The U.S. Department of Health and Human Services (HHS) and the Department of Justice (DOJ) have jointly announced the launch of a reinvigorated DOJ-HHS False Claims Act Working Group aimed at enhancing interagency coordination around key fraud enforcement priorities in the healthcare space. This initiative underscores the federal government’s ongoing reliance on the False Claims … Continue Reading
The Centers for Medicare & Medicaid Services (CMS) has launched the WISeR Model (Wasteful and Inappropriate Service Reduction) to modernize and streamline Medicare’s prior authorization process. By partnering with tech companies, CMS will test the use of modern tools, such as artificial intelligence, to reduce unnecessary or low-value services that drive up costs and pose … Continue Reading
In the largest health care fraud takedown in U.S. history, the Justice Department announced charges against 324 individuals—including 96 licensed medical professionals—in connection with schemes involving over $14.6 billion in intended losses across 50 federal districts and 12 State Attorneys General Offices. The coordinated enforcement action led to the seizure of more than $245 million … Continue Reading
Oregon is on the verge of passing a bill that would block private-equity ownership in healthcare practices. If passed, this measure would be the strictest ban on the corporate practice of medicine in the nation (read press release here). The bill would prohibit Management Services Organizations (MSOs) and their affiliates from owning or controlling shares … Continue Reading
In attempt to deliver more effective and affordable care, Oracle, Cleveland Clinic, and G42 have announced a strategic partnership that will build a global AI-powered healthcare platform (see news release here). Per the news release published by Cleveland Clinic, the platform will: (i) deliver an AI-driven healthcare infrastructure rooted in data privacy, clinical quality, and … Continue Reading
On Thursday, May 22, from 6:00 – 7:00 PM, attorneys Michael Cassidy and Adam Appleberry will present a virtual program focused on the legal framework surrounding restrictive covenants in healthcare employment contracts. The presentation will cover recent developments in the law, including the Fair Contracting for Health Care Practitioners Act, and other regulatory changes that … Continue Reading
Attorneys Mike Cassidy and Adam Appleberry co-authored an insightful article, 2025 Medicare Final Rule Highlights, featured in the December 2024 issue of the Allegheny County Medical Society (ACMS) Bulletin. The article explores the key updates to Medicare regulations and their implications for healthcare providers. Click here to access the ACMS Bulletin to read the full … Continue Reading
In a continuation of the saga surrounding the FTC’s ban on non-compete agreements for for-profit businesses, on August 20, 2024, a ruling from the United States District Court for the Northern District of Texas struck down the FTC’s final rule. In the Texas court’s ruling, U.S. District Judge Ada Brown stated that the FTC’s authority … Continue Reading
On July 17, 2024, Pennsylvania Governor Josh Shapiro signed the Fair Contracting for Health Care Practitioners Act into law, which will become effective as of January 1, 2025 (click here see the full bill). Any noncompete covenants that are greater than one year in length in an employment agreement for a healthcare provider, entered into … Continue Reading
Challenges to the FTC Rule As we previously discussed on Med Law Blog, following the FTC’s approval of the final rule to ban non-compete agreements for for-profit businesses in April, several businesses have challenged the FTC’s authority to enforce this rule. The final rule is set to take effect on September 4, 2024, but in … Continue Reading
The Press has announced that the Merger Agreement between UPMC and Washington Health System was approved by the Pennsylvania Attorney General with certain conditions, one of which was that UPMC would honor existing employment contracts and not impose restrictive covenants or non-compete agreements more restrictive than those that currently exist. We will be researching that … Continue Reading
In light of the ongoing investigation of Change Healthcare’s ransomware attack that resulted in the improper disclosure of thousands of individuals’ PHI, now seems like a perfect time to discuss HIPAA’s requirements surrounding the notification process following a breach. Whether it’s a small breach where someone in your organization accidentally sent a patient’s contact information … Continue Reading
As expected, businesses have sued the FTC challenging the recent final rule that ends non-compete agreements, as reported by the Wall Street Journal Wednesday morning (read WSJ article here). The U.S. Chamber of Commerce challenged the final rule in federal court in East Texas, which has been joined by other business groups. A lawsuit was … Continue Reading
In a Special Open Commission Meeting held this afternoon, the Federal Trade Commission voted to approve the final rule to ban non-compete agreements for for-profit businesses, the effective date of such ban being in 120-days. Important items of note with the final rule: The FTC acknowledged that much of the healthcare industry operates under a … Continue Reading
The Federal Trade Commission has announced that it will be holding a Special Open Commission Meeting on Tuesday, April 23, 2024, at 2pm EST regarding the rule to ban non-compete agreements (read the announcement here). The expectation for this meeting is that the FTC will disclose the proposed final rule followed by remarks by the … Continue Reading
In March of this year, The Office for Civil Rights of the Department of Health and Human Services issued a letter addressing the recent cybersecurity incident impacting many health care entities, primarily Change Healthcare, a unit of UnitedHealthcare Group (read the letter here). This incident was a great reminder of the constant vigilance required to … Continue Reading
Penn State Health has agreed to pay $11,712,336 to settle allegations of civil liability from submitting improper claims to Medicare for Annual Wellness Visit services. DOJ Press Release Link Penn State Health has voluntarily disclosed that between December 2015 and November 2022 claims were submitted to Medicare for Annual Wellness Visit services that were not … Continue Reading
As Mike Cassidy and Adam Appleberry discussed during their presentation at PBI’s A Day in Health Law earlier this month, private equity’s involvement in healthcare will be an interesting item to watch over the next few years. Just last week, the FTC sued the U.S. Anesthesia Partners, Inc. and their private equity backer Welsh, Carson, … Continue Reading
