Articles and Blogs

The Fifth Circuit recently addressed pre-suit disclosure and causation requirements for FCA theories of liability in United States ex rel. King v. Solvay Pharmaceuticals Inc., 871 F.3d 318 (5th Cir. 2017). Two former employees (“Relators”) of Solvay Pharmaceuticals, Inc. filed a qui tam suit claiming that Solvay induced false Medicaid claims through a variety... READ MORE

Trump Administration Announces Plans to Weaken ACA On October 12, President Trump signed an executive order to overhaul health insurance regulations. The order instructs the Departments of Treasury, Labor and Health and Human Services to expand health coverage through inexpensive, short-term health plans exempt from current Affordable Care Act (“ACA”) insurance market rules. One... READ MORE

NATIONAL Survey: Healthcare execs name data analytics, population health among top challenges for 2018 10 Common Physician Compensation Mistakes Most hospitals tie doctor pay to productivity; new research examines how that impacts academic medicine Trump could make waves with health-care order CMS releases star ratings for Medicare Advantage and drug plans, Kaiser earns top... READ MORE

Register for the free Modern Healthcare and Hall Render webinar, How Leaders Can Protect Themselves from Individual Liability. The webinar will take place October 25 at 2 PM EDT. In the last three years, the government’s focus in health care fraud has shifted from corporate civil liability to individual civil and criminal liability. Now,... READ MORE

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On September 7, 2017, the Second Circuit realigned its stance on false certifications under the False Claims Act (“FCA”) in light of the Supreme Court’s decisions in Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S.Ct. 1989, 195 L.Ed.2d 348 (2016). Background In the initial action, relators brought a qui tam action... READ MORE

House and Senate Committees Advance CHIP Funding After Congress missed the September 30 deadline to renew funding for the Children’s Health Insurance Program (“CHIP”), both the House and Senate worked to advance bipartisan CHIP legislation this week. The Senate Finance Committee advanced a bill, known as the Keep Kids’ Insurance Dependable and Secure (“KIDS”)... READ MORE

NATIONAL Which ASC company has grown the most in 2017? Five questions on healthcare following Price’s resignation Pence protégé seen as frontrunner to replace Price Congress moves toward funding lapsed federal children’s health insurance program 3 things to know about HHS Acting Secretary Dr. Don Wright 18 things to know about the 6 CEOs... READ MORE

On September 6, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued a Survey and Certification (“S&C”) Memo 17-44 with new guidance to State Survey Agencies pertaining to the application of the Medicare statutory definition of  “hospital” and whether a hospital is “primarily engaged” in the provision of inpatient services. CMS clarified that a... READ MORE

On September 13, 2017, the Department of Justice (“DOJ”) announced a $4 million settlement with a New York-based hospital owner that owns and operates two hospitals in New York. The qui tam lawsuit was filed July 15, 2013, and the relator was an employed physician at one of the hospitals implicated in the lawsuit... READ MORE