News & Analysis as of

Enforcement Actions Hospitals Healthcare

Bradley Arant Boult Cummings LLP

New Healthcare Practitioner Non-Compete Provisions Effective September 1, 2025

On June 20, 2025, Texas enacted SB 1318, modifying the criteria for enforceable healthcare practitioner non-competes in the Texas Business and Commerce Code. The modifications (1) limit the scope of enforceable physician...more

Arnall Golden Gregory LLP

OIG Audit Finds Cybersecurity Gaps at Large Northeastern Hospital

On July 11, 2025, the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) posted a report that announced the findings of a cybersecurity audit it conducted of a large Northeastern...more

Venable LLP

OIG Reminds Us that Flat Fee Business Arrangements Aren’t Immune from AKS Scrutiny

Venable LLP on

On July 1, 2025, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued Advisory Opinion No. 25-08, concluding that a medical device manufacturer’s proposed payment to access a...more

Epstein Becker & Green

Latest Moves by Federal Agencies Regarding Gender-Affirming Care: Risks Mount for Providers

Epstein Becker & Green on

Since day one, a policy priority of the Administration has been to discourage and prevent gender-affirming care for children and adolescents that involves surgery or medication....more

Skadden, Arps, Slate, Meagher & Flom LLP

OIG Issues Unfavorable Advisory Opinion: Provision of Free Services to Referral Sources Creates Kickback Risk

Key Points - - The Office of Inspector General of the Department of Health and Human Services (OIG) has issued Advisory Opinion No. 25-04 (AO 25-04), its first advisory opinion of the year addressing a proposed arrangement...more

Health Care Compliance Association (HCCA)

From $5,000 to $800,000: Days Apart, OCR Security Settlements Show Puzzling Math

A single incident that may have started as a personal vendetta or an extortion threat seven years ago has cost a Florida health care system $800,000, and comes on the heels of an unrelated breach suffered by a different...more

McDermott Will & Schulte

CMS Requires Hospitals to Publish More Pricing Information, Signals Focus on Enforcement

On May 22, 2025, the Centers for Medicare & Medicaid Services (CMS) released new guidance for compliance with the hospital price transparency rule and published a request for information (RFI) seeking ways to bolster hospital...more

Jones Day

California Prosecutors Aggressively Pursue Compliance With Medical and Hazardous Waste Disposal Requirements

Jones Day on

Health care facilities' compliance with medical and hazardous waste disposal laws comes under scrutiny in recent—and costly—investigations in California. ...more

McDermott+

CMS Requests Hospitals Submit Gender-Affirming Care Data- (UPDATED)

McDermott+ on

On May 28, 2025, the Centers for Medicare & Medicaid Services (CMS) sent a letter to “select hospitals” that provide gender-affirming care services, requesting information about how those hospitals adhere to quality standards...more

Greenbaum, Rowe, Smith & Davis LLP

Legal Risks and Challenges for Private Equity in Healthcare Acquisitions

Private Equity (PE) firms continue to be significant players in U.S. healthcare, acquiring assets across various sectors such as physician practices, home health, behavioral health, and urgent care. However, recent legal...more

Buchalter

Navigating Immigration Compliance in U.S. Hospitals: Key Concerns for Administrators and Providers

Buchalter on

The healthcare sector, a cornerstone of U.S. public infrastructure, relies heavily on a diverse and multinational workforce. From physicians to support staff, many hospital employees are immigrants—often working under...more

Cadwalader, Wickersham & Taft LLP

Washington State Adopts First Broad State Antitrust Premerger Notification Act and Filing Requirement

Effective July 27, 2025, any person that files a Hart-Scott-Rodino (HSR) Act Notification and Report Form (HSR Form) with the Federal Trade Commission (FTC) and the Department of Justice (DOJ) must also submit an electronic...more

Paul Hastings LLP

Check-Up and Diagnosis: The Ongoing Scrutiny of Private Equity Healthcare Investments

Paul Hastings LLP on

In 2024 alone, over 676 private equity firms and related investors acquired healthcare companies or related assets. The growing influence of private equity in the healthcare industry has not gone unnoticed on either of the...more

Spilman Thomas & Battle, PLLC

Decoded - Technology Law Insights, V 6, Issue 4, April 2025

Welcome to our fourth issue of 2025 of Decoded - our technology law insights e-newsletter. We hope you enjoy this issue and thank you for reading. Sector by Sector: How Data Breaches are Wrecking Bottom Lines - “Data...more

Saul Ewing LLP

New Executive Order and the Risks of Non-Compliance with Healthcare Price Transparency Rules

Saul Ewing LLP on

On February 25, 2025, President Trump issued an Executive Order titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information” (the 2025 Order). This directive...more

Epstein Becker & Green

Criminal Health Care Fraud Enforcement: Projections for 2025 and Beyond – Diagnosing Health Care Video Podcast

Since Pam Bondi was appointed U.S. Attorney General, we’ve seen notable shifts in the U.S. Department of Justice’s criminal enforcement priorities. How significant are some of these changes, and how might they affect your...more

Bass, Berry & Sims PLC

13th Annual Healthcare Fraud & Abuse Review - 2024

Bass, Berry & Sims is pleased to announce the release of the 13th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2024. Compiled by the firm's Healthcare Fraud & Abuse Task Force,...more

Robinson+Cole Health Law Diagnosis

Trump Administration Issues Executive Order Prioritizing Hospital Price Transparency Enforcement

On February 25, 2025, President Donald Trump issued an Executive Order titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information” (the 2025 Order). The...more

Quarles & Brady LLP

PE in Healthcare – Recent Governmental Commentary Could Indicate Policy Changes on the Horizon and Time for Increased Vigilance

Quarles & Brady LLP on

Recent reports published by the Senate Budget Committee (the “Committee”) and the U.S. Department of Health and Human Services (“HHS”) highlight what the authors characterize as concerns related to private equity (“PE”)...more

Lowenstein Sandler LLP

In Trump’s Second Term, Healthcare Enforcement May Remain Business as Usual

Compared with other issues, healthcare enforcement during President-elect Donald Trump’s upcoming second term has received little attention. When he takes office again on January 20, should industry actors like pharmaceutical...more

Health Care Compliance Association (HCCA)

Overlapping surgeries: Time for a compliance checkup?

Overlapping surgeries is a practice that has been used for many years by healthcare providers (such as hospitals and surgical centers). This practice generally refers to situations where one lead attending surgeon is...more

Health Care Compliance Association (HCCA)

Employees’ Misdeeds, Lack of Risk Analysis Cost NY Hospital $4.75M; OCR Issues Warning

Although the HHS Office for Civil Rights (OCR) described its recent $4.75 million agreement with a Bronx, New York, hospital as settling a “malicious insider cybersecurity investigation,” the agency considered a total of 11...more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

Health Care Compliance Association (HCCA)

Hospital Settles CMP Case Over Free APPs; 'Bona Fide' Use Shouldn't Inspire Fear, Lawyer Says

In a case that may hit a raw compliance nerve, Ascension Macomb Oakland Hospital in Michigan has agreed to pay $100,000 in a settlement with the HHS Office of Inspector General (OIG) over free services provided to certain...more

McDermott Will & Schulte

New Illinois Protections Against Patient Medical Debt May Also Help Reduce Hospital Bad Debt

Starting in mid-2024, Illinois hospitals will be required to take a much more active role in limiting consumers’ medical debt by screening all consenting uninsured patients for both public health insurance program coverage...more

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