On August 20, 2024, OIG issued Advisory Opinion No. 24-07 in which it responded to a request for an advisory opinion regarding a nonprofit grant-making organization’s (Requestor) proposal to fund a patient assistance program...more
On March 5, 2024, the Federal Trade Commission (FTC) hosted a virtual workshop titled “Private Capital, Public Impact: an FTC Workshop on Private Equity in Healthcare” (the Workshop). The agenda, together with a recording of...more
n January 9, 2024, the HHS Office for Civil Rights (OCR) announced a final rule, entitled “Safeguarding the Rights of Conscience as Protected by Federal Statutes” (the 2024 Final Rule). The 2024 Final Rule clarifies the...more
On June 16, 2023, the U.S. Supreme Court affirmed that the DOJ properly secured a dismissal of a whistleblower suit accusing Executive Health Resources Inc. of violating the False Claims Act by improperly billing Medicare....more
6/22/2023
/ Article II ,
Constitutional Challenges ,
Corporate Misconduct ,
Dismissals ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Fraud ,
Healthcare ,
Inpatient Billing ,
Investigations ,
Qui Tam ,
Relators ,
SCOTUS ,
United States ex rel Polansky v Executive Health Resources Inc ,
Whistleblowers
On March 24, 2023, the Illinois House of Representatives passed HB 2222. If passed by the Illinois Senate and signed by Illinois’ Governor, HB 2222 would amend the Illinois Antitrust Act (the Act) to add reporting...more
GAO issued a report on December 12, 2022, that identified gaps in the reporting requirements for hospice abuse and neglect allegations as compared with requirements for extended care provided in hospitals and nursing homes....more
On June 23, 2022, OIG issued Advisory Opinion No. 22-14 in which it responded to a request for an advisory opinion regarding an ophthalmology practice’s proposal to offer continuing education (CE) programs for local...more
On March 11, 2022, OIG issued Advisory Opinion No. 22-05 in which it responded to a request for an advisory opinion regarding a proposed subsidization of certain cost-sharing obligations in the context of a clinical trial...more
4/4/2022
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Clinical Trials ,
Cost-Sharing ,
Manufacturers ,
Medical Devices ,
Medicare ,
Medicare Part D ,
OIG ,
Reimbursements ,
Sanctions
On February 4, 2022, OIG issued Advisory Opinion No. 22-02 in which it responded to a request for an advisory opinion submitted by a hospital system that operates a children’s hospital (Requestor) regarding a proposed...more
On December 15, 2021, CGHI announced the development the Global Health Innovation District in Midtown Atlanta. The Center for Global Health Innovation (CGHI) is a 501(c)(3) organization that was launched in January 2020 to...more
On November 19, 2021, OIG issued Advisory Opinion No. 21-17 in which it responded to a request for an advisory opinion regarding a proposed subsidization of certain Medicare cost-sharing obligations in the context of a...more
On June 24, 2021, CMS sent letters to Arizona and Indiana informing them that the agency has revoked its approval of provisions in their state Medicaid demonstration projects that had required adults to be employed as a...more
On May 24, 2021, OIG provided additional guidance in the form of an FAQ as to whether an offer or provision of cash, cash-equivalent, or in-kind incentives or rewards to Federal health care program beneficiaries who receive...more
On April 7, 2021, CMS issued a proposed rule for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and a proposed rule for the Inpatient Psychiatric Facility (IPF) PPS for fiscal year (FY) 2022. ...more
On March 18, 2021, OIG issued Advisory Opinion 21-01, addressing whether a pharmaceutical manufacturer may provide a personalized medicine made from a patient’s own cells as a one-time, potentially curative treatment (the...more
On August 3, 2020, CMS issued a proposed rule which updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2021 (the...more
On November 18, 2019, CMS published the proposed Medicaid Fiscal Accountability Rule (the Proposed Rule) which, if finalized, would result in dramatic changes to the Medicaid program. Through the Proposed Rule, CMS aims to...more
On September 19, 2019, the OIG released a report relating to recent audits of the CHIPRA program. The audits, performed from April 2012 through September 2017, identified over $277 million in unallowable payments made to 12...more
On July 18, 2019, CMS published a proposed rule titled “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (the Proposed Rule). According to...more
On June 13, 2019, The University of Southern California’s (USC’s) $215 million settlement to resolve proposed class claims alleging that a former gynecologist, Dr. George Tyndall, sexually abused women for decades, has...more
On May 2, 2019, CMS issued a proposed rule that would add requirements and a specific process to address changes of ownership as they relate to the sale, transfer, and/or purchase of assets of CMS-approved Accrediting...more
On March 25, 2019, the Hospital and Healthsystem Association of Pennsylvania (HAP), Pennsylvania’s largest hospital association, filed a motion in the Middle District of Pennsylvania to intervene in University Pittsburgh...more
On November 29, 2018, at the American Conference Institute’s International Conference on the Foreign Corrupt Practices Act in National Harbor, Maryland, Mr. Rosenstein announced noteworthy policy changes related to the...more
On October 31, 2018, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (CMS-1689-FC) (the “Final Rule”) that makes significant changes to the Home Health Prospective Payments System (“PPS”). These...more
On October 18, 2018, the Office of Inspector General (OIG) issued a favorable advisory opinion to a Medicaid managed care organization (MCO) regarding its proposal to incentivize the MCO’s contracted providers to increase the...more