I

Every year, the New Jersey legislature passes statutes that impact healthcare beyond rate increases under the Medicaid program. Last year was no different, and the discussion below highlights some of those statutes, such as...more

CMS Extends Medicaid Waivers through June 2025

In an informational bulletin, the Centers for Medicare & Medicaid Services (CMS) announced it will further extend waivers for “unwinding” under Section 1902(e)(14)(A) of the Social Security Act until June 30, 2025. The...more

FDA Expands Oversight to Laboratory Tests in Hospitals

The U.S. Food and Drug Administration (FDA) published a final rule amending its regulations to include in vitro diagnostic products (IVDs) as devices, even those manufactured in a laboratory, and issuing policy to phase out...more

New Jersey Regulatory Update Part II

Part II of our New Jersey Regulatory Update further identifies proposed and adopted regulations that may impact healthcare providers, from additional financial transparency rules impacting facilities to rules attempting to...more

New Jersey Regulatory Update Part I

It is that time of year for our regulatory update. Parts I and II will discuss proposed and adopted rules from the second half of last year to the first quarter of this year that impact healthcare providers in New Jersey,...more

What Does the GEICO Decision Mean for New Jersey Providers?

The Third Circuit Court of Appeals held in a recent precedential case that the court must compel arbitration between Government Employees Insurance Company (Geico) and several medical practices, which Geico had sued for fraud...more

FTC Votes to Ban Non-Compete Agreements: What Healthcare Organizations Need to Know

The Federal Trade Commission (FTC) approved a sweeping ban on non-compete agreements by employers on April 23, 2024, in a 3-2 vote. The final rule provides that it is “an unfair method of competition” and thus a violation of...more

Federal Rule to Establish Minimum Staffing Requirements for Long-Term Care Facilities

The contentious “Nursing Home Minimum Staffing Rule,” which sets minimum staffing requirements for federally funded long-term care facilities throughout the U.S., was finalized on April 22, 2024. The rule was initially...more

HHS Issues Final Rule Strengthening HIPAA Protections for Reproductive Healthcare

On April 22, 2024, the Department of Health and Human Services (HHS) announced a Final Rule titled HIPAA Privacy Rule to Support Reproductive Health Care Privacy. The Final Rule strengthens the Health Insurance Portability...more

Federal Efforts to Address Opioid Use Disorder

On April 4, 2024, a final rule published on February 2, 2024 (the Final Rule) went into effect that concerns medication for the treatment of opioid use disorder. The Final Rule, published by the Substance Abuse and Mental...more

New Informed Consent Guidance and Pharmacy Immunity

New guidance released by the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) on April 1, 2024, clarified that hospitals will not be eligible for Medicare or Medicaid...more

OCR Updates Bulletin on Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates

On March 18, 2024, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services updated its bulletin on the Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates. The...more

Payment Flexibilities and New Legislation Introduced Regarding Healthcare Cyberattacks

For the past month or longer, many providers have reported a significant impact on their revenue cycle due to the cyberattack on Change Healthcare, LLC. In light of that impact, the Centers for Medicare & Medicaid Services...more

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