On July 1, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule that included certain enrollment-related policy changes under the Home Health Prospective Payment System (HHPPS) designed to “reduce improper Medicare payments and protect beneficiaries.”[1]

As explained by CMS, “[t]he overarching purpose of the enrollment process is to help confirm…

Two New York residents were recently indicted in the Eastern District of New York federal court in Central Islip for conspiracy to commit healthcare fraud, among other charges. The defendants allegedly paid kickbacks and submitted fraudulent claims to government payors, including Medicaid, for transportation services that were either not provided or for which the mileage…

California Attorney General Rob Bonta recently announced a proposed settlement with Carbon Health Technologies, Inc., which operates primary care clinics throughout the state. The settlement follows allegations that the company’s physician practice management structure ran afoul of California’s corporate practice of medicine (CPOM) doctrine, as well as certain state consumer protection and billing laws. Carbon…

On Thursday, July 23, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Chris Kutner and Emily Manning will present “Resolving Payment Disputes Under the No Surprises Act: An Analysis of the Federal IDR Process.”

The federal Independent Dispute Resolution (IDR) process, administered by the U.S. Department of Health and Human Services (HHS)…

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion (No. 26-14) to a pharmaceutical manufacturer that is proposing to offer free antibody testing to patients.

In the proposed arrangement, the manufacturer would offer free antibody testing to determine whether patients would qualify for a prescribed…

New workplace safety mandates are on the horizon for certain New York healthcare providers. Under recently enacted Public Health Law section 2832, covered facilities – defined as general hospitals and nursing homes – must establish workplace violence prevention programs by September 18, 2027. In addition, general hospitals must conduct annual workplace safety and security assessments…

On June 16, The Department of Justice (DOJ) sued the New York Department of Health (DOH), the DOH Medicaid Director, and Public Partnerships LLC (PPL) – the Georgia-based company selected by DOH in 2025 to manage New York’s Consumer Directed Personal Assistant Program (CDPAP) – in federal district court.  The lawsuit alleges that the defendants…

The American College of Physicians (ACP) recently issued a new position paper entitled “Regulatory Framework for Private Equity and Corporatization in Health Care” that examines the impact of private equity on healthcare costs, access, equity, innovation, and clinical autonomy. The ACP is the largest specialty organization in the U.S., with 163,000 members including…

On May 28, the U.S. Department of Health and Human Services (HHS) finalized regulations intended to make the Independent Dispute Resolution (IDR) process under the No Surprises Act (NSA) more efficient and transparent in helping to resolve out-of-network payment disputes between healthcare providers and payors.

Under the IDR process, insurers and healthcare providers both file…