Articles and Blogs

In a move likely to ignite strident industry opposition, on January 30, 2023, the Centers for Medicare & Medicaid Services (“CMS”) announced finalization of its rule on Medicare Risk Adjustment Data Validation (“RADV”) audit methodology and resulting collection of overpayments from Medicare Advantage Organizations (“MAOs”). Experts estimate that the final rule will result in... READ MORE

Background In a press release dated February 3, 2023, the Department of Justice’s Antitrust Division (“DOJ”) announced the withdrawal of three important policy statements that health systems and providers have relied upon for decades in ordering operations, setting internal protocols, and conducting diligence during transactions. The three policy statements include, Department of Justice and... READ MORE

When an entity first decides to undertake a new capital project, one of the most important decisions it will make is choosing what kind of financing method to use. A common option for 501(c)(3) organizations, including hospitals and health care systems, is to issue tax-exempt bonds, which are obligations of a state or political... READ MORE

CVS Health announced plans to buy Oak Street Health for $9.5 billion in cash. Oak Street Health is a large primary care provider with 160 locations. CVS plans to grow the Oak Street business to 300 locations by 2026. Tower Health is planning to sell 17 urgent care centers in the coming months. The... READ MORE

NATIONAL AHA seeks meeting with HHS on 340B repayments Biden’s State of the Union: 10 healthcare takeaways CMS proposes universal quality measures across all programs Drugmakers restrict 340B sales after appellate court ruling False Claims Act Settlements and Judgments Exceed $2 Billion in Fiscal Year 2022 Kaufman Hall: Hospital financial pressures may be easing... READ MORE

*Updated on April 23, 2024. The Federal Trade Commission (“FTC”) has announced their intent to vote on a final rule that would ban most employers from entering into or enforcing noncompetes against workers and would require employers to rescind existing non-competes. The vote is planned during a special Open Commission Meeting on Tuesday, April... READ MORE

The U.S. Department of Health and Human Services Office of Inspector General (“OIG”) recently announced that it coordinated with law enforcement partners in launching a multi-state enforcement action dedicated to uncovering a massive fraudulent nursing diploma scheme. Referred to as Operation Nightingale, it has exposed an alleged scheme involving the sale of fake and... READ MORE

On January 3, 2023, the U.S. Food and Drug Administration (“FDA”) released an updated Mifepristone Risk Evaluation and Mitigation Strategy (the “Mifepristone REMS Program”), which reverses the requirement that the drug be dispensed directly to a patient by certified prescriber in a clinic or a medical office (the “in-person dispensing requirement”). The updated Mifepristone... READ MORE

The Biden administration announced plans to end the COVID-19 national emergency and public health emergency (“PHE”) on May 11, 2023. In the wake of this announcement, the Kaiser Family Foundation published a report on the repercussions of ending the PHE. The Consolidated Appropriations Act of 2023 will extend certain PHE-related coverage of telehealth, but... READ MORE

NATIONAL Biden plans to end the Covid public health emergency this spring in a major shift to federal response Biden administration will end COVID-19 emergencies on May 11 Can a drugstore be your only doctor? CMS finalizes RADV rule, leaves MA plans on the hook for billions CMS begins publicizing disputed nursing home deficiencies... READ MORE