A final federal rule raising minimum staffing requirements for long-term care (LTC) facilities that receive Medicare or Medicaid funding becomes effective June 21, starting a staggered timeline for LTCs to create and...more
Ballard Spahr attorneys from the firm’s Life Sciences and Health Care Industry Teams were on the ground for the 42nd Annual J.P. Morgan Healthcare Conference (JPM24) from January 7-10. While still less crowded than...more
1/22/2024
/ Acquisitions ,
Antitrust Provisions ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Drug Pricing ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Initial Public Offering (IPO) ,
Life Sciences ,
Medicare ,
Mergers ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Private Equity
Summary -
On June 1, 2023, the Supreme Court issued a landmark decision in False Claims Act cases. In United States ex rel. Schutte v. SuperValu Inc., it unanimously held that liability under the False Claims Act depends...more
6/20/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Healthcare ,
Medicaid ,
Medicare ,
Pharmacies ,
Prescription Drugs ,
Reimbursements ,
Safeco Insurance Co of America v Burr ,
SCOTUS ,
US ex rel Tracy Schutte et al v SuperValu Inc et al ,
Whistleblowers
Summary -
The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more
3/1/2023
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Citations ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Nursing Homes ,
OIG ,
Prescription Drugs ,
Skilled Nursing Facility
On January 30, 2023, CMS posted for inspection a final rule describing its Risk Adjustment Data Validation audit methodology (the Final RADV Rule). As we have discussed in prior alerts, the finalization of the RADV Rule,...more
Summary -
On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) published notice that it will postpone for another three months the finalization of a methodology to audit Medicare Advantage (MA)...more