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
ARA agrees to be acquired by Nautic in deal which values company at
$853M -
Under the terms of the purchasing agreement between American Renal Associates (ARA) and mid-market PE firm Nautic, ARA can take advantage of a...more
As many health care providers consider applying for CARES Act Paycheck Protection Program (PPP) loans under SBA Section 7(a), we would like these providers to be mindful of SBA's "affiliation rules." These rules may require...more