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Amicus Brief Filed Urging Georgia Supreme Court to Uphold Wrongful Death Award Statutory Cap

On behalf of two of the state’s largest healthcare associations — the Georgia Hospital Association (“GHA”) and the Medical Association of Georgia (“MAG”) — AGG Healthcare attorneys Jason Bring, Jerad Rissler, and Lisa Churvis...more

OIG Approves Pharmaceutical Manufacturer’s Proposed Travel-Related Subsidies

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-13 (the “Opinion”) to a pharmaceutical manufacturer (the...more

OIG Approves Pharmaceutical Manufacturer’s Proposed Free Genetic Testing

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-12 (the “Opinion”) to a pharmaceutical manufacturer (the...more

OIG Approves Pharmaceutical Manufacturer’s Proposed Free Vaccination Program

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-11 (the “Opinion”), to a pharmaceutical manufacturer (the...more

OIG Approves Dental Supplies Distributor’s Plan to Expand Loyalty Program

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-10 (the “Opinion”) to a dental supplies distributor (the “Requestor”...more

OIG Approves Municipality’s Plan to Bill Insurance and Waive Co-Pays for Treatment-in-Place Emergency Medical Services

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-09 (the “Opinion”) to a municipal corporation (the “Requestor” or...more

Pandemic-Era Telehealth Flexibilities Currently on Life Support

Medicare coverage of telehealth services is reaching a critical point as many pandemic-era flexibilities are set to expire on December 31, 2024. As it stands, after the close of the year, Medicare coverage for telehealth...more

States, Interest Groups Launch Fresh Attack Against Federal Nursing Home Minimum Staffing Rule in New Litigation

The Biden administration’s controversial Final Rule establishing minimum staffing requirements for nursing homes is under new attack. The Final Rule, long decried by nursing home industry leaders as a one-size-fits-all...more

OIG Issues Unfavorable Opinion on MAO’s Proposed Gainshare Program

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released an unfavorable advisory opinion, OIG Advisory Opinion No. 24-08 (the “Opinion”), to a Medicare Advantage Organization (“MAO”)....more

OIG Approves Arrangement Regarding Drug Cost Subsidies for Certain Low-Income Medicare Enrollees

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-07 (the “Opinion”), to a nonprofit tax-exempt grant-making...more

AGG Talks: Healthcare Insights Podcast - Episode 6: Charting the Future of Nursing Home Staffing [Audio]

In this episode, AGG Healthcare attorneys Lisa Churvis and Alan Horowitz discuss critical aspects of nursing home staffing requirements. Lisa and Alan delve into the implications of recent legislative proposals and regulatory...more

What the Supreme Court’s Loper Decision Means for the Affordable Housing Industry

Ending 40 years of judicial deference to administrative agencies’ interpretations of ambiguous statutes governing them, the Supreme Court of the United States finally pulled the plug on this experiment that it, just five...more

Dead at 40: Supreme Court Finally Ends Legal Deference to Regulators

Ending 40 years of judicial deference to administrative agencies’ interpretations of ambiguous statutes governing them, the Supreme Court of the United States finally pulled the plug on this experiment that, just five years...more

OIG Approves Arrangement Regarding Patient Assistance Funds for Patients With Certain Rare Diseases, Pending Medicare Part D...

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-02 (the “Opinion”) to a nonprofit organization that provides...more

OIG Approves Arrangement Incentivizing Medigap Policyholders to Seek Treatment From PHO Network Hospitals

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more

Home Health & Hospice Quarterly - Q3

AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more

Third Circuit Resurrects FCA Lawsuit Against Hospice Due to Disputed Materiality of Eligibility Documentation

A New Jersey hospice provider must continue its long fight against whistleblowers alleging it violated the False Claims Act (“FCA”) by seeking Medicare reimbursement for patients whose documentation did not support hospice...more

CMS Addresses Benefit Integrity Issues Related to Hospice Care

The U.S. Centers for Medicare & Medicaid Services (“CMS”), the agency that administers the Medicare hospice benefit, has announced increased scrutiny of hospice programs in the wake of growing concerns over hospice service...more

Home Health & Hospice Quarterly - Q2

AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more

Impact of Health & Hospital Corporation of Marion County v. Talevski on Government-Owned Nursing Homes

Does legislation enacted pursuant to Congress’s Spending Clause power give rise to rights privately enforceable via 42 U.S.C. § 1983? If so, do provisions regarding medication and transfer in the Federal Nursing Home Reform...more

OIG Developing Updated Compliance Guidance for Hospices and Other Providers

Over the last three decades, the OIG has developed a series of voluntary compliance program guidance documents (“CPGs”) directed at various segments of the healthcare industry, such as hospitals, nursing homes, and hospices....more

Battle Over No Surprises Act Rages on and Expands to New Fronts

Texas Medical Association (“TMA”) and LifeNet Inc. are expanding their fight over the regulations implementing the No Surprises Act (“NSA”). The NSA protects patients from surprise medical bills when they receive...more

MedPAC to Discuss Draft Hospice Payment Recommendations for 2024; MedPAC’s Recommended Hospice Cuts Considered by Congress

The Medicare Payment Advisory Commission (“MedPAC”) will hold a public virtual meeting on December 8, 2022, to assess payment adequacy and updating payments for hospice services. By law, each year MedPAC reviews Medicare’s...more

OIG Issues New Guidance on Financial Restructuring Arrangements With FQHC Look-Alikes

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 22-17, analyzing the proposed restructuring of financial relationships...more

Eleventh Circuit Holds Objectively Reasonable Belief of Fraud Required for Protection Under FCA Retaliation Provision

The Eleventh Circuit recently clarified the standard for deciding whether a plaintiff has engaged in a protected activity for purposes of successfully pleading a False Claims Act (“FCA”) retaliation claim. In Simon ex rel....more

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