Hospitals

On March 26, the U.S. Department of Justice (DOJ) and the U.S. Attorney’s Office for the Southern District of New York filed a civil antitrust lawsuit against The New York and Presbyterian Hospital (NYP). The Complaint alleges that NYP violated Section 1 of the Sherman Act by requiring restrictive anti-competitive language in its commercial contracts…

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.

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has announced another settlement for alleged violations of HIPAA. OCR investigated BayCare Health System, which serves central Florida, after a patient complained to OCR in 2018 that her medical record was accessed by an unauthorized individual.

The patient told OCR that she…

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…

The U.S. Department of Justice announced on January 15 that Jeffrey Paul Madison, the former chief executive officer of a Texas hospital, was sentenced to 36 months in federal prison for conspiring to violate the federal Anti-Kickback Statute (AKS). In October 2024, Madison also agreed to pay over $5.3 million to settle allegations under the…

2025 promises to see a significant increase in the volume of healthcare mergers, acquisitions and consolidations. On Thursday, January 23, Rivkin Radler’s first Health Law Executive Briefing, 2025 Healthcare Mergers & Acquisitions, will take the form of a Q&A session led by Benjamin Malerba and featuring Norton Travis, veteran healthcare executive and the newest…

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…

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…

The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.

Supportive Care’s companies…

On July 1, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that Heritage Valley Health System, a provider in Pennsylvania, Ohio and West Virginia, agreed to pay $950,000 to resolve potential violations of the HIPAA Security Rule. Heritage Valley’s alleged violations included failure to conduct a risk analysis to…