Health Care Counsel Blog

The Department of Health and Human Services Office of the Inspector General (OIG) published a Special Fraud Alert on November 16, 2020 (the Alert) regarding a common practice within the pharmaceutical and medical device industry known as “speaker programs.” 

Calling it a “straightforward inquiry,” the US Court of Appeals for the 11th Circuit recently opted to expand access to the Medicare Secondary Payer Act (the MSP Act) private right of recovery to Medicare Advantage “downstream actors.” 

Headlines that Matter for Companies and Executives in Regulated Industries

The Department of Consumer Affairs (DCA) continues to issue and extend waivers under Governor Newsom’s March 30, 2020 Executive Order, which authorized the DCA to temporarily modify licensing and staffing requirements for healthcare professionals licensed under the California Business and Profession

Headlines that Matter for Companies and Executives in Regulated Industries

On November 3rd, the Department of Labor’s Wage and Hour Division published an opinion letter addressing whether the FLSA requires employers to pay non-exempt employees for time that they spend in voluntary training programs.

In a Public Notice released today, the FCC announced that its “Connected Care Pilot Program” (Pilot Program) application filing window will open on Friday, November 6, 2020, at 12:00 pm ET and will close on Monday, December 7, 2020, at 11:59 pm ET.

Headlines that Matter for Companies and Executives in Regulated Industries

The Federal government is warning that the threat of cybercrime, and especially ransomware, to US hospitals and healthcare providers has increased.

The Sixth Circuit has issued an important decision that condemns plan provisions that provide different benefits based on a patient’s need for continued dialysis, even if the provision applies to all dialysis patients and not just those with end-stage renal disease (ESRD). 

Headlines that Matter for Companies and Executives in Regulated Industries

Three organizations serving primarily HIV and AIDS patients and who each are also considered “Covered Entities”.

The Determination of Need Program (certificate of need in other states) of the Massachusetts Department of Public Health (DON Program) has for many years had a moratorium on accepting and reviewing applications for construction that would add new nursing home beds to the healthcare system.

Home health is a $100 billion industry in the U.S., spanning more than 33,000 provider organizations.

Headlines that Matter for Companies and Executives in Regulated Industries

With increased financial pressure on the health care delivery system, there is likely to be an increase in health care provider financial restructurings.

On September 24, 2020, the California Court of Appeal shed additional light on meeting the public interest requirements in anti-SLAPP motions in its opinion of Murray v. Tran (Cal. Ct. App., Sept. 24, 2020, No. D076104).

California Governor Newsom signed Senate Bill 1237 (SB 1237), broadening the certified nurse midwife (CNM) scope of practice, among other changes to the Nursing Practice Act and other Sections of the Business and Professions Code. 

The California Consumer Privacy Act (CCPA), the landmark privacy law making waves since taking effect earlier this year, has continued to evolve as legislators and the California Office of the Attorney General refine and clarify its requirements.

For the first time, California has granted nurse practitioners who meet certain qualifications a separate scope of practice. This eventually will allow them to practice specified medical functions independently, without standardized procedures.

Arent Fox Partner David Greenberg is presenting on health care policy issues at Gallagher’s ‘2020 Election: Healthcare Policy Outcomes & Impacts to Plan Sponsors’ virtual town hall.

Last month, in Pharmaceutical Care Management Association v. Tufte et al. No. 18-2926 (8th Cir. August 7, 2020), the United States Court of Appeals for the Eighth Circuit invalidated legislation in North Dakota on the grounds that it was preempted by ERISA.

Headlines that Matter for Companies and Executives in Regulated Industries

HHS has finalized the CARES Act provider reporting and recoupment rules and they are different from those put forth in the proposed form. Providers should take careful note — the new requirements are significant and detailed.

On September 18, 2020, under the authority of the Center for Medicare and Medicaid Innovation, CMS finalized the new Radiation Oncology Alternative Payment Model (Model), with a new payment methodology for radiation therapy (RT) services.