News Briefs - HHS Drops Appeal of Court's Ruling in Hospital Web Tracking Case - The Department of Health and Human Services is dropping its appeal of a June U.S. District Court ruling that vacated the government's...more
9/11/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Healthcare ,
Medical Devices ,
Medicare ,
Physicians ,
Popular ,
Ransomware ,
Rural Health Care Providers ,
Telehealth ,
Web Tracking
News Briefs - State Governments Taking Steps to Make Rules on Healthcare AI - In the absence of federal guardrails on artificial intelligence in healthcare, state governments are figuring out their own rules of the road....more
8/21/2024
/ Artificial Intelligence ,
Drug Pricing ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Medical Devices ,
Medicare ,
Prescription Drugs ,
Private Equity ,
Rural Health Care Providers ,
Surprise Medical Bills
AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more
7/23/2024
/ Administrative Authority ,
Administrative Law Judge (ALJ) ,
Artificial Intelligence ,
Drug Trafficking ,
Expert Testimony ,
Expert Witness ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Fraud ,
Government Agencies ,
Government Investigations ,
Health Care Providers ,
Jury Trial ,
Medicare ,
Qui Tam ,
Regulatory Authority ,
SCOTUS ,
SEC v Jarkesy ,
Securities and Exchange Commission (SEC) ,
Statutory Authority ,
Whistleblowers
News Briefs - Texas Federal Court Ruling Puts Noncompete Ban on Hold - A Texas federal court issued a preliminary injunction against the Federal Trade Commission's noncompete ban, which if implemented would allow existing...more
7/12/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Hospice ,
Hospitals ,
Medical Devices ,
Medicare ,
Nursing Homes ,
Prescription Drugs ,
Shared Savings Program
News Briefs - New Foreign Nurse Visas Frozen by State Department - The State Department has essentially frozen foreign nurse visas for the rest of the fiscal year amid high demand, and health groups are warning it threatens...more
6/28/2024
/ Department of Health and Human Services (HHS) ,
Foreign Workers ,
Health Care Providers ,
Healthcare Workers ,
Hospitals ,
Labor Shortage ,
Medicare ,
Nurses ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Telemedicine ,
Visas
The United States Court of Appeals for the Seventh Circuit recently considered a district court’s nearly $6 million judgment in a qui tam False Claims Act (“FCA”) suit based on Anti-Kickback Statute (“AKS”) violations. The...more
News Briefs - Groups Urge Appeals Court to Revive Drug Price Negotiation Suit - Healthcare and drug industry groups urged a U.S. appeals court to revive their challenge to a law requiring manufacturers to negotiate the prices...more
5/13/2024
/ Centers for Disease Control and Prevention (CDC) ,
Coronavirus/COVID-19 ,
Cyber Attacks ,
Drug Pricing ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Hospital Mergers ,
Hospitals ,
Medicare ,
Non-Compete Agreements ,
Nurses ,
Telehealth ,
Whistleblowers
News Briefs - Medicare Proposal Would Require Hospitals to Report Emissions - Hospitals for the first time could be asked to report their greenhouse gas emissions to the federal health department. A new Medicare proposal to...more
4/26/2024
/ Artificial Intelligence ,
Cyber Attacks ,
Cybersecurity ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Hospitals ,
Labor Shortage ,
Medicare ,
Non-Compete Agreements ,
Nursing Homes ,
Physicians ,
Prescription Drugs ,
Section 340B
News Briefs - Telehealth Access Challenged as Internet Subsidy Program Ends - More than 23 million low-income households -- urban, suburban, rural, and tribal -- are enrolled in the federal discount program Congress created...more
4/15/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
DEA ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare Facilities ,
Hospitals ,
Medicare ,
Prescription Drugs ,
Rural Health Care Providers ,
Telehealth
News Briefs - U.S. to Accelerate Medicare Payments in Wake of Cyberattack - The U.S. government said it will accelerate Medicare and Medicaid payments to some hospitals hurt by a hack at insurer UnitedHealth's technology unit...more
3/15/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Cyber Attacks ,
Cybersecurity ,
Health Care Providers ,
Health Insurance ,
Hospice ,
Medicaid ,
Medicare ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Ransomware
News Briefs - Massive Cyberattack Could Spur Movement in Healthcare Industry - As the disruption caused by the cyberattack at Change Healthcare stretches beyond its tenth day, cybersecurity experts say the incident could spur...more
3/13/2024
/ Artificial Intelligence ,
Cybersecurity ,
Drug Pricing ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Hospitals ,
Labor Shortage ,
Medicare ,
Non-Compete Agreements ,
Nursing Homes ,
Price Transparency
News Briefs - House to Consider 19 Bills That Will Impact Healthcare System - The House of Representatives will consider 19 bills that affect various aspects of the U.S. healthcare system. The House Energy & Commerce...more
12/14/2023
/ Cyber Attacks ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Physician Fee Schedule ,
Private Equity ,
Ransomware ,
Risk Management ,
Telehealth
News Briefs - Lawmakers Reintroduce Healthcare Workforce Resilience Act - Federal lawmakers are trying again to push through immigration reform that would allow officials to recapture unused visas and reprocess them for...more
News Briefs - Google Cloud Unveils AI to Help Doctors with Search Capabilities - Google Cloud announced new artificial intelligence-powered search capabilities that it said will help healthcare workers quickly pull accurate...more
10/12/2023
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
DEA ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Workers ,
Long Term Care Facilities ,
Medicare ,
Nurses ,
Nursing Homes ,
Physicians ,
Prescription Drugs ,
Telehealth ,
Telemedicine
News Briefs - Feds Propose New Nursing Home Minimum Staffing Requirements - The nation's most thinly staffed nursing homes would be required to hire more workers under new rules proposed by the Biden administration, the...more
9/13/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Hospitals ,
Long Term Care Facilities ,
Medicare ,
Nursing Homes ,
Physicians ,
Popular ,
Surprise Medical Bills
News Briefs - More States Introducing 'Conscience' Healthcare Bills - A new Montana law will provide sweeping legal protections to healthcare practitioners who refuse to prescribe marijuana or participate in procedures and...more
8/9/2023
/ Cybersecurity ,
Data Breach ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Hospice ,
Manufacturers ,
Medical Devices ,
Medicare ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Physicians
News Briefs - FTC-Proposed Merger Guidelines Could Slow Healthcare Deals - Newly proposed merger guidelines from the Federal Trade Commission could chill dealmaking in the healthcare sector, as well as increase the costs and...more
8/2/2023
/ Data Breach ,
Data Privacy ,
Federal Trade Commission (FTC) ,
Hospice ,
Hospitals ,
Medicare ,
Mergers ,
Nursing Homes ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Price Transparency ,
Telehealth
News Briefs - High Court Rules Residents Can Sue Publicly Owned Nursing Homes - The U.S. Supreme Court preserved the ability of people to sue for civil rights violations under an 1871 law as it rejected a bid to prevent an...more
News Briefs - Debt Limit Deal Will Claw Back $27.1B in Unspent COVID Funding - President Joe Biden signed a debt limit deal that includes some minimal cuts for healthcare programs just days before the federal government was...more
The financial stakes are often very high for providers when statistical sampling and extrapolation is used to calculate an alleged Medicare overpayment. In post-payment audits involving extrapolation, an actual claims denial...more
Between 2006 and 2014, affiliated long-term care hospitals and a skilled nursing facility (“the Providers”) provided covered services to patients who were eligible for both Medicare and Medicaid (“dual-eligible...more
CMS Announces Hospice Capitation Rates for Medicare Advantage -
The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design...more
On July 9, 2018, in United States ex rel. Polukoff v. St. Mark’s Hosp., the Tenth Circuit Court of Appeals added to the debate over the role of the False Claims Act in policing medical necessity. ...more
Medicare’s implementation of post-payment review through overly aggressive zone program integrity contractors (ZPICs) and unified program integrity contracts (UPICs), combined with an ineffective review process at the first...more
Medicare’s implementation of post-payment review through overly aggressive private contractors, combined with an ineffective review process at the first two levels of the administrative appeal process (redetermination and...more