Earlier this week, the District of Massachusetts held a hearing on defendants’ motion to dismiss in United States ex rel. Shea v. eHealth, Inc., et al. (No. 21-cv-11777-DJC), a notable False Claims Act (FCA) case examining the intersection of Medicare Advantage marketing, broker compensation, and FCA and Anti-Kickback Statute (AKS) compliance.
On December 31, 2025, the Drug Enforcement Administration (“DEA”) and the Department of Health and Human Services (“HHS”) jointly issued a Fourth Temporary Rule again extending the telemedicine flexibilities of the Ryan Haight Act (the “RHA”), now through December 31, 2026.
The ABA’s 2026 False Claims Act Mock Trial Institute, held in New Orleans this year and sold out, once again offered a bevy of lessons, information, and insight. As always, the FCA Mock Trial Institute provided a valuable opportunity for members of the government, relator, and defense bars to network and talk cheerfully outside the
I have to admit to an instinctive gut reaction of skepticism when Kimberly Powell of NVIDIA on Monday said that “AI is a once-in-a-lifetime shift for the healthcare industry.” Intellectually, I am excited by AI and its possibilities, but I well know healthcare’s slow and steady approach and rigid workflows can chew up technology gains
The One Big Beautiful Bill Act (OBBBA), enacted in July 2025, is no longer a policy debate or a future concern. It is already changing how coverage works, how Medicaid dollars flow, and how much operational friction health systems will face over the next several years.
J.P. Morgan continues to surprise us at lunch, with the Mayor of San Francisco sharing on Monday an update on recent improvements in the city. Then on Tuesday at the Grand Ballroom lunch, it was the first episode of my favorite new sit-com “Everyone but Abe…”
At the 44th Annual J.P. Morgan Healthcare Conference, Jamie Dimon (CEO of J.P. Morgan) told the audience that we should be teaching healthcare in school from kindergarten to 12th grade. He was right…but we don’t. And, therefore, artificial intelligence will come to dominate the U.S. healthcare system, which spent over $5.6 trillion in 2025. Wait,
The Centers for Medicare & Medicare Services’ (“CMS”) Innovation Center will begin accepting applications on January 12 for the recently announced Advancing Chronic Care with Effective, Scalable Solutions (“ACCESS”) Model—a nationwide voluntary alternative payment model for Medicare Part B commencing July 5, 2026 that will run for 10 years and focus on chronic conditions affecting
Earlier this month, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced that it opened a new investigation into a state health department’s behavioral-health licensing practices. The investigation will examine whether the state’s licensing standards, interpretations, or enforcement activities for behavioral-health facilities and licensed professionals comply with federal conscience
Providers and suppliers participating in the Medicare program should take note of new requirements and compliance considerations related to Medicare enrollment, information updates, changes of ownership, and increased risk for revocation, set to take effect on January 1, 2026. The most consequential changes are found in the CY 2026 Home Health Agency Prospective Payment System
