On June 27, 2025, the Centers for Medicare & Medicaid Services (“CMS”), through its Innovation Center (“CMMI”), released the Request for Applications (“RFA”) for a new payment and service delivery initiative: the Wasteful and...more
7/2/2025
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Fee-for-Service ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Healthcare Reform ,
Hospitals ,
Innovative Technology ,
Machine Learning ,
Medicare
Fresenius hiring Ascension Capital exec to head care delivery -
The appointment of Craig Cordola as CEO of the dialysis company’s care delivery segment takes effect Jan. 1. He was at Ascension Capital for the past six...more
11/14/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Dialysis ,
Dialysis Providers ,
ESRD ,
Health Care Providers ,
Healthcare Workers ,
Hospitals ,
Medicare ,
Pharmaceutical Industry ,
Prescription Drugs
FTC, DoJ propose changes to HSR Act for more effective, efficient merger reviews -
The FTC, along with the Assistant Attorney General of the Antitrust Division, proposed changes to the premerger notification form and...more
9/8/2023
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Dialysis ,
Dialysis Providers ,
Federal Trade Commission (FTC) ,
Hart-Scott-Rodino Act ,
Health Insurance ,
Healthcare Facilities ,
Medicare ,
Merger Reviews ,
Organ Donation ,
Organ Transplant Centers ,
Partnerships ,
Rural Health Care Providers ,
Startups
NY non-compete ban still receiving pushback as Governor waits to sign off -
While NY Governor Kathy Hochul waits to sign off on one of the country’s toughest bans on non-compete agreements, many lobby groups from the...more
8/7/2023
/ Business Model ,
Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
ESRD ,
Healthcare Facilities ,
Medicare ,
Non-Compete Agreements ,
Organ Donation ,
Organ Transplant Centers ,
Spinoffs
Benesch: NLRB decision overturns use of ‘entrepreneurial opportunity’ super factor for classifying employees -
Benesch explains the labor board’s decision retains the 10-point test to determine who can be considered an...more
Benesch: MN ban on non-compete agreements includes carveout for business sale, dissolution -
Benesch Law notes the bill only awaits the signature of MN’s Governor and could become law as early as July 1. It would prevent...more
6/9/2023
/ Capital Raising ,
Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
ESRD ,
Fraud ,
Healthcare Facilities ,
Medicare ,
No-Poaching ,
Non-Compete Agreements ,
Organ Donation ,
Organ Transplant Centers ,
Private Equity ,
Proposed Legislation ,
Spinoffs
ME trial reminiscent of DaVita anti-poaching case that also ended in acquittal; DOJ strategy questioned -
In Apr. 2022, juries in TX and CO acquitted healthcare companies charged by the DOJ’s Antitrust Division. In the CO...more
4/12/2023
/ Acquittals ,
Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Criminal Prosecution ,
Dialysis ,
Dialysis Providers ,
ESRD ,
Government Investigations ,
Healthcare Facilities ,
Medical Research ,
Medicare ,
Medigap ,
Organ Donation ,
Veterans Administration
Correction to our January 31, 2023 newsletter article, “Dialysis Provider Satellite Healthcare Reports Data Breach Affecting Nearly 100k Patients”:
Media Statement, Satellite Healthcare -
In January 2023, Satellite...more
Federal omnibus spending bill rolls back some Medicare payment cuts scheduled for 2023, 2024 -
Buried within the $1.7-trillion spending package signed by the President on Dec. 29 was partial relief for a planned 4.5% cut...more
1/16/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
Donors ,
ESRD ,
False Claims Act (FCA) ,
Fraud ,
Fresenius ,
Health Care Providers ,
Medicare ,
Organ Donation ,
Physician Fee Schedule ,
Physician Medicare Reimbursements ,
Physicians
Benesch: AKS claims against Azura dropped; FCA allegations to continue with DOJ intervention -
The DOJ filed an Amended Intervenor Complaint in Aug. alleging between 2012 and 2018, Fresenius Medical Care’s business unit,...more
Benesch: DOL proposed rule aims to clarify independent contractor classification -
The Department of Labor (DOL) proposes changes to the Fair Labor Standards Act to clarify the difference between an independent contractor...more
Benesch outlines five states with data protection laws coming into effect in 2023 -
Next year, statutes for data security and data privacy will go into effect in CA and VA on Jan. 1, while laws in CO and CT will be...more
Fresenius CEO resigning; to be replaced by head of company’s pharmaceutical business -
Michael Sen, President and CEO of Fresenius Kabi, will replace Stephan Sturm as CEO of Fresenius SE on Oct. 1. Shares in the company...more
SCOTUS sides with OH-based medical plan in dispute with DaVita over dialysis reimbursements -
In a 7-2 vote, the Supreme Court ruled in favor of the Marietta Memorial Hospital Employee Benefit Plan in a case that hinged...more
SCOTUS questions appear to support DaVita’s position in dialysis care discrimination case -
Private plans are supposed to provide coverage for dialysis for the first 30 months before the patients can transition to...more
CMS calls for applications for second cohort of KCC Model; deadline set for Mar. 25 -
The Center for Medicare and Medicaid Innovation says performance period participation agreements for the CMS Kidney Care First Option...more
SCOTUS to consider case alleging private plan’s ESRD coverage violates MSPA -
The Supreme Court agreed to hear the case of Marietta Memorial Hospital Employee Health Benefits Plan v. DaVita, which alleges a private...more
12/6/2021
/ Antitrust Litigation ,
Biden Administration ,
Coronavirus/COVID-19 ,
Dialysis ,
Dialysis Providers ,
Employer Group Health Plans ,
ESRD ,
Medicare ,
Organ Transplant Centers ,
SCOTUS ,
Vaccinations
Industry players agree on need for quality assurance but believe CMS’ QIP program for ESRD care delivery flawed -
The ESRD Quality Incentive Program (QIP) implemented by CMS provides a payment penalty of up to 2% for...more
DaVita, former CEO indicted in federal market collusion case -
DaVita and the company’s former CEO, Kent Thiry, were alleged to have conspired with Surgical Care Affiliates to suppress competition for senior-level...more
OSHA introduces mandatory workplace rule to protect healthcare workers from COVID
The Occupational Safety and Health Administration (OHSA) issued an emergency temporary standard (ETS) that sets out how it wants workplaces...more
Former CMS administrator Seema Verma joins Monogram Health’s board -
Seema Verma was the CEO of health policy firm SVC when she was tapped by the Trump Administration to act as administrator of CMS, a position she held...more
5/6/2021
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Class Action ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Dialysis Providers ,
Environmental Social & Governance (ESG) ,
Federal Funding ,
Medicare ,
Medicare Advantage ,
No-Poaching ,
Settlement ,
Startups ,
Value-Based Care
AMA report suggests Medicare spending fell 19% YoY during first half of 2020; reduction in nephrology much smaller The report from the American Medical Association (AMA) found Medicare payments to physicians the first six...more
3/15/2021
/ Acquisitions ,
American Medical Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
Health Insurance ,
Healthcare Facilities ,
Joint Venture ,
Medicare ,
Mergers ,
Organ Donation ,
Pharmaceutical Industry ,
Private Equity ,
Proposed Legislation
Fresenius to defend itself from FCA suit following whistleblower allegations -
A former employee alleges Fresenius engaged in arrangements with hospitals and nephrologists to ensure patient referrals to its dialysis...more
3/2/2021
/ Ambulatory Surgery Centers ,
Annual Meeting ,
Centers for Disease Control and Prevention (CDC) ,
Department of Health and Human Services (HHS) ,
Dialysis Providers ,
False Claims Act (FCA) ,
Final Rules ,
Fresenius ,
Hospitals ,
Industry Consolidation ,
Inpatient Billing ,
Medicare ,
Pharmaceutical Industry ,
Physicians ,
Vaccinations