Insights & Resources

Save the Date for the Garfunkel Wild Health Care Conference – October 29, 2025. Our complimentary virtual conference is dedicated to the most important business, legal, clinical, and operational issues facing the health care community.

As part of our “Employment Law – What Employers Need to Know Now” webinar series, Garfunkel Wild’s Andy Zwerling and Lauren Levine will present “Remote Employment: Best Practices and Key Legal Considerations” on July 16, 2025, from 12:30 pm – 1:30 pm (ET).

Governor Murphy recently signed the Fiscal Year 2026 Budget into law, simultaneously with numerous other bills, including the “Healthcare Finance Enhancement Act”. The Act subjects surgical practices that are required to become licensed as ASCs to the “ambulatory care facility assessment” starting in Fiscal Year 2026.

On June 20, 2025, the United States District Court for the Southern District of New York issued an Opinion and Order finding, among other things, that the Federal No Surprises Act (NSA) does not automatically prevent health care providers from suing insurance companies when the insurer fails to pay for their services.

OIG recently rejected a medical device company’s (Company) novel proposal to pay a third-party (Screener) to perform exclusion screenings of the Company for the Company’s customers. OIG’s unfavorable Advisory Opinion (25-04) determined that this proposed arrangement (Arrangement) implicates the Federal Anti-Kickback Statute and raises concerns about inappropriate steering and anti-competitiveness.

In this podcast, we sit down with David Traskey, former Senior Counsel at HHS-OIG and current co-head of Garfunkel Wild’s D.C. office, to talk about what makes for an effective compliance program. In the fifth of seven episodes exploring this topic, we discuss the importance of establishing appropriate incentives for compliance and disciplinary actions for violations.

Over the past several months, Roosevelt Road Re, Ltd. and Tradesman Program Managers, LLC have filed multiple lawsuits alleging a RICO scheme in which various law firms and medical providers purportedly directed workers to stage worksite injuries and undergo unnecessary medical procedures to inflate the value of workers’ compensation claims.

The U.S. Department of Health and Human Services, Office of Inspector General (OIG), recently issued a favorable Advisory Opinion (25-03) regarding a proposed arrangement (Arrangement) where a non-clinical management support organization and an affiliated professional corporation wholly owned by physician shareholders (PC) enters into lease agreements with telehealth platforms (Platforms) and providers employed by or contracted with these Platforms (Platform Providers).

The Maryland Department of Health’s (DOH) Office of Health Care Quality (OHCQ) recently announced revisions to the regulations that govern Assisted Living Programs (ALPs).

The U.S. Department of Health and Human Services, Office of Inspector General (OIG) recently released its Semiannual Report (SAR) covering the period October 1, 2024 to March 31, 2025. The SAR is a must-read because it identifies a wide array of risk areas, which will undoubtedly help providers modify their own risk assessments and audit work plans to stay ahead of government regulators in the ongoing fight against fraud, waste, and abuse.

As part of our “Employment Law – What Employers Need to Know Now” webinar series, Garfunkel Wild’s Marianne Monroy and Andy Zwerling will present “Conducting Effective Workplace Investigations: Responding to Employee Complaints and Key Legal Considerations” on June 10, 2025, from 12:30 pm – 1:30 pm (ET).

Garfunkel Wild’s Barry B. Cepelewicz and Elisabeth Pimentel will present “Legal Considerations: Setting Up Your Practice” at the Fairfield County Medical Association’s (FCMA) event “Physicians: How to Start a Concierge Practice or Side Gig” on June 8, 2025.

The U.S. Department of Justice, Criminal Division (DOJ) recently and unexpectedly announced changes to the manner in which it handles criminal investigations and prosecutions of white-collar and corporate cases. These changes are aimed at clarifying DOJ’s criminal enforcement priorities, increasing the efficiency with which cases are investigated and resolved, and emphasizing the benefits of voluntarily self-disclosing potential misconduct. They also signal a more business-friendly approach than in the past, and will be undoubtedly welcomed by corporations and executives alike.

On May 21, 2025, Centers for Medicare & Medicaid Services (CMS) announced it will immediately expand its audits of Medicare Advantage (MA) plans to verify that the MA plans only submit accurate diagnoses for its enrollees. Although CMS directs these audits toward the MA plans, they inevitably impact providers.

This month, the New York Department of Health (DOH) published a Material Transactions Notice Form for “heath care entities” to report “material transactions” to DOH.

On May 14, 2025, Judge Michael P. Shea of the Connecticut District Court soundly rejected the Texas NSA decision, and held that “the NSA creates a private cause of action to enforce IDR awards.”

Garfunkel Wild’s Applied Behavioral Analysis and Medical and Education Services (BAMES) Practice Group Members Steven R. Antico (Practice Group Chair), David Traskey, and Julia Belton will present “ABA Therapy Practice Audit and Compliance Issues and Recent Developments” on May 20, 2025, from 12:00 PM to 1:00 PM.

As part of our “Employment Law – What Employers Need to Know Now” webinar series, Garfunkel Wild’s Andy Zwerling and Sal Puccio will present the webinar “Navigating Employee Terminations: Practical Strategies and Best Practices for Employers When Separating from an Employee” on May 14, 2025, from 12:30 pm – 1:30 pm (ET).

In this podcast, we sit down with David Traskey, former Senior Counsel at HHS-OIG and current co-head of Garfunkel Wild’s D.C. office, to talk about what makes for an effective compliance program. In the fourth of seven episodes exploring this topic, we discuss the importance of having effective lines of communication, and how having these lines can create a sense of ally-ship between an organization and its compliance team.

In this podcast, we sit down with David Traskey, former Senior Counsel at HHS-OIG and current co-head of Garfunkel Wild’s DC Office, to talk about what makes for an effective compliance program.  In the third of seven episodes exploring this topic, we discuss the pivotal role that compliance training and education have within an organization as well as key considerations when formulating such training and education programs.