On February 6, Rhode Island introduced legislation that would significantly expand its corporate practice of medicine (CPOM) restrictions and impose new healthcare ownership transparency requirements. The proposal would prohibit unlicensed entities from owning medical practices or employing licensed providers, while requiring physicians to hold majority ownership and control. It also targets MSO arrangements by banning…

In a March 3 letter addressed to Gov. Kathy Hochul, CMS Administrator Dr. Mehmet Oz raised pointed concerns about fraud, waste and abuse (“FWA”) within New York’s Medicaid Program involving payments for home health-related services. 

In his letter, Dr. Oz states:

Recent public reporting, federal prosecutions, and CMS analyses raise serious concerns about New York’s…

New York Gov. Kathy Hochul recently signed a new law that will allow registered dental hygienists in the state to practice without the direct supervision of a dentist by mid-2027, pursuant to collaborative agreements with dentists. The legislation broadens permissible practice settings to include foster care agencies, signaling a path toward a semi-independent business model…

A STAT News article, “How a Texas Couple is Getting Rich Off Out-of-Network Medical Bills,” explores how entrepreneurs Scott and Alla LaRoque built profitable businesses like MPOWERHealth, an intraoperative neuromonitoring company, by finding ways to exploit the 2020 No Surprises Act—a law intended to protect patients from unexpected medical bills by out-of-network providers.

When does marketing cross the line? Learn from recent cases and enforcement trends reshaping anti-kickback risk for companies and counsel. On April 2, from 2:00 PM to 3:00 PM, Rivkin Radler’s Jeff Kaiser will speak on the ABA Litigation Section webinar, “Marketing or Misconduct? Trends and Hot Topics on Anti-Kickback Enforcement.” To register, click here

NEW DATE! On Wednesday, March 18, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Tamika Hardy and Syma Shulman Levine will present “Restrictive Covenants and Related Topics in the Health Care Space and Beyond.” Moderated by Ben Malerba, the presenters will report on the law related to restrictive covenants including non-compete, non-solicitation…

On March 11, the U.S. Department of Justice and U.S. Attorney’s Office announced that Aetna, a national health insurer, has agreed to pay $117,700,000 to settle alleged violations of the False Claims Act (FCA). The government was investigating Aetna for submitting inaccurate and untruthful diagnosis codes for its Medicare Advantage Plan beneficiaries, which increased Aetna’s…

Last month, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) published Medicare Advantage Industry Segment-Specific Compliance Program Guidance (“Guidance”). OIG described the Guidance as “OIG’s updated and centralized source of voluntary compliance program guidance for Medicare Advantage.”[1] The impetus for creating the Guidance was “the growing popularity” and OIG’s…

Maternal health has received increased attention in federal and state Medicaid reform efforts in recent years, particularly in states with elevated mortality and disparity metrics.[1] As Medicaid agencies and managed care organizations consider alternative ways of structuring prenatal care, some providers are expanding services beyond traditional clinic settings.

Nest Health recently launched Nest Origin…

On February 6, New York Gov. Kathy Hochul signed the Medical Aid in Dying Act (MAID), making New York the 13th state to adopt similar legislation along with the District of Columbia. MAID has created a new Article 28-F to the New York Public Health Law, which will be effective August 5, 2026.

What…