Legislation and Public Policy

We have previously reported that a number of states have proposed legislation to address growing concerns about the potential negative impacts of private equity (PE) investments in healthcare businesses. Vermont has now joined this list by passing legislation on June 15 (H.583, “An act relating to clinical decision making”) that imposes significant limitations…

On July 1, 2026, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule that included certain enrollment-related policy changes under the Home Health Prospective Payment System (HHPPS) designed to “reduce improper Medicare payments and protect beneficiaries.”[1]

As explained by CMS, “[t]he overarching purpose of the enrollment process is to help confirm…

On Thursday, July 23, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Chris Kutner and Emily Manning will present “Resolving Payment Disputes Under the No Surprises Act: An Analysis of the Federal IDR Process.”

The federal Independent Dispute Resolution (IDR) process, administered by the U.S. Department of Health and Human Services (HHS)…

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion (No. 26-14) to a pharmaceutical manufacturer that is proposing to offer free antibody testing to patients.

In the proposed arrangement, the manufacturer would offer free antibody testing to determine whether patients would qualify for a prescribed…

New workplace safety mandates are on the horizon for certain New York healthcare providers. Under recently enacted Public Health Law section 2832, covered facilities – defined as general hospitals and nursing homes – must establish workplace violence prevention programs by September 18, 2027. In addition, general hospitals must conduct annual workplace safety and security assessments…

On May 28, the U.S. Department of Health and Human Services (HHS) finalized regulations intended to make the Independent Dispute Resolution (IDR) process under the No Surprises Act (NSA) more efficient and transparent in helping to resolve out-of-network payment disputes between healthcare providers and payors.

Under the IDR process, insurers and healthcare providers both file…

Aspen Dental, one of the nation’s largest dental service organizations (DSOs), recently settled charges alleging violations of California’s corporate practice of medicine (CPOM) and unfair competition laws. This was not the first time similar charges had been lodged against Aspen Dental; in 2015, it entered into a settlement with the New York Attorney General after…

On May 27, in furtherance of the March 16, 2026 Executive Order on Eliminating Fraud, Assistant Attorney General Brett A. Shumate issued a memo titled “Accelerating Review and Enhancing Enforcement in Benefits Fraud Matters.” The Memo announced new measures by the U.S. Department of Justice (DOJ) to strengthen False Claims Act (FCA) enforcement…