On May 22, 2025, after a marathon markup session, the U.S. House of Representatives passed a bill containing significant proposed changes to the Medicaid program....more
6/25/2025
/ Affordable Care Act ,
CBO Report ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Congressional Budget Office ,
Federal Funding ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicaid Work Requirements ,
Medicare ,
Physician Fee Schedule ,
Physicians ,
Proposed Legislation ,
State and Local Government
On May 22, 2025, the U.S. Department of Health and Human Services, Department of Treasury and Department of Labor (the “Agencies”) announced new steps intended to “strengthen healthcare price transparency.” ...more
5/27/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Disclosure Requirements ,
Drug Pricing ,
Employer Group Health Plans ,
Health Insurance ,
Hospitals ,
Prescription Drug Coverage ,
Prescription Drugs ,
Reporting Requirements ,
Request For Information ,
Transparency ,
U.S. Treasury
Health care providers and payers have been subject to a flurry of developments at the federal level in recent weeks. Considering that health care represents almost 18% of the U.S. gross domestic product, this was perhaps...more
4/10/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Final Rules ,
Healthcare Reform ,
Involuntary Reduction in Force ,
Medical Research ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
OIG ,
Prescription Drugs ,
Proposed Rules ,
Regulatory Reform ,
Trump Administration
In what it describes as a “First-of-its-Kind Healthcare Generative AI Investigation”, the Texas Attorney General (AGO) recently reached a settlement agreement with an artificial intelligence (AI) healthcare technology...more
11/6/2024
/ Artificial Intelligence ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Criminal Investigations ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
False Statements ,
Health Care Providers ,
Health Technology ,
Hospitals ,
Medicare Advantage Organizations (MAOs) ,
Mental Health ,
Proposed Legislation ,
Regulatory Oversight ,
Settlement ,
State Attorneys General ,
Unfair or Deceptive Trade Practices
In early May 2024, the University of Pittsburgh Medical Center (UPMC) agreed to pay $38 million to resolve a False Claims Act case based on alleged Stark Law violations. The size of the settlement in United States ex rel. J....more
6/4/2024
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Fair Market Value ,
False Claims Act (FCA) ,
Health Care Providers ,
Hospitals ,
Patient Referrals ,
Physicians ,
Relators ,
Settlement ,
Stark Law
The COVID-19 public health emergency (PHE) will expire at the end of the day on May 11, 2023, which is less than three months away. In the early days of the pandemic, the U.S. Department of Health and Human Services (HHS),...more
2/23/2023
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Health Care Providers ,
Physician Fee Schedule ,
Physicians ,
Public Health ,
Public Health Emergency ,
Stark Law
Health care providers began receiving direct deposits into their bank accounts on April 10, 2020 as part of the first disbursement of the $100 billion in provider relief funds allocated under the CARES Act. Providers are...more