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
Medtronic, DaVita forming kidney tech company to develop dialysis delivery systems -
The healthtech and the dialysis provider will be 50-50 partners in the venture, which will include the entirety of Medtronic’s renal...more
Denver jury acquits DaVita, former CEO, of all charges in antitrust trial -
After two days of deliberations, a Denver jury found DaVita and former CEO Kent Thiry not guilty of all charges relating to charges they...more
5/10/2022
/ Acquisitions ,
Criminal Prosecution ,
Dialysis ,
Dialysis Providers ,
Food and Drug Administration (FDA) ,
Grants ,
Medical Devices ,
Medical Research ,
Organ Donation ,
Proposed Legislation ,
Sherman Act ,
Whistleblowers
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
Benesch: SCOTUS decisions on COVID-19 vaccine mandates have repercussions for employers, healthcare facilities
The Supreme Court decided two cases relating to COVID-19 vaccination mandates. In the first case, SCOTUS ruled...more
2/4/2022
/ Acquisitions ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Dialysis ,
Dialysis Providers ,
Employer Mandates ,
Infectious Diseases ,
OSHA ,
Physician Medicare Reimbursements ,
Vaccinations ,
Workplace Safety
Benesch reviews state, federal modifications to restrictive covenant laws -
In a “Year-End Review,” Benesch points out there was considerable activity in trade secret and restrictive covenant law in 2021. Some of the...more
1/12/2022
/ American Medical Association ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Contract Terms ,
Dialysis Providers ,
Employment Contract ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Hospitals ,
Medical Research ,
Non-Compete Agreements ,
Organ Transplant Centers ,
Physicians ,
Restrictive Covenants ,
State and Local Government ,
Surprise Medical Bills
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
Carolina Kidney Partners: Addition of Ga.-based nephrology practice expands Medicare, commercial insurance footprint -
Savannah’s Nephrology & Hypertension Medical Associates operates seven clinics in Ga. and S. Car....more
Benesch: FTC to more stringently enforce PHR breaches by apps, connected medical devices -
The FTC issued a policy statement to provide guidance to developers of health apps and connected medical devices and how they’re...more
10/7/2021
/ Antitrust Litigation ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Dialysis ,
Electronic Protected Health Information (ePHI) ,
Employer Mandates ,
Organ Transplant Centers ,
PHI ,
Private Equity ,
Telemedicine ,
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
On July 9, 2021, President Biden signed a sweeping Executive Order (“EO”) intended to promote competition in a number of sectors of the economy, including healthcare. The EO targets 4 areas of healthcare in particular -...more
8/10/2021
/ Anti-Competitive ,
Biden Administration ,
Competition ,
Department of Justice (DOJ) ,
Employment Contract ,
Executive Orders ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Insurance Industry ,
Low-Wage Workers ,
Non-Compete Agreements ,
Restrictive Covenants ,
Technology Sector
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
DOJ reports University of Miami agrees to $22M settlement over FCA allegations -
The U.S. Department of Justice (DOJ) alleged the University of Miami engaged in three fraudulent practices under the False Claims Act:...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
Cricket Health unveils value-based kidney care model for MA plans -
A program from startup kidney care provider Cricket Health is designed for MA plans managing care for patients with end-stage renal disease who are...more
Study contends lifestyle, chronic ailments to drive 56% growth in value of global peritoneal dialysis market through 2027 -
A report (available for purchase) from Canadian research firm Emergen Research suggests the...more
3/24/2021
/ Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
CIGNA ,
Dialysis ,
Dialysis Providers ,
Healthcare Facilities ,
Medical Research ,
Regulatory Requirements ,
Settlement ,
Sutter Health ,
Telemedicine
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
IRC completes acquisition of kidney care provider ARA -
In Oct., it was revealed that Franklin, Tenn.-based Innovative Renal Care (IRC), an affiliate of equity firm Nautic Partners, would purchase American Renal...more
On February 5, 2021 a long-time former Fresenius Medical Care North America (“Fresenius”) employee, Martin Flanagan, filed a qui tam relator amended complaint (“Complaint”) against Fresenius alleging that the company had...more
CMS to reprocess excepted off-campus provider-based outpatient claims following court ruling -
CMS says it’ll begin reprocessing claims for outpatient clinic visit services provided at excepted off-campus provider-based...more
2/1/2021
/ Acquisitions ,
Acute Facilities ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Dialysis ,
Dialysis Providers ,
Food and Drug Administration (FDA) ,
Healthcare Facilities ,
Hospitals ,
No-Poaching ,
Pharmaceutical Industry ,
Physician Fee Schedule
On December 21, 2020, Congress passed the Consolidated Appropriations Act of 2021 (CRA), which combines a $1.4 trillion omnibus government spending bill with a $900 billion COVID-19 relief package. The massive bill, which was...more