News & Analysis as of

Medicaid Opioid

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Quarles & Brady LLP

Accessing Opioid Settlement Funds

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While federal funding for addiction treatment programs and research is being cut, more than $50 billion is being distributed to state and local programs from opioid-related lawsuits. There is great debate on the use of these...more

Cozen O'Connor

Pennsylvania Perspective for Monday, July 7, 2025

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PA’s Lottery Allowed to Allocate More Money to Player Payouts- Lawmakers passed legislation last week aimed at raising millions of more dollars for senior citizens by allowing the Pennsylvania Lottery to funnel more funds...more

Miles & Stockbridge P.C.

DOJ Remains Focused on Domestic Health Care Fraud

The Department of Justice (DOJ) recently issued its annual Health Care Fraud Takedown results, announcing a record-breaking 324 defendants, including 96 doctors and licensed professionals, as well as more than $14.6 billion...more

McDermott+

McDermott+ Check-Up: February 7, 2025

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Key Nominations Move Forward. The Senate Finance Committee advanced Robert F. Kennedy (RFK) Jr.’s nomination to lead the US Department of Health & Human Services (HHS) in a 14 – 13 vote along party lines. The nomination now...more

Cozen O'Connor

McKinsey to Pay $650 Million to Resolve Investigations into Alleged Role in OxyContin Crisis

Cozen O'Connor on

McKinsey & Company, Inc., has entered into a deferred prosecution agreement (DPA) to resolve a federal criminal investigation into its advice to Purdue Pharma L.P. (Purdue) on how to increase sales of OxyContin, and a civil...more

Foley & Lardner LLP

Substance Use Disorder Treatment Services: 2025 Physician Fee Schedule Proposed Rule Would Expand Access and Medicare Coverage

Foley & Lardner LLP on

On July 10, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule Proposed Rule (Proposed Rule) for the calendar year 2025. The Proposed Rule would implement certain provisions of the...more

McAfee & Taft

2024 Oklahoma legislative session in review: Healthcare edition

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By Cori H. Loomis While the healthcare industry was not a specific area of focus for this year’s Oklahoma legislative session as it has been in previous years when Medicaid reform and managed care were addressed, a number of...more

Hendershot Cowart P.C.

A Pharmacist's Guide To Prescription Drug Fraud Investigations

Hendershot Cowart P.C. on

Prescription drug fraud has long been a focus for government regulators, but it has taken on new significance in the wake of America’s opioid crisis. The U.S. Department of Justice (DOJ), Department of Health and Human...more

Harris Beach Murtha PLLC

OIG February 2024 Enforcement Actions

The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

ArentFox Schiff

Investigations Newsletters: Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations

ArentFox Schiff on

Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations - On February 28, the US Department of Justice (DOJ) announced the guilty plea of Andrew Maloney, who, along with his clinical laboratory...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 25 - February 2024

The Georgia State Capitol hallways and hoppers continued to overflow on Thursday. Law Enforcement Day at the Capitol converged with an onslaught of hundreds of charter school students to fill the People’s House with Georgians...more

King & Spalding

HHS Announces Continuing Telehealth Flexibilities Following the End of the COVID-19 PHE

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On May 10, 2023, HHS announced that many telehealth and teleprescribing flexibilities will remain in place after the end of the COVID-19 Public Health Emergency (PHE) on May 11, 2023. Congress extended many telehealth...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Harris Beach Murtha PLLC

Continued: Summary of Fraud and Abuse Enforcement Yields Insight for Health Care Compliance and Risk Assessment

The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more

Fox Rothschild LLP

Enhanced Scrutiny of Opioid Prescriptions Poses Legal Risks for Medical Professionals

Fox Rothschild LLP on

The U.S. Department of Justice recently charged multiple physicians and health care professionals for opioid-related crimes in a crackdown with a clear message to individuals in the industry: If you are involved with...more

Mintz - Health Care Viewpoints

False Claims Act Settlements and Judgments Exceed $5.6 Billion in Fiscal Year 2021

The Department of Justice announced in a February 1, 2022 press release (Press Release) that it obtained more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims in the fiscal year...more

Womble Bond Dickinson

Opportunity Economy: Telehealth in the Pandemic - and Beyond

Womble Bond Dickinson on

Takeaways: ..Telehealth greatly expanded during the COVID-19 pandemic, in large part due to regulatory waivers. Those regulatory waivers aren’t permanent, but lawmakers are evaluating ways to permanently expand some...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 32. News Briefs: September 2021

Report on Medicare Compliance 30, no. 32 (September 13, 2021) - Saint Francis Medical Center in Missouri agreed to pay $1.625 million in a civil settlement of allegations it violated the Controlled Substances Act, the...more

McGuireWoods Consulting

Washington Healthcare Update - July 2021 #1

This week in Washington: Senate in recess, conversations continue on infrastructure and administration’s health initiatives. ...more

King & Spalding

OIG Releases Semiannual Report to Congress

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On May 28, 2021, OIG released its Semiannual Report to Congress (the Report). The Report describes OIG’s work during the 6-month semiannual reporting period of October 1, 2020, through March 31, 2021 (the Semiannual Reporting...more

Foley & Lardner LLP

COVID-19 Compounds Opioid Crisis and Treatment Gaps for Vulnerable Americans: Will a Biden Administration and New Congress Expand...

Foley & Lardner LLP on

Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms - New opportunities for investor-backed behavioral health platforms in...more

ArentFox Schiff

Investigations Newsletter: HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute

ArentFox Schiff on

HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute - On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services (HHS) published...more

Akin Gump Strauss Hauer & Feld LLP

President-Elect Biden’s Potential Executive Actions: A Health Care & Life Sciences Perspective

President-elect Biden’s agenda and approach for his first 100 days in office will depend to a large degree on which party controls the United States Senate. Many of the incoming President’s major campaign promises—such as...more

Epstein Becker & Green

Opioids, Sober Homes and “Telefraud”: an Overview of the DOJ 2020 Healthcare Fraud Takedown

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In September 2020, the U.S. Department of Justice (“DOJ”) and the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) announced its annual healthcare-related “takedown.” The takedown,...more

Troutman Pepper Locke

The “New” Enforcers: How States and Localities Are Changing the Landscape of Regulatory Authority

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Over the last decade, observers have noted that states have begun to play a greater role as regulatory enforcers – a trend that increased with the federal regulatory roll-back that began with the advent of the Trump...more

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