Articles and Blogs

The Centers for Medicare & Medicaid Services (“CMS”) recently issued its calendar year (“CY”) 2026 Outpatient Prospective Payment System (“OPPS”) proposed rule (“Proposed Rule”). The following summarizes several major proposals of the Proposed Rule, and the corresponding fact sheet can be found here. For interested parties and stakeholders, comments should be submitted by September... READ MORE

UPMC and GoHealth have announced the opening of 81 urgent care centers, including 33 in the Pittsburgh area. The primary purpose of these centers is to enable patients to receive care for non-life-threatening conditions, but they can serve as an initial access point for those with more serious conditions. Novant Health is planning to... READ MORE

NATIONAL 1st-of-its-kind nurse certification to launch 2026 340B drug rebates coming as HRSA launches pilot program Ambience Healthcare reaches $1.25B valuation As CMS Has Certificate of Need Laws in Crosshairs, States Debate Their Usefulness to Nursing Homes Bundled payments lead to better joint replacement outcomes: Study Dr. Oz to outline rural healthcare plans at... READ MORE

On July 14, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced its CY 2026 Physician Fee Schedule (“PFS”) Notice of Proposed Rulemaking (“Proposed Rule”). The Proposed Rule includes information on a new Center for Medicare & Medicaid Innovation (“CMMI”) mandatory payment model called the Ambulatory Specialty Model (“ASM”). If finalized, the new... READ MORE

Health care continues to drive private equity (“PE”) activity, creating opportunities for investors and traditional health care providers. Transactions in the health care space are especially complicated, layering health care regulatory and reimbursement considerations on top of a complex securities, antitrust, privacy and security framework. Hall Render’s PE team of attorneys and advisors leverage... READ MORE

On June 30, 2025, the Joint Commission announced the launch of Accreditation 360: The New Standard (the “Accreditation 360”). This initiative is designed to reduce administrative burden, enhance transparency and align accreditation more closely with real-world care delivery and outcomes. Accreditation 360 will remove over 714 requirements from the Joint Commission hospital accreditation program,... READ MORE

The Ninth Circuit’s (also referred to as the “Court”) decision in U.S. v. Schena (“Schena“) marks the first appellate interpretation of the Eliminating Kickback in Recovery Act of 2018 (“EKRA”). The Ninth Circuit held that EKRA extends to payments made to third-party marketers indirectly influencing referrals for medical testing services, expanding its scope beyond... READ MORE

The complex world of health care mergers and acquisitions (“M&A”) involves intricate processes that require effective integration of systems and services to maximize value. A Transition Services Agreement (“TSA”) is a contractual agreement that can play a crucial role in ensuring a smooth transition post-acquisition. The purpose of a TSA is two-fold: (1) to... READ MORE

In U.S. ex rel. Cooley v. ERMI, LLC, the U.S. District Court for the Northern District of Georgia (the “Court”) denied the employer’s motion for summary judgment after the employer provided unclear and inconsistent explanations for the employee’s termination. The Court explained that the reasons provided by the employer may serve as pretext rather... READ MORE

The U.S. Department of Health and Human Services (“HHS”) recently announced a major reform initiative aimed at strengthening oversight of the organ transplant system for donations after circulatory death (“DCD”). This announcement follows an investigation by the Health Resources and Services Administration (“HRSA”) that uncovered instances where HRSA found potentially preventable harm to neurologically... READ MORE