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
On May 28, 2025, the Centers for Medicare & Medicaid Services (“CMS”) Innovation Center formally announced the early termination of the Kidney Care First (“KCF”) model effective December 31, 2025, and issued a suite of...more
DOJ scores first victory in criminal antitrust labor market trial -
A federal jury convicted a former home healthcare staffing executive in Las Vegas for orchestrating a three-year wage-fixing conspiracy targeting...more
5/12/2025
/ Antitrust Investigations ,
Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Dialysis ,
Dialysis Providers ,
Enforcement Actions ,
Failure To Disclose ,
Health Care Providers ,
Medical Research ,
Medicare ,
Medicare Advantage ,
Nurses ,
Sherman Act ,
Staffing Agencies ,
Wage-Fixing
ESRD ETC among value-based care models being ended early by CMS -
This decision to end the ESRD ETC payment model and several others on Dec. 31 aligns with CMS’ goal to focus on models that demonstrate potential for...more
On March 12, 2025, the CMS announced its intent to terminate the ESRD Treatment Choices (“ETC”) Model as of December 31, 2025, two years ahead of its original end date....more
A New Hope in Kidney Transplants: The Promise of Xenotransplantation -
Joe’s struggle for a kidney transplant highlights a dire reality: donor shortages are leaving countless patients in limbo. Enter Dr. PK, a pioneering...more
2/14/2025
/ Animal Health ,
Centers for Medicare & Medicaid Services (CMS) ,
Clinical Trials ,
Dialysis ,
Dialysis Providers ,
Health Care Providers ,
Health Technology ,
Healthcare ,
Innovative Technology ,
Life Sciences ,
Medical Devices ,
Medical Research ,
Organ Transplant Centers ,
Professional Conferences ,
Public Health
Happy New Year and welcome to our 2024 Trade Secret and Restrictive Covenant Year in Review. 2024 was less stressful and dramatic than most people feared at the start of the year, but there still were some significant rulings...more
1/22/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Contract Terms ,
Dialysis ,
Dialysis Providers ,
Final Rules ,
Non-Compete Agreements ,
Physician Fee Schedule ,
Private Equity ,
Regulatory Reform ,
Restrictive Covenants ,
Trade Secrets
Senators not giving up on reversing CMS physician payment cuts during lame duck session -
Forty-one U.S. Senators from both sides of the aisle are urging the upper chamber’s leadership to allow a bill to be introduced...more
RPA Perspective: 2025 Medicare Fee Schedule and ESRD PPS Final Rules—Highlights for Nephrology -
The final rule for the 2025 Medicare Physician Fee Schedule was released on November 1, and the highlights from the rule...more
11/18/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
ESRD ,
Fresenius ,
Health Care Providers ,
Medical Research ,
Medicare ,
OIG ,
Organ Transplant Centers ,
Pharmaceutical Industry ,
Physician Fee Schedule ,
Physicians ,
Telehealth
The House Ways and Means Committee has postponed discussions on several healthcare bills, including those related to physician pay, due to scheduling conflicts and disagreements over legislative language. This delay affects...more
10/10/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Congressional Committees ,
Dialysis ,
Dialysis Providers ,
Health Care Providers ,
Health Insurance ,
Medical Devices ,
Medicare ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Proposed Legislation ,
Proposed Rules ,
Qualified Health Plans
Appellate court ruling widens scope of NY fee-splitting law to include earnouts -
The decision overturned a lower court ruling relating to the sale of part of a dental practice in 2015. The plaintiff agreed to sell...more
9/24/2024
/ Asset Purchase Agreements ,
Centers for Medicare & Medicaid Services (CMS) ,
Certification Requirements ,
Consent ,
Corporate Practice of Dentistry ,
Earn-Outs ,
ESRD ,
Federal Trade Commission (FTC) ,
Fee-Splitting ,
Health Care Providers ,
Non-Compete Agreements ,
Private Equity
As value-based care (VBC) models continue to grow across our nation’s health system and specifically within different specialties like nephrology, the costs and challenges of maintaining these models continue to rise. In...more
8/13/2024
/ Antitrust Investigations ,
Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Kickbacks ,
Non-Compete Agreements ,
Organ Transplant Centers ,
Physician Fee Schedule ,
Private Equity ,
Spinoffs ,
Value-Based Care ,
Whistleblowers
We encourage all CKCC Model participants to review these updates carefully and take necessary actions to ensure compliance with the deadlines for KCE CKCC Model Performance Year 2024 Risk Option selections....more
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
The shift in health care from a retrospective fee for service (“FFS”) model to a value based care (“VBC”) model is growing across our nation’s health system and different specialties, including nephrology. VBC models in...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
On March 22, 2023, the Centers for Medicare and Medicaid Services (“CMS”) issued revised Guidance and Survey Process for Reviewing Home Dialysis Services in a Nursing Home (Rev QSO-18-24-ESRD) to State Survey Agency...more
MedPAC recommends no additional increase in payments for dialysis in 2024 -
MedPAC’s report on outpatient dialysis services recommends Congress not increase Medicare payments for dialysis services next year beyond the...more
5/9/2023
/ Acquisitions ,
Centers for Medicare & Medicaid Services (CMS) ,
Dialysis ,
Dialysis Providers ,
Divestiture ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Joint Venture ,
MedPAC ,
Organ Donation ,
Restrictive Covenants ,
Trade Secrets
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