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.
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).