Insights on Health Care

On June 6, the US Department of Health and Human Services’ Office of Inspector General (OIG) issued Advisory Opinion No. 25-03, providing important guidance for telehealth organizations and management services organizations (MSOs).

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Congress enacted the No Surprises Act (NSA) to protect patients from unexpected medical bills. A central pillar of the NSA is its independent dispute resolution (IDR) process, under which payers and providers can submit disputed claims to binding arbitration.

As of mid-2025, private equity (PE) investors remain intensely interested in health care services and technology companies despite higher borrowing costs, heightened regulatory scrutiny, and an increasingly complex state review landscape.

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Welcome to the Summer 2025 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and compliance tips. We bring you the most recent and significant insights in an accessible format, concluding with our main takeaways — aka “And the Fox Says…” — on what you need to know.

Join AFS Health Care Partner Annie Lee for an insightful Strafford Webinar on June 18, 2025, from 1:00pm-2:30pm EDT.

A recent decision from the US District Court for the Eastern District of New York has significant implications for providers navigating the No Surprises Act (NSA) independent dispute resolution (IDR) process.

Gayland Hethcoat was quoted on a federal judge’s order to remove the confidentiality designation from hundreds of hours of recordings of presentations and panel discussions that were produced in discovery by the World Professional Association for Transgender Health (WPATH), which is often cited by expert witnesses in cases regarding gender-affirming care.

Health care organizations are under pressure to shore up their cybersecurity response efforts. Much of this pressure is coming from the US Department of Health and Human Services Office for Civil Rights (OCR), which has made clear through recent enforcement actions that conducting a proper risk assessment under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule is not optional.

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ArentFox Schiff is pleased to announce that 69 attorneys were recognized as leaders in their field and 23 practices spanning the firm’s litigation, regulatory, and transactional capabilities were ranked in the 2025 edition of Chambers USA: America’s Leading Lawyers for Business.

On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party billing agent, manipulated the federal No Surprises Act’s (NSA) independent dispute resolution (IDR) process.

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ArentFox Schiff is pleased to announce that Partner Debra Albin-Riley has been named among Daily Journal’s “Top Women Lawyers” in California for 2025.

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As we approach midyear, the ArentFox Schiff Labor, Employment & OSHA team highlights some of the most pressing legal issues facing employers this year, including artificial intelligence (AI) regulation at the state level, reshaping of the National Labor Relations Board (NLRB), continuing expansion of state paid family and medical leave laws, challenges to diversity, equity, and inclusion (DEI) in the workplace, and changes to US Equal Employment Opportunity Commission (EEOC) guidance and enforcement.

On July 1, the Virginia Consumer Protection Act (VCPA), as amended by Senate Bill (SB) 754, will provide additional privacy protections for reproductive and sexual health information. The legislation expands the VCPA to expressly prohibit the unauthorized collection and use of this category of information. Businesses that violate the law may be sued by affected Virginia consumers.

Health Care Partner Stephanie Trunk will participate in the External Counsel Fireside Chat at Informa Connect’s Pricing & Contracting USA 2025 conference in Philadelphia, Pennsylvania, on May 21.

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Health Care Partners Lowell Brown, Debra Albin-Riley, Annie Lee, and Jeff Weston will present at the California Association Medical Staff Services’ (CAMSS) 54th Annual Education Forum in Universal City, California, on May 14-16, 2025.

Within the last month, the US District Court for the Northern District of California rejected efforts by United Behavioral Health (UBH) to dismiss and decertify two class actions seeking relief related to UBH’s processing of mental health claims.

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There are currently six states with active Prescription Drug Affordability Boards (PDABs) — Colorado, Maryland, Washington, Oregon, New Hampshire, and Minnesota.

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