Hospice Insights Podcast - Hospice Audit Updates: Hospices Fare Well in Federal Court
HHS OIG’s Nursing Facility: Industry Segment-Specific Compliance Program Guidance
Podcast - Innovations and Insights in the Palliative Care Space
Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath
False Claims Act Insights - Trump DOJ Sharpens Its Focus on Healthcare Fraud
UPIC Audits
AGG Talks: Home Health & Hospice Podcast - Episode 10: Anti-Kickback Compliance for Hospice and Skilled Nursing Providers
Healthcare Industry Segment-Specific Compliance Program Guidances (ICPGs)
Hospice Insights Podcast - One Size Doesn’t Fit All: Figuring Out What is Your Hospice+
AGG Talks: Cross-Border Business Podcast - Episode 27: U.S. Healthcare Reimbursement Guidance for Foreign Life Sciences Companies
AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
In the past few months, federal prosecutors in California have brought multiple indictments under the Eliminating Kickbacks in Recovery Act (EKRA) charging the owners of substance abuse treatment facilities and their...more
To offset the cost of other provisions in the bill, the One Big Beautiful Bill Act (OBBBA) includes significant reforms to Medicaid, Medicare, and Affordable Care Act (ACA) premium tax credits that are expected to result in...more
On July 4, 2025, President Trump signed into law the legislation commonly referred to as the “One Big Beautiful Bill Act” (OBBBA), which includes significant changes to Medicaid, Medicare, and Affordable Care Act (ACA)...more
Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more
Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more
Insufficient collaboration between plaintiff and defense attorneys regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting requirements creates administrative complications which can negatively...more
New York State recently adopted “network adequacy” regulations that will require health care plans in the state to improve access to behavioral health services, including mental health and substance use treatment services....more
The Medicare program continues to face long term financial pressures associated with inflationary effects on health care costs and the growing wave of aging baby boomers. The Medicare Trust Fund, which is often viewed as a...more
Historically, the U.S. Department of Justice has directed its efforts on combatting healthcare fraud by focusing on persons and companies who defraud or attempt to defraud federally funded healthcare programs, such as...more
Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing,...more
This August, a working group sponsored by the National Association of Insurance Commissioners (the "NAIC") unanimously approved revisions to the NAIC's Unfair Trade Practices Act Model #880 (the "Model Law") to restrain...more
In this session, McDermott Will & Emery Partner Patrick Healy moderated a panel that examined the expansion of value-based care in the employer market. We summarize the panel’s insights on how stakeholders can successfully...more
On February 24, 2023, CMS issued a proposed rule that would modify the Medicare Disproportionate Share Hospital (DSH) payment regulation to limit the universe of Section 1115 demonstration beneficiaries who can be “regarded...more
On November 18, 2022, the U.S. Department of Justice (DOJ) announced charges against 10 defendants in its first coordinated action against individuals using business email compromise (BEC), money laundering, and wire fraud...more
Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more
The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2022 Summer National Meeting which was held in Portland, Oregon on August 9-13th. We have...more
Healthcare fraud related to durable medical equipment (DME) is extremely costly to insurers yet often continues without criminal or civil consequences. Fraudulent schemes by DME supply companies vary in complexity but...more
A national vaccination mandate directed at employers with more than 100 employees became effective 1/10/2022. Although the U.S. Supreme Court has expedited oral arguments regarding judicial stays facing the mandate, the...more
In the closing days of 2020, Congress passed federal legislation aimed at protecting patients against surprise medical bills and facilitating payment dispute resolutions among providers and insurers. Slated to take effect on...more
Sitting in the dark before 6 am in my Los Angeles house with my face lit up by yet another Zoom screen, wearing a stylish combination of sweatpants, dress shirt and last year’s JPM conference badge dangling around my neck for...more
The Trump Administration has put out its latest prescription to try to slash out-of-control prescription drug prices: Officials want to call medication “rebates” what they say they’ve really become — “kickbacks” — and crack...more
I. REGULATIONS, NOTICES, & GUIDANCE - On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United...more
Personalized medicine can be described as the science of targeted therapies. Advances in diagnostic and molecular medicine have made it possible to more precisely identify alternative treatment options for patients based on...more
In dealing with a workers’ compensation claim, adjusters will want to be sure to be aware of any other entities that may have a lien on money that might be awarded to the injured worker. In North Carolina workers’...more