On October 31, Elevance Health filed suit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to challenge the 2025 Star Ratings system used for Medicare Advantage and Part D plans. CMS published the final Star Ratings to the public on October 10 through the
CA Physician and Practice Resolve FCA Allegations for $3.8 Million
The U.S. Attorney’s Office for the Southern District of California announced on October 11 that Dr. Janette Gray and her former medical practice, The Center for Health & Wellbeing in San Diego, resolved False Claims Act (FCA) allegations by agreeing to pay $3.8 million.
Gray and her practice allegedly billed Medicare and TRICARE from 2012
Lab Owner Pleads Guilty to COVID-19 Testing Fraud Scheme
On October 1, the U.S. Attorney’s Office for the Northern District of Illinois announced that Zishan Alvi, the owner of a Chicago laboratory, pleaded guilty to one count of wire fraud for his role in a COVID-19 testing fraud scheme.
Alvi pleaded guilty to causing claims to be submitted to the U.S. Department of Health
HRSA to J&J: Cease Implementation of New 340B Rebate Model
As previously discussed here, Johnson & Johnson (J&J) recently announced its intention to change its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of STELARA and XARELTO. However, the Health Resources and Services Administration (HRSA) notified J&J that its rebate model was contrary to the 340B statute
J&J Announces New Rebate Model for 340B Program, but HRSA Pushes Back
On August 23, Johnson & Johnson (J&J) announced changes to its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of two of J&J’s most popular drugs, STELARA and XARELTO.
As of October 15, J&J will make a 340B discount on these drugs available through a rebate. According to
Hospital Terminates Employees for Allowing Another to Do Their Jobs
An article in the September issue of Healthcare Risk Management’s HIPAA Regulatory Alert, “Hospital Terminates Employees for Allowing Another to Do Their Jobs,” discussed a recent incident at Mass General Brigham in Somerville, MA. Upon investigation, the hospital discovered that two employees inappropriately allowed a third person, who was not a hospital
Enforcement Trends Impacting the Drug and Device Industries
On September 19, Rivkin Radler’s Jeff Kaiser will participate on a panel at Practising Law Institute’s “Life Sciences 2024: Navigating Legal Challenges in Drug and Device Industries” program in New York City.
Held at PLI’s NY Conference Center at 1177 Avenue of the Americas and also available to view online, the program will cover the
FTC Bans Non-Competes: What It Means for You
The Federal Trade Commission (FTC) recently enacted a regulation that would effectively ban non-compete agreements for almost all employers. Unless the rule is blocked by legal challenges, it will take effect on September 4.
Long Island Business News hosted a webinar on June 26, which explored the ban’s viability. Ken Novikoff, who leads Rivkin Radler’s
Fader Co-Authors Article, Presents Podcast on Neuromonitoring “Surgeon Deals”
Rivkin Radler Partner Eric Fader co-authored an article in the March-April issue of SpineLine, the magazine of the North American Spine Society (NASS). The article, “OIG Advisory Opinion Cautions Against ‘Surgeon Deals’ in Neuromonitoring,” was written with Rich Vogel, PhD, DABNM, FASNM, the current President of the American Society of Neurophysiological Monitoring
Must You Rehire Suspended Providers Who Get Their License Back? Look to Contract
A May 20 article in Part B News, “Must You Rehire Suspended Providers Who Get Their License Back? Look to Contract,” discussed whether an employer must rehire a suspended provider who gets his or her license back. Rivkin Radler’s Chris Kutner was quoted in the article.
Chris said that the contract between