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…

On Thursday, May 29 at 12:00 PM, Rivkin Radler Partners Benjamin Malerba and Sean Simensky will present the webinar “Practice Transitions for the Practicing Dentist.”

This lecture is designed to inform dentists of some of the legal and practical issues surrounding practice transitions. Ben and Sean will explore the differing perspectives of the buyer and…

The U.S. Attorney’s Office for the Eastern District of Pennsylvania announced on April 23 that Genexe, LLC (doing business as Genexe Health) and its parent company, Immerge, Inc., along with two of their executive officers/owners, Jason Green and Jason Gross, collectively agreed to pay $6 million to settle claims that they violated the False Claims…

The 12 regional Medicare Administrative Contractors (MACs) were recently audited by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG). Each of the MAC jurisdictions was found by the OIG to have failed to meet Medicare cost report oversight requirements in at least one year during the 2019-2021 fiscal years under…

Rivkin Radler’s Norton Travis wrote an article, “It’s More Than Just the Money: The importance of analyzing both economic and noneconomic key issues for a successful health care transaction,” which was published in the April 14 issue of Medical Economics.

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23andMe’s recent Chapter 11 bankruptcy filing has sparked significant concerns over the privacy and security of genetic data belonging to its 15 million customers.

Founded in 2006, 23andMe built its business around direct-to-consumer DNA testing, offering insights into ancestry and health risks. However, declining demand, financial struggles, and a major data breach in October 2023…

A Florida jury recently found two laboratory co-owners of Innovative Genomics LLC (“IGX”) not guilty in connection with an allegedly fraudulent COVID-19 testing scheme.

The Government alleged that from November 2019 through June 2023, the co-owners conspired to defraud Medicare and the Health Resources and Services Administration COVID-19 Uninsured Program by billing healthcare benefit plans…

The American Dental Association (ADA) has joined a coalition of other healthcare organizations in writing a letter to U.S. Trade Representative Jamieson Greer urging the Trump administration to exempt medical and dental supplies, equipment and devices from the President’s newly announced widespread tariffs.

The coalition’s letter explained, “Given the important role of our work in…

An article in the March 10 issue of Part B News, “In trend, court limits drug rebate AKS charges to easier ‘but-for’ standard,” discussed a recent ruling on the False Claims Act (FCA) implications of the federal Anti-Kickback Statute (AKS). Rivkin Radler’s Jeff Kaiser was quoted in the article.

“Every time a…