First Circuit Clarifies “Resulting From” standard under Anti-Kickback...
The United States Court of Appeals for the First Circuit issued a pivotal ruling earlier this week, finding that in order to establish falsity in a False Claims Act (“FCA”) case premised on...
View ArticleHouse Task Force on AI Issues Report and Proposes Healthcare Recommendations
On December 17, 2024, the House Task Force on Artificial Intelligence (Task Force) released a highly-anticipated report titled, “Bipartisan House Task Force Report on Artificial Intelligence,” (the...
View ArticleCMS Issues FY 2026 Hospital IPPS Proposed Rule and LTCH PPS Proposed Rule
On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the Fiscal Year (FY) 2026 update to the Inpatient Prospective Payment System (IPPS) and Long-Term...
View ArticleCMS Issues FY 2026 Hospital IPPS Proposed Rule and LTCH PPS Proposed Rule
On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the Fiscal Year (FY) 2026 update to the Inpatient Prospective Payment System (IPPS) and Long-Term...
View ArticleMAHA’s Vision for Healthier Diets: Awaiting Concrete Steps and Assessing...
OOn May 24, 2025, Robert F. Kennedy, Jr. and the Make America Healthy Again (MAHA) Commission are expected to submit the Make our Children Healthy Again Assessment to President Trump as required by the...
View ArticleThe Role of Federal and State Governments in Maintaining Healthcare During...
This year, thousands of individuals in Southern California were impacted by the Palisades Fire and Eaton Fire. The fires were the second and fourth most destructive in the state’s history.[1] In 2024,...
View ArticleLegal Challenges to the One Big Beautiful Bill Act’s Restrictions on Federal...
Overview The President signed H.R. 1, the One Big Beautiful Bill Act (the “Act”), into law on July 4, 2025. In Section 71113, the Act restricts the flow of Federal Medicaid funds to certain...
View ArticleNot So Surprising: The Fifth Circuit Finds No Private Right of Action in the...
On June 12, 2025, the Fifth Circuit ruled in Guardian Flight I[i] and Guardian Flight II[ii] that the No Surprises Act (“NSA”) does not confer a private right of action on parties to confirm an...
View ArticleDOJ and HHS Launch FCA Working Group: Heightened Enforcement Risk for Health...
On July 2, 2025, the U.S. Department of Justice (DOJ) Civil Division and the U.S. Department of Health and Human Services (HHS) jointly announced the formation of a False Claims Act (FCA) Working...
View ArticleRecent Federal Cases on Information Blocking Violations Pave Way for State...
Two recent federal cases are providing insight into what to expect in state court litigation related to information blocking, defined in the 21st Century Cures Act (Cures Act) as a practice that...
View ArticleSeventh Circuit Clarifies Limits on Advertising Payments under the AKS
The United States Court of Appeals for the Seventh Circuit recently reversed the conviction of Mark Sorensen, the owner of SyMed Inc., a Medicare-registered distributor of durable medical equipment...
View ArticleHHS Suggests It Will Provide Less Notice and Opportunity for Comment on Grant...
On February 28, the Department of Health and Human Services (HHS) announced that it was rescinding the Richardson Waiver, a policy in place since 1971 which said HHS would provide notice of proposed...
View ArticleFirst Circuit Clarifies “Resulting From” standard under Anti-Kickback...
The United States Court of Appeals for the First Circuit issued a pivotal ruling earlier this week, finding that in order to establish falsity in a False Claims Act (“FCA”) case premised on...
View ArticleFDA Proposes Framework to Assess AI Model Output Credibility to Support...
On January 7, 2025, in the last weeks of the Biden Administration and before President Trump returned to the White House, the Food and Drug Administration (FDA) issued draft guidance, entitled...
View ArticleStringent Requirements for Pleading Fraud Under Rule 9(b).
Dr. John Pepe and Dr. Richard Sherman (“Relators”), acting as whistleblowers, brought a qui tam action against Fresenius Medical Care Holdings, Fresenius Vascular Care, Inc., and Dr. Gregg Miller...
View ArticleGeneral Allegations Without Representative Examples Are Insufficient to...
The United States District Court for the Northern District of Indiana recently dismissed a case involving allegations of fraudulent Medicaid claims and self-referrals. The case, United States of...
View ArticleThe Anatomy of a Failed Qui Tam Case: Lessons from U.S v. Radiation Therapy...
In the world of False Claims Act (“FCA”) litigation, the recent case United States ex rel. Robert C. O’Laughlin, M.D. v. Radiation Therapy Services, P.S.C., et al. serves as an important reminder of...
View ArticleFuture Promises of Compliance with Federal Laws Cannot Form the Basis of a...
The United States District Court for the Eastern District of Michigan recently dismissed a False Claims Act (“FCA”) lawsuit brought against the City of Detroit. The core issue in United States ex...
View ArticleHow much (information) is too much? Caselaw shines a light on avoiding...
United States of America v. Sutter Health is exemplary of the delicate balance courts must strike when dealing with attorney-client privilege. Here, the United States District Court for the Northern...
View ArticleThe Intricacies of Qui Tam Actions and the Role of Government Dismissals
In the world of legal battles, few are as complex and as fraught with procedural intricacies as qui tam actions brought under the False Claims Act (“FCA”). The qui tam provision of the FCA allows...
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