Articles and Blogs

The Indiana Court of Appeals (the “Court”) affirmed a trial court’s determination that a patient was gravely disabled—even though he initially sought care for a physical ailment. The Court held that the patient’s refusal of necessary treatment, combined with his lack of insight into both his medical and psychiatric conditions, satisfied the clear-and-convincing-evidence standard.... READ MORE

For years, we’ve heard that outpatient services and home care are the future of health care in the U.S. To a certain extent, that’s true. We’ve seen tremendous growth in outpatient care across the country. Procedures that were once provided in inpatient settings are now provided in ambulatory surgery centers and physician offices. Payers,... READ MORE

NATIONAL 4 senators push CMS to tackle Medicare Advantage upcoding: Bloomberg 7 health systems with boosted outlooks 131 hospitals sue HHS over DSH cuts: 5 notes ACA plans denied 19% of in-network claims in 2024: report AHA urges CMS to limit hospital burden in fraud crackdown, calls for MA scrutiny Bipartisan bill would cap... READ MORE

Indiana Medicaid implemented significant updates for applied behavior analysis (“ABA”) therapy—one of the most widely used interventions for children with autism spectrum disorder—effective April 1, 2026. The reforms include phased cuts to reimbursement for ABA therapy, updates to member eligibility and revisions to provider qualifications. The Indiana Health Coverage Programs (“IHCP”) began covering ABA... READ MORE

Our previous article, In Defense of IGTs from Governmental Health Care Providers, noted that the Secretary of the Department of Health and Human Services (“HHS”) is required to “consult with the States” before issuing any regulations changing the treatment of intergovernmental transfers (“IGTs”). We received requests for further information about this requirement following the... READ MORE

NATIONAL 1 in 3 adults using AI chatbots for healthcare advice: KFF Academic medical models are under financial strain: 5 things to know Aetna, Elevance, Humana May Be Sued In Alleged Kickback Scheme, Judge Says AHA cautions CMS on provider ID rule implementation AHA: FBI warns of Iranian hacks via Telegram app AHA urges... READ MORE

The Centurion Foundation has financially stabilized Roger Williams Medical Center and Our Lady of Fatima Hospital in Rhode Island and returned them to local nonprofit management through a bond-financed recapitalization exceeding $100M. The hospitals had been at risk of closure after their prior owner, Prospect Medical Holdings, filed for Chapter 11 bankruptcy in 2025.... READ MORE

On March 20, 2026, Federal Trade Commission (“FTC”) Chairman Andrew Ferguson announced the formation of an internal Healthcare Task Force (the “Task Force”) and, in a memorandum issued the same day, directed the FTC’s Bureaus of Competition, Consumer Protection, and Economics, along with the Office of Policy Planning and the Office of Technology, to... READ MORE

On March 24, 2026, the U.S. Department of Health and Human Services (“HHS”), through the Centers for Medicare & Medicaid Services (“CMS”), published a long‑anticipated final rule adopting national Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) standards for health care claims attachments transactions and electronic signatures (the “Final Rule”). The Final Rule... READ MORE

In a significant decision with implications for 340B enforcement and False Claims Act (“FCA”) whistleblower litigation, the United States Court of Appeals for the Ninth Circuit (the “Court”) held on March 17, 2026, that a health system (the “System”) may proceed with its qui tam action alleging that pharmaceutical manufacturers engaged in fraudulent price-inflation... READ MORE