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
Resolving Payment Disputes Under the No Surprises Act
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)…
OIG Green-Lights Free Testing by Pharmaceutical Manufacturer
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…
NYS Hospitals, Nursing Homes Must Adopt Violence Prevention Programs
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…
DOJ Sues New York and PPL Over Alleged Fraud in Revamping CDPAP Program
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…
American College of Physicians Issues Position Paper on Private Equity in Healthcare
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…
HHS Finalizes Major Reforms to IDR Process under NSA
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…
Aspen Dental Reaches CPOM Settlement with CA AG
Aspen Dental, one of the nation’s largest dental service organizations (DSOs), recently settled charges alleging violations of California’s corporate practice of medicine (CPOM) and unfair competition laws. This was not the first time similar charges had been lodged against Aspen Dental; in 2015, it entered into a settlement with the New York Attorney General after…
DOJ Announces New Measures to Promote Meritorious Qui Tam Actions Targeting Fraud Against Benefits Programs
On May 27, in furtherance of the March 16, 2026 Executive Order on Eliminating Fraud, Assistant Attorney General Brett A. Shumate issued a memo titled “Accelerating Review and Enhancing Enforcement in Benefits Fraud Matters.” The Memo announced new measures by the U.S. Department of Justice (DOJ) to strengthen False Claims Act (FCA) enforcement…
Medicaid Provider Freebies Create Risk, Per OIG
Health care providers may want to offer free or discounted services to help patients, and that instinct may be good. Most providers, however, don’t think of “free care” as a kickback issue in the same way they might think about gifts or rewards as a kickback issue. They should, because the Office of Inspector General…
OIG Opinion: Free Orthodontic Services Did Not Trigger AKS Risk
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion (No. 26-09) regarding certain free treatment that would be offered to patients of a pediatric dental clinic. Specifically, the clinic planned to offer free comprehensive orthodontic treatment to one select patient per year.
As a general…
