Articles and Blogs

On January 1, 2025, the Centers for Medicare and Medicaid Services’ (“CMS”) new 60-Day Rule became effective. The 60-Day Rule states several changes, with some changes significantly impacting False Claims Act (“FCA”) liability. Background CMS’s 60-Day Rule is a regulation under the Affordable Care Act (“ACA”) that requires health care providers and suppliers to... READ MORE

On November 17, 2023, the Centers for Medicare & Medicaid Services (“CMS”) finalized its proposed rule (“Final Rule”), found here, implementing certain sections of the Affordable Care Act to require the disclosure of certain ownership, managerial and other information regarding Medicare-participating skilled nursing facilities (“SNFs”) and Medicaid-participating nursing facilities (“NFs”). As previously summarized by... READ MORE

As required by the Physician Payments Sunshine Act (“Sunshine Act”), by March 31, 2023, manufacturers of covered drugs, medical devices, biologicals and other medical supplies (“Applicable Manufacturers”), as well as applicable group purchasing organizations (“GPOs”), must report to the Centers for Medicare and Medicaid Services (“CMS”) payments made and other investment interests given in... READ MORE

On February 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) proposed a rule, found here, to implement certain sections of the Affordable Care Act (“ACA”) that would require the disclosure of certain ownership, managerial and other information regarding Medicare-participating skilled nursing facilities (“SNFs”) and Medicaid-participating nursing facilities (“NFs”). The purpose of the... READ MORE

On August 17, 2020, just one day before a Health and Human Services (“HHS”) Patient Protection and Affordable Care Act (“ACA”) rule retracting discrimination protections for transgender people and pregnant women (“2020 Rule”)[1] was set to go into effect, Judge Frederic Block of the U.S. District Court in the Eastern District of New York... READ MORE

On March 2, 2020, the Supreme Court agreed to hear a case directly challenging the constitutionality of the Affordable Care Act (“ACA”),[1] but it is likely that the fate of ACA will not be decided before the 2020 presidential election. In Texas v. United States[2], multiple plaintiffs challenged the ACA in the District Court... READ MORE

Supreme Court Agrees to Hear ACA Validity Case Today, the Supreme Court agreed to hear a third major Affordable Care Act (“ACA”) case. The Court will consider whether a legislative change to the ACA’s individual mandate rendered the landmark law unconstitutional. Learn more from a recent Hall Render article here. By granting petitions from... READ MORE

On January 21, 2020, the Supreme Court denied a motion to expedite consideration of a petition for certiorari in a case directly challenging the constitutionality of the Affordable Care Act (“ACA”).[1] Given the Supreme Court’s decision, it is likely that the fate of Obamacare will not be decided until sometime after the 2020 presidential... READ MORE

On December 18, 2019, in a 2-1 decision, the U.S. Court of Appeals for the Fifth Circuit held that the plaintiffs in Texas v. United States[1] had standing to bring a case challenging a provision of the Affordable Care Act (“ACA”) known as the individual mandate (26 U.S.C. §5000A) and that the individual mandate requiring... READ MORE

Massive FY 2020 Funding Bills Loaded with Health Care-Related Provisions Just hours before another looming government shutdown, President Trump signed a two-part spending deal funding federal agencies that include CMS, FDA and NIH, among others. The funding bill contains several significant health policy provisions. Most notably, it will repeal three taxes enacted as part... READ MORE