News & Analysis as of

Health Care Providers Risk Management

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - October 6th - 9th, San Antonio, TX

Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more

Oberheiden P.C.

Pharmacy Claim Reversals: Mitigating Risk Before, During, and After an Investigation

Oberheiden P.C. on

Pharmacy claim reversals can be costly. Not only can they have an immediate impact on pharmacies’ cash flow; but, in many cases, they can lead to additional consequences as well. Pharmacies accused of improperly billing...more

Husch Blackwell LLP

False Claims Act Insights - An FCA Perspective on Artificial Intelligence in the Healthcare Industry

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Host Jonathan Porter welcomes the Coker Group’s Andy Sobczyk to the podcast to discuss the risks and opportunities associated with implementing artificial intelligence (AI) solutions in the healthcare industry. The...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - September 8th - 11th, Scottsdale, AZ

Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more

Health Care Compliance Association (HCCA)

‘We Cannot Do It Alone’: Cutbacks in Federal Funds, Engagement Spur Cries for HIPAA Help, New Laws

At the very top of Fisher-Titus Medical Center’s website is a link to the Change Healthcare HIPAA notice informing visitors of the last day to register for credit monitoring related to the world’s largest breach, which...more

Arnall Golden Gregory LLP

Navigating the Evolving M&A Landscape in the Care-at-Home Industry

The merger and acquisition environment for the care-at-home sector, including hospice, home health, and private duty services, has shifted significantly. At the 2025 Financial Summit hosted by the National Alliance for Care...more

Warner Norcross + Judd

Escalating ICE Presence in Health Care Settings — What Providers and Administrators Must Know Now

On July 8, a routine enforcement action by Immigration and Customs Enforcement (ICE) agents at a surgery center in California escalated into criminal charges for two health care workers. ICE agents were attempting to detain...more

Baker Donelson

EKRA's Application to Marketing Arrangements: Laboratories and Other Providers

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The Ninth Circuit recently affirmed two decisions that provide additional guidance regarding how arrangements with marketing agents implicate and violate the Eliminating Kickbacks in Recovery Act, 18 U.S.C. § 220(a)(EKRA)....more

Quarles & Brady LLP

Risks and Regulations with the Use of AI in Behavioral Health

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As some studies estimate that nearly 23% of the adult population lives with a mental illness, the integration of artificial intelligence (AI) into mental health care has transformative potential in terms of accessibility,...more

Hogan Lovells

Key takeaways – UK MHRA’s response to consultation on ‘Medical Devices Regulations: Routes to market and in vitro diagnostic...

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The UK Medicines and Healthcare products Regulatory Agency (MHRA) has published its responses to the consultation on Medical Device Regulations: Routes to market and in vitro diagnostic devices carried out last year....more

Roetzel & Andress

Planning for the Unexpected: How Unwind Agreements Help Medical Practices

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If your medical practice is considering joining a larger group or hospital, it’s important to ask: what if the new relationship doesn’t work out? In some situations, an unwind agreement can provide a path back to...more

Benesch

Dental/DSO Intelligence Monthly Report: July 2025

Benesch on

As government scrutiny of the healthcare industry intensifies, enforcement agencies are casting wider nets to recover funds based on narrowly interpreted violations. This puts not only healthcare providers but also those...more

Polsinelli

Virtual Oversight, Real Impacts: “Incident-To” and Beyond in CMS’s CY 2026 PFS Proposed Rule

Polsinelli on

Key Takeaways - CMS proposes to significantly expand the use of virtual direct supervision for incident-to services, removing prior limitations based on Professional Component (PC)/Technical Component (TC) indicators and...more

Roetzel & Andress

What’s in Your Operating Agreement? Legal Tips for Healthcare Providers

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This week on the HealthLawHotSpot, host Ericka Adler welcomes Roetzel shareholder Jonna Eimer to discuss the essential role of operating agreements in healthcare practices. Whether you're starting a new practice or reviewing...more

Sheppard Mullin Richter & Hampton LLP

Potential False Claims Act Liability for Providers of Gender-Affirming Care for Minors

On July 9, 2025, the U.S. Department of Justice (“DOJ”) announced it sent more than 20 subpoenas to physicians and clinics involved in providing gender-affirming care to minors, and that the subpoenas related to...more

Husch Blackwell LLP

Beyond the Bylaws: The Medical Staff Show - Need to Know: How to Manage Medical Staff Confidentiality and Privilege Protections

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Host Nick Healey welcomes to the show Deb Wade, who serves as the medical staff coordinator at a large rural hospital, to discuss the confidentiality and privilege protections that medical staff routinely encounter as they...more

Constangy, Brooks, Smith & Prophete, LLP

Cybersecurity challenges in the health care industry: Legal, regulatory, and risk considerations

Health care remains one of the most targeted and vulnerable sectors when it comes to cyberattacks. In fact, a recent breach at a major health care analytics firm exposed the data of 5.4 million U.S. patients, making it one of...more

ArentFox Schiff

AI Service Agreements in Health Care: Indemnification Clauses, Emerging Trends, and Future Risks

ArentFox Schiff on

As artificial intelligence (AI) becomes increasingly embedded in health care, from diagnostics and clinical decision support to administrative automation, health care providers are increasingly reliant on AI vendors to...more

NAVEX

[Webinar] AI Governance in Healthcare: How Compliance Teams Can Manage Risk and Stay Ahead - July 30th, 10:00 am - 11:00 am PDT

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As AI adoption accelerates in healthcare, compliance, privacy, and risk teams are under pressure to adapt. Join experts from NAVEX and Granite GRC to learn how a proactive AI governance strategy can help you stay compliant,...more

Whiteford

Employment Law Update: Maryland’s Restrictions on Non-Compete Agreements for Healthcare Professionals, Among Other Employment...

Whiteford on

As of July 1, 2025, Maryland prohibits or restricts non-compete provisions for nearly all healthcare professionals. The prohibition applies to individuals: (1) required to be licensed under the Maryland Health Occupations...more

Polsinelli

CMS Proposes New Mandatory, Two-Sided Risk Model for Heart Failure and Low Back Pain

Polsinelli on

Key Takeaways - CMS has proposed a mandatory two-sided risk model for specialists treating heart failure and low back pain in outpatient settings....more

Woods Rogers

New Virginia "Workplace Violence" Definition and Healthcare Reporting Law: What's the Tea in L&E?

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In this episode of What’s the Tea in L&E, Healthcare Regulatory and Compliance attorney Lindsey Brock joins host Leah Stiegler to unpack a new Virginia law that went into effect on July 1, 2025, introducing updated reporting...more

Holland & Hart LLP

Navigating Utah's Expanded Peer Review Privilege: A Roadmap for Healthcare Providers

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The term “peer review privilege” generally refers to a discovery and evidentiary privilege that can be asserted by hospitals and other healthcare entities to protect the confidentiality of credentialing, quality improvement,...more

Morgan Lewis

AI in Healthcare: Opportunities, Enforcement Risks and False Claims, and the Need for AI-Specific Compliance

Morgan Lewis on

The risks associated with the growth of AI in the healthcare and life sciences industries, as well as recent federal and state activity and enforcement actions, emphasize the importance of understanding and implementing a...more

Warner Norcross + Judd

Insights from the Largest DOJ Health Care Fraud Enforcement Effort in U.S. History

On June 30, the Department of Justice (DOJ) announced the largest coordinated health care fraud enforcement effort in U.S. history, involving criminal charges against over 300 defendants and over $14.6 billion in health care...more

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