Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses -
On March 26, the US Department of Justice (DOJ) announced that a California-based medical group and related parties...more
3/31/2025
/ California ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Imports ,
Medicare Advantage ,
Physicians ,
Settlement ,
Whistleblowers
Long Island Businessman Arrested in $22 Million Medicare Fraud Scheme -
A Long Island, New York, businessman was arrested on conspiracy, kickback, and money laundering charges stemming from an alleged scheme to defraud...more
Jury Clears SuperValu of Liability in Whistleblower FCA Prescription Pricing Case -
A federal jury in Illinois recently found SuperValu not liable in a whistleblower lawsuit that accused the company of overcharging the...more
3/10/2025
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Medicare Fraud ,
Prescription Drugs ,
SCOTUS ,
Settlement ,
Whistleblowers
With 2025 underway, the AFS Health Care team highlights some of the most pressing legal issues facing the health care industry this year....more
Previously, we discussed how the US Supreme Court’s opinion in Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce could create opportunities for private litigants to challenge health...more
7/30/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Loper Bright Enterprises v Raimondo ,
Payment Systems ,
Regulatory Agenda ,
SCOTUS ,
Secretary of HHS ,
Stark Law
The US Supreme Court recently overturned its ruling in Chevron USA, Inc. v. Natural Resources Defense Council, Inc., changing the landscape for federal agency rulemaking and actions, particularly in the health care industry....more
Change Healthcare, an affiliate of Optum and UnitedHealth Group, processes more than 15 billion health care transactions annually and touches one of every three patient records. On February 21, Change disconnected its...more
3/15/2024
/ American Medical Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Cyber Attacks ,
Cybersecurity ,
Health Care Providers ,
Healthcare ,
Insurance Industry ,
Medicare Part B ,
Payment Systems ,
Policies and Procedures ,
Popular ,
Prescription Drug Coverage ,
Prescription Drugs ,
Ransomware
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
A pair of reports recently issued by the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) highlight the important role telehealth services have played in ensuring access to medical...more
9/21/2022
/ Beneficiaries ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Fee-for-Service ,
Fraud ,
Medicare ,
Medicare Advantage ,
OIG ,
Public Health Emergency ,
Telehealth
Makes Permanent Telehealth Behavioral Health Rules -
CMS published the 2022 Physician Fee Schedule Final Rule on November 2, 2021. The Rule keeps intact CMS’s temporary physician supervision requirements related to the...more
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
As part of its recent rulemaking process, the Centers for Medicare and Medicaid Services (CMS) finalized a new exception to the Physician Self-Referral Law (the Stark Law) to protect arrangements where limited remuneration is...more
The Centers for Medicare and Medicaid Services (CMS) recently released the CY 2020 Proposed Physician Fee Schedule....more
8/6/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Hospitals ,
Medical Devices ,
Medical Records ,
Medicare ,
Open Payments ,
Opioid ,
Pharmaceutical Industry ,
Physician Assistants ,
Physician Fee Schedule ,
Physicians ,
Sunshine Act ,
Telehealth ,
Telemedicine