As of mid-2025, private equity (PE) investors remain intensely interested in health care services and technology companies despite higher borrowing costs, heightened regulatory scrutiny, and an increasingly complex state...more
With 2025 underway, the AFS Health Care team highlights some of the most pressing legal issues facing the health care industry this year....more
Throughout 2021 and 2022, states have been seeking to include or have successfully included medical respite to Medicaid 1115 waivers. These experimental Medicaid-reimbursed programs are reviewed and approved by the Secretary...more
An outcome of the COVID-19 pandemic has been the attractiveness of innovative care alternatives, for patients and providers alike. One model that has become increasingly popular in the United States (and which is already...more
Over 2500 hospitals across the country historically have relied upon Disproportionate Share Hospital (DSH) Medicaid payments for financial stability. These DSH payments, made in large measure to hospitals with high Medicaid...more
3/31/2023
/ Affordable Care Act ,
American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
DSH ,
Financial Distress ,
Funding ,
Hospice ,
Hospitals ,
MACPAC ,
Medicaid ,
Proposed Rules ,
Provider Payments
On February 15, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule which would require greater disclosures of the ownership and management of Medicare and Medicaid nursing homes. Specifically,...more
With the new year underway, the ArentFox Schiff Health Care team highlights 10 of the most pressing legal issues facing the industry in 2023.
End of the COVID-19 Public Health Emergency. After being in effect for more than...more
2/17/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Dobbs v. Jackson Women’s Health Organization ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Healthcare ,
HIPAA Privacy Rule ,
Inflation Reduction Act (IRA) ,
No Surprises Act (NSA) ,
Popular ,
Proposed Rules ,
Public Health Emergency ,
Reproductive Healthcare Issues ,
Roe v Wade ,
SCOTUS ,
Telehealth
On January 18, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Memorandum to all state survey agency directors addressing erroneous schizophrenia coding and increased transparency of Nursing Home Care...more
The Biden Administration has embraced an aggressive and multi-part agenda designed to improve the safety and quality of care nationally in skilled nursing facilities (SNFs). The Biden Administration’s nursing home agenda...more
12/16/2022
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Medicaid ,
Medicare ,
OIG ,
Quality of Care Standards ,
Skilled Nursing Facility
Since the US Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization (Dobbs) in June 2022, the impact of the Court’s decision continues to ripple across the health care delivery system. In this multi-part series,...more
12/9/2022
/ Abortion ,
Centers for Medicare & Medicaid Services (CMS) ,
Dobbs v. Jackson Women’s Health Organization ,
EMTALA ,
Environmental Social & Governance (ESG) ,
Hospitals ,
Planned Parenthood of Southeastern Pennsylvania v Casey ,
Reproductive Healthcare Issues ,
Risk Assessment ,
Roe v Wade ,
SCOTUS
Click the link below for our complete analysis of recent updates to the Stark Law and Anti-Kickback Statute and their impact on health care providers.
...more
3/3/2021
/ 21st Century Cures Act ,
Anti-Kickback Statute ,
Bonuses ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Commercially Reasonable Efforts ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Fair Market Value ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Medicare Part D ,
OIG ,
Pharmacy Benefit Manager (PBM) ,
Profit Sharing ,
Safe Harbors ,
Stark Law ,
Value-Based Care
OIG and CMS, through a coordinated effort, have issued sweeping and much-anticipated final changes to the Anti-kickback and Stark rules. These changes are generally industry-friendly.
Introduction -
On November 20,...more
12/9/2020
/ ACOs ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
DMEPOS ,
New Rules ,
OIG ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Across the country, health care providers have struggled during the COVID-19 pandemic in the face of declining revenue and increased expenses.
This financial stress has adversely affected almost all entities within the...more
In what is widely considered to signal intensified focus by the Federal government on Medicaid supplemental payments and related State Medicaid financing mechanisms, the Centers for Medicare & Medicaid Services (CMS) on...more
11/26/2019
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
DSH ,
Health Care Providers ,
Mandatory Reporting Laws ,
Medicaid ,
Proposed Rules ,
Regulatory Oversight ,
State Medicaid Programs ,
State Regulators ,
Supplemental Payments