Earlier this month a federal judge unsealed a federal qui tam relator complaint originally filed in January 2020 by Dr. Jay Radhakrishnan and Dr. William Julien against Arizona-based Modern Vascular and certain of its...more
9/29/2022
/ Anti-Kickback Statute ,
Clinical Laboratories ,
Corporate Integrity Agreement ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Investors ,
Laboratories ,
Medicare ,
Physicians ,
Qui Tam ,
Stark Law
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
On July 13, 2021 the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) proposed rule for calendar year (CY) 2022 that could result in potentially significant reductions to...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