Last month, the head of the Criminal Division of the U.S. Department of Justice (DOJ), Matthew R. Galeotti, issued a Memorandum outlining DOJ’s enforcement priorities and policies for prosecuting white-collar crime, identifying three core tenets to guide prosecutors: “(1) focus; (2) fairness; and (3) efficiency.”

Among the areas of focus listed, the Memorandum identified as…

The Centers for Medicare & Medicaid Services (CMS) recently published a press release rescinding its June 2022 guidance concerning hospitals’ obligations to pregnant women under the Emergency Medical Treatment & Labor Act (EMTALA). EMTALA is a federal law that requires hospitals to provide emergency care to all patients, regardless of their ability to pay.

The…

An article in the June 9 issue of Part B News, “To ease doctor-departing woes, write careful terms into the contract,” discussed best practices for medical practices’ employment contracts with their physician employees. Rivkin Radler’s Norton Travis was quoted in the article.

Norton suggested that practices try to enforce restrictive covenants where…

Two Pennsylvania nursing home operators were recently sentenced in federal court to pay more than $15 million in restitution in a healthcare fraud case. Comprehensive Healthcare Management Services, the operator of Brighton Rehabilitation and Wellness Center, and the affiliated operator of Mount Lebanon Rehabilitation and Wellness Center were convicted of making false statements in connection…

On April 30, the Federal Bureau of Investigation (FBI) released a Public Service Announcement warning consumers about fraudulent discount medical scams. These scams typically involve deceptive offers for health insurance plans that, in reality, provide little to no legitimate coverage. Scammers are contacting people through text messages, phone calls, or emails falsely claiming to represent…

Just last week, we reported that the 2025/26 NYS Budget Bill did not include a provision that would have increased the requirements for seeking Department of Health (DOH) approval of a material healthcare transaction (which generally means one that increases revenues from healthcare services by at least $25 million) [here]. We have previously…

The U.S. Court of Appeals for the Seventh Circuit recently rejected an effort by the federal government to extend the federal Anti-Kickback Statute (AKS) to a marketing company in the absence of influence by the company over decision makers.

Mark Sorensen, the owner of SyMed Inc., a durable medical equipment (DME) distributor, had been convicted…

We recently wrote about proposed legislation that would have substantially increased the existing reporting requirements for material healthcare transactions in NYS that have existed since Public Health Law (PHL) Article 45-A was enacted two years ago. We provided a detailed review of the current PHL 45-A here and here.

The proposed legislation would have…

On May 1, a whistleblower filed a complaint under the federal False Claims Act (FCA) against Aetna, Elevance Health (formerly Anthem) and Humana alleging that the insurers paid hundreds of millions of dollars in illegal kickbacks to induce brokers including GoHealth, eHealth and SelectQuote (the “Brokers”) to steer beneficiaries to their Medicare Advantage plans. While…