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Health Care Providers Appeals

Pietragallo Gordon Alfano Bosick & Raspanti,...

Rare Circuit Court Decision on Eliminating Kickbacks in Recovery Act Demands Notice In and Beyond Addiction Treatment Industry

The Ninth Circuit recently decided United States v. Schena, 142 F.4th 1217 (9th Cir. 2025), which considered the Eliminating Kickbacks in Recovery Act (“EKRA”). EKRA, enacted in 2018 to address “body brokering” and other...more

Husch Blackwell LLP

Hospice Insights Podcast - Hospice Audit Updates: Hospices Fare Well in Federal Court

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Increasing audit activity combined with certain decreasingly favorable audit appeal outcomes has resulted in hospices appealing audit results beyond the administrative law judge phase and into federal court. In this episode,...more

King & Spalding

Second Circuit Affirms Lower Court’s Ruling Rejecting Neurological Surgery Provider’s Challenge to the No Surprises Act

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On July 22, 2025, the United States Court of Appeals for the Second Circuit affirmed the judgment of the United States District Court for the Eastern District of New York, which dismissed an amended complaint brought by...more

Warner Norcross + Judd

Federal Court Flags Stark and Anti-Kickback Risks in Physician Pay, Spotlights FCA Constitutional Questions on Appeal

On July 28, the federal district court in the Southern District of Ohio issued a pair of orders in related whistleblower cases under the False Claims Act (FCA): United States ex rel. Murphy v. TriHealth, Inc., et al., No....more

Husch Blackwell LLP

Federal Court Vacates 2024 HIPAA Reproductive Health Privacy Rule: Key Impacts for Covered Entities and NPP Compliance

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On June 18, 2025, the U.S. District Court for the Northern District of Texas issued a decision in Carmen Purl, et al. v. United States Department of Health and Human Services, et al., vacating nearly all of the 2024 HIPAA...more

Marshall Dennehey

Superior Court Reverses Nonsuit, Holds Trial Court Bound by Prior Ruling on Expert Qualification

Marshall Dennehey on

Joyner v. Thomas Jefferson Univ. Hosps., Inc., No. 534 EDA 2024, 2025 WL 933175, at *1 (Pa. Super. Ct. Mar. 26, 2025), reargument denied (May 29, 2025) - In her suit, the pro se plaintiff alleged negligent placement of leg...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Lessons From the Seventh Circuit on Relying on FMLA Certifications and Requiring the Use of Paid Leave

A recent May 2025 opinion from the U.S. Court of Appeals for the Seventh Circuit warns employers that they may not be able to rely strictly on a health care provider’s certification under the Family and Medical Leave Act...more

Holland & Hart - Health Law Blog

Federal Court Vacates HIPAA Reproductive Health Rule

As anticipated, a Texas federal district court has vacated the HIPAA Reproductive Health Rule (the “Rule”) nationwide. (Memorandum Opinion and Order, Purl v. HHS, 2:24-CV-228-Z (N. Dist. Tex (Jun. 18, 2025), available here)....more

Proskauer - Health Care Law Brief

No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide...

In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No...more

Alston & Bird

Texas Court Strikes Down 2024 HIPAA Reproductive Health Care Rule

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A Texas federal court has vacated a 2024 HIPAA rule that created special protections for reproductive health care information. Our Health Care Group examines the ruling and its impact on health care providers and plan...more

Smart & Biggar

Health Canada must redetermine exemption requests for psilocybin (magic mushroom)-assisted psychotherapy training

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TheraPsil, a patient advocacy organization, and 73 healthcare practitioners (HCPs) have succeeded in the Federal Court of Appeal (FCA) to overturn the refusal of the Minister of Mental Health and Addictions and Associate...more

Troutman Pepper Locke

U.S. Supreme Court Holds Medicaid’s Any-Qualified-Provider Provision Does Not Confer Enforceable Rights

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The U.S. Supreme Court, in a 6-3 decision, ruled that the Medicaid Act’s any-qualified-provider provision does not confer individual rights enforceable under 42 U.S.C. §1983. This decision reverses the Fourth Circuit’s...more

King & Spalding

Fifth Circuit Finds No Private Right of Action for Providers to Enforce Surprise Billing Awards

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On Thursday, June 12, 2025, a panel of the United States Court of Appeals for the Fifth Circuit issued two rulings construing parts of the No Surprises Act (NSA) to limit judicial review of arbitration awards issued under the...more

ArentFox Schiff

Federal Courts Divided Over Private Enforcement of ‘No Surprises Act’ Arbitration Awards

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Congress enacted the No Surprises Act (NSA) to protect patients from unexpected medical bills. A central pillar of the NSA is its independent dispute resolution (IDR) process, under which payers and providers can submit...more

Nossaman LLP

When Are Hospitals on the Hook? Reconciling Elam and Bichai

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Din v. Sutter Valley Hospital (June 10, 2025, C099101, unpublished) puts the spotlight on a dividing line in California law: when can a hospital be liable for actions taken by its medical staff? The case sharpens the contrast...more

Troutman Pepper Locke

Fifth Circuit Clarifies Enforcement of IDR Awards Under the No Surprises Act

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On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more

Arnall Golden Gregory LLP

Limitations to the Anti-Kickback Statute? Seventh Circuit Reverses Conviction Finding “Aggressive” Marketing Tactics Insufficient...

On April 14, 2025, the United States Court of Appeals for the Seventh Circuit reversed the conviction of the owner of a durable medical equipment (“DME”) distributor, ruling that there was insufficient evidence to support a...more

Cranfill Sumner LLP

Kickbacks and Causation: Supreme Court Could Soon Settle the Question of Anti-Kickback Statute and False Claims Act Causation...

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A decision by the First Circuit Court of Appeals has deepened the legal debate surrounding False Claims Act (FCA) actions based on violations of the Anti-Kickback Statute (AKS). This decision has increased speculation that...more

McDermott Will & Schulte

PointClickCare Denied En Banc Hearing to Overturn PI

On April 23, 2025, the US Court of Appeals for the Fourth Circuit denied PointClickCare Technologies, Inc.’s petition for en banc review in Real Time Medical Systems, LLC v. PointClickCare. A Fourth Circuit panel previously...more

King & Spalding

Second Circuit Holds No FCA Violation Where Defendant Relied on Favorable OIG Advisory Opinions

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On April 14, 2025, the Second Circuit issued a summary order holding that the relator failed to plead scienter, a necessary element under the Anti-Kickback Statute (AKS) and the False Claims Act (FCA), where the defendant...more

Marshall Dennehey

Pennsylvania Superior Court Vacates Summary Judgment Due to Procedural Error in Response Time

Marshall Dennehey on

Jordan v. Lynde, 330 A.3d 817 (Pa. Super. Ct. 2024) - The Pennsylvania Superior Court ruled that the trial court abused its discretion by failing to grant the appellants the 30-day response period required under Pa. R.Civ.P....more

McDermott Will & Schulte

CMS Poised for Medicare, Medicaid Integrity Enforcement Actions

The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid enrollment terminations, and...more

Perkins Coie

First Circuit Imposes Higher “But-for” Causation Standard for False Claims Act Liability Based on Alleged Anti-Kickback Statute...

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On February 18, 2025, the U.S. Court of Appeals for the First Circuit added its voice to a growing chorus of appellate courts to elevate the standard of proof required to show a violation of the federal False Claims Act in...more

Hanson Bridgett

Peer Review by Licentiates Only: Beware Health Care Service Plans!

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On February 19, 2025, the California Court of Appeal published a decision, Lin v. Board of Directors of PrimeCare Medical Network, Inc., 108 Cal.App.5th 1163, emphasizing California Business and Professions Code’s requirement...more

Tyson & Mendes LLP

Privacy vs. Relevance: How Deep Can Discovery Go in Colorado Lien Cases?

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Jina Garcia found herself entangled in a legal battle with Centura Health Corp. after receiving medical treatment and subsequently facing a lien on any potential settlement or judgment in In Re Garcia v. Centura Health Corp....more

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