Archive
Wade Emmert
CMS Issues Interim Rule in Response to State Medicaid Disenrollment Trend
From Nelson Mullins Riley & Scarborough LLP, by Shane Duer, Knicole Emanuel, Cara Ludwig: The Centers for Medicare & Medicaid Services (CMS) has issued an interim…
What Cigna’s FCA Settlement Means for Other Medicare Advantage Plans
From HealthPayerIntelligence, Victoria Bailey: Cigna’s recent brush with False Claims Act violations serves as a reminder that Medicare Advantage organizations should be routinely assessing their risk…
Two Dallas Physicians Charged in $12 Million Fraud Scheme
From D Magazine, by Will Maddox: Drs. Desi and Deno Barroga were indicted for allegedly receiving $12 million from fraudulent claims and illegally distributing hydrocodone to…
The New Health Privacy Landscape—Out of the Frying Pan and Into the Fire
From Perkins Coie, by Stephanie Duchesneau, Susan Fahringer, Meredith Halama, Janis Kestenbaum: The legal landscape around health privacy has become much more complex in recent years,…
Enhanced Nursing Home Ownership Data Required by Biden HHS
From Bloomberg Law, by Tony Pugh: The Biden administration finalized a rule requiring nursing homes to provide more detailed information about their ownership structure, including whether…
OIG Publishes a New Guidance Resource and a Report
OIG released our General Compliance Program Guidance (GCPG). The GCPG is a reference guide for the health care compliance community and other health care stakeholders. The…
Defending Executive Compensation in Nonprofit Health Care Systems
From American Health Law Association, by Albert Lin, Husch Blackwell LLP, and Connor Campbell, Weaver and Tidwell LLP: This article reviews the rules surrounding the IRS…
Advisory Opinion 23-7 OIG Issues Favorable Opinion Regarding Proposal to Pay Bonuses to Its Employed Physicians Based on Net Profits
From Health Law Diagnosis, by Nathaniel Arden & Michael Lisitano: On October 13, 2023, the Office of Inspector General (OIG) published Advisory Opinion 23-07, in which…
UnitedHealth Defends Lucrative Billing Tactic in Appeals Court
From Bloomberg Law, by Jacklyn Wille: “Cross-Plan Offsetting” is the practice by an insurer of clawing back benefits it says were overpaid to a provider under…
Ozempic’s Success Treating Other Ailments Is Bad News for Rivals
From Bloomberg Law, by Madison Muller: Ozempic, and other GLP-1 receptor agonists, are diabetes medications that have become popular for weight loss. Now, there is evidence…