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…

Noncompete agreements remain in the Federal Trade Commission’s crosshairs. Although the FTC abandoned its pursuit of a nationwide ban, targeted enforcement is here, and the healthcare industry specifically has been placed on notice.

The Background

On September 5, 2025, the FTC announced it was walking away from its proposed national ban on noncompetes. However, in…

On February 3, President Trump signed the Consolidated Appropriations Act, 2026 (H.R.7418), which extends certain Medicare telehealth flexibilities through December 31, 2027. These flexibilities were initially enacted by Congress in response to the COVID-19 pandemic and rising need for telehealth services.

The most important aspect of these flexibilities was that they permitted Medicare beneficiaries to…

Last month, Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), accompanied by other CMS officials, visited with home health and hospice providers and related industry associations to discuss ways to strengthen program integrity enforcement.  CMS was reacting to calls from industry stakeholders and members of Congress to get a handle…

The New York “Shield Law” refers to several statutes intended to protect patients and providers seeking or offering services concerning gender-affirming care or abortion. These statutes were enacted in response to certain other states increasingly criminalizing these types of healthcare services. The Shield Law prohibits state cooperation with hostile actions, prevents the forced production of…