Articles and Blogs

On October 8, 2026, the Michigan Attorney General, on behalf of the State and in its parens patriae authority on behalf of the people of Michigan, sued Blue Cross Blue Shield of Michigan (“BCBSM”) alleging federal and state antitrust violations and state claims of nuisance and unjust enrichment. The complaint alleges that BCBSM conspired... READ MORE

The Indiana Court of Appeals (the “Court”) recently reversed a regular commitment for a schizophrenic patient because the hospital failed to offer any evidence that the patient was dangerous to himself or others and that he was unable to function independently. The Court found the hospital did not present clear and convincing evidence. In... READ MORE

National $1.5B in DME fraud cases mount AHA comments to MedPAC on differences in post-acute care use between MA, fee-for-service Medicare beneficiaries AHA, others file amicus brief supporting hospital in challenge to Lilly 340B policy CMS finalizes new drug pricing model: 7 notes CMS opens new portal ahead of mandatory 340B data deadline: 4... READ MORE

On September 29, 2026, in LifeLink Foundation, Inc. v. Kennedy, the U.S. District Court for the Middle District of Florida (the “Court”) upheld the Centers for Medicare & Medicaid Services (“CMS”) 2020 rule governing Organ Procurement Organization (“OPO”) performance measures and tier classifications (the “Final Rule”). The decision rejects one significant legal challenge to... READ MORE

On October 1, 2026, Colin M. McDonald, Assistant Attorney General for the National Fraud Enforcement Division (“NFED” or the “Fraud Division”), issued a memorandum (the “Memo”) announcing key priorities of the Fraud Division’s Corporate Enforcement Section. The Memo follows significant changes to internal U.S. Department of Justice (“DOJ”) workflows for criminal fraud enforcement and... READ MORE

In revisions released earlier this year to its General Questions Regarding Certain Fraud and Abuse Authorities, the Office of Inspector General (“OIG”) emphasized that compliance with the physician self-referral law (“Stark Law”) does not automatically resolve risk under the federal Anti-Kickback Statute (“AKS”). Furthermore, OIG clarified that fair market value (“FMV”) compensation, by itself,... READ MORE

The U.S. Department of Justice (“DOJ”) recently revised its Justice Manual to strengthen its approach to False Claims Act (“FCA”) enforcement. The revisions address two issues particularly relevant to FCA defendants: the use of sub-regulatory guidance and DOJ’s consideration of dismissing declined qui tam actions. DOJ Reinforces Limits on Sub-Regulatory Guidance The revised Justice... READ MORE

On September 18, 2026, President Trump issued two related measures affecting the H-1B program—a Proclamation extending the $100,000 H-1B fee to certain H-1B workers and an Executive Order directing federal agencies to strengthen H-1B oversight, including by considering employers’ recent or planned layoffs of similarly situated U.S. workers. The $100,000 fee, which applies to... READ MORE

NATIONAL 340B hospitals lag behind peers in charity care spending: report 4 top PBMs now control 75% of market: 6 notes 6 physician groups refute RFK Jr. claim that AI is ‘better informed than any doctor’ A 50% Medicare cut has physicians sounding the alarm AHA: AI vendors outside HIPAA need tougher standards  AI... READ MORE

The U.S. Department of Justice (“DOJ”) recently issued a memorandum announcing the priorities of its newly established National Fraud Enforcement Division (the “Division”), identifying health care fraud as a key enforcement focus. The Division was created to combat fraud and will concentrate its efforts on public trust and financial integrity, health care, internal revenue,... READ MORE