Articles and Blogs

NATIONAL Children’s Hospital Association teams with Vizient CMS official defends flat Medicare Advantage rate proposal for 2027 CMS pitches stricter oversight of organ procurement groups: 6 takeaways CMS proposes nearly flat Medicare Advantage payments for 2027: 5 notes CMS proposes excluding chart reviews from MA risk scoring in 2027 payment rule CMS seeks input... READ MORE

On January 16, 2026, the Department of Justice (“DOJ”) announced that it recovered a record-breaking $6.8 billion in False Claims Act (“FCA”) related settlements and judgments in the 2025 fiscal year. The 2025 recovery amount more than doubles the previous year’s recovery of $2.9 billion and marks the highest recovery in a single year... READ MORE

Congress’s fiscal year 2026 health care appropriations bill introduces a significant new statutory condition of Medicare payment for off-campus hospital outpatient departments. If enacted, effective January 1, 2028, Medicare payment would be prohibited for items and services furnished by an off-campus hospital outpatient department unless two conditions are met: (1) the department has a... READ MORE

On January 21, 2026, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) released its Semiannual Report to Congress for the six-month period ending September 30, 2025 (“Report”). OIG’s enforcement actions during this period resulted in “the largest health care fraud takedown in the Department of Justice history, involving more... READ MORE

Amendments to the Illinois Workplace Transparency Act (“WTA”) were introduced by HB 3638 and became effective on January 1, 2026. The amendments broaden the scope of protection for employees and impose additional restrictions on employers when drafting contract provisions in a variety of employment-related agreements, including severance, settlement and arbitration agreements. Going forward, Illinois... READ MORE

NATIONAL AHA responds to House request for information on modernizing MACRA AMA ‘disappointed’ in MedPAC for backing off deeper Medicare pay reform Amazon One Medical launches AI assistant Behavioral health trends reshaping essential hospitals CMS pain procedure reimbursement policy draws pushback Congress eyes tackling healthcare consolidation Congress unveils bipartisan health bill, funding deal Federal... READ MORE

Some of the advocacy groups and think tanks that lobbied for the Medicaid provider tax restrictions in last year’s H.R. 1 are now renewing their criticisms of the states’ use of “intergovernmental transfers” (“IGTs”) from governmental health care providers to fund the non-federal share of Medicaid payments to those same providers.[1] The critics’ goal... READ MORE

The Hart-Scott-Rodino Antitrust Improvements Act of 1976 (“HSR Act”), as amended, requires all persons contemplating certain mergers or acquisitions that meet or exceed the jurisdictional thresholds (shown below) to file a premerger notification (an “HSR Filing”) with the Federal Trade Commission (“FTC”) Premerger Notification Office and the Department of Justice (“DOJ”) Antitrust Division and... READ MORE

Health care organizations planning major capital projects, such as hospital expansions, surgical centers and outpatient facilities, often face familiar frustrations: delays, cost overruns, redesign cycles and coordination breakdowns. Traditional delivery models like design‑bid‑build or construction manager‑at‑risk can unintentionally reinforce silos. Integrated Project Delivery Agreements (“IPDA”) offer a collaborative alternative designed to align incentives, reduce... READ MORE

The health care transactional landscape may have been quieter than anticipated at the beginning of 2025, with providers experiencing financial strains, but the year finished out with a high level of activity, marked by opportunistic growth strategies. Transactions will continue to be anything but “cookie-cutter.” In this article, we highlight eight M&A trends demonstrating... READ MORE