Practice Groups

Health Services

Rivkin Radler represents a variety of healthcare stakeholders. Rivkin Radler's attorneys are ready to assist their clients in navigating the myriad healthcare laws and regulations, and in identifying emerging trends and opportunities in changing laws, regulations and policies that allow clients to succeed in an ever-changing marketplace. Committed to our clients who are engaging in payment and delivery system reform initiatives,...

Rivkin Radler represents a variety of healthcare stakeholders. Rivkin Radler’s attorneys are ready to assist their clients in navigating the myriad healthcare laws and regulations, and in identifying emerging trends and opportunities in changing laws, regulations and policies that allow clients to succeed in an ever-changing marketplace.

Committed to our clients who are engaging in payment and delivery system reform initiatives, we are pleased to offer new alternatives to traditional hourly (fee-for-services) billing arrangements and have developed “value-based” fee arrangements with many of our healthcare clients. We are open to creating new arrangements that reward us for the quality and value of the services we provide.

Our attorneys have a detailed understanding of healthcare law, and Rivkin Radler is the firm of choice for complicated business and regulatory matters. We represent a diverse group of healthcare clients:

Outpatient Care Centers
Clinically Integrated Networks
Performing Provider Systems
Hospitals, Health Systems and Academic Medical Centers
Telemedicine, Telehealth and Mobile Health Providers
Accountable Care Organizations
Private Equity Firms
Management Companies
Subacute Providers
Long-Term Care Providers
Mental Health Providers
Developmental Disability Providers
Ambulatory Surgery Centers
Urgent Care Centers
Durable Medical Equipment Providers
Federally Qualified Health Centers
Independent Practice Associations
Physician and Dental Practices
Pharmacies
Managed Care Plans, Employers, Unions and Other Payers

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With the proliferation of precision and individualized medicine, genetic testing and counseling will likely remain on the radar of the Department of Health and Human Services’ Office of Inspector General (OIG) and the Department of Justice for years to come. Biopharma companies and manufacturers must carefully consider the facts and…
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Regulators are now better armed to cite and fine health plans that are not complying with the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. A recent report to Congress highlights the enforcement work to date and illustrates the extent to which many plans are noncompliant with the law.…
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The increased use of telehealth services is a trend that is expected to continue long after the COVID-19 pandemic ends. In keeping with this trend, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion that allowed a federally qualified health…
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A New York woman was sentenced last month to 78 months in prison for defrauding healthcare programs, including obtaining more than $6.5 million from Medicare Part D plans and Medicaid drug plans. Queens resident Aleah Mohammed owned five pharmacies, four of which operated under variations of the name “Superdrugs.” Between…
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On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal programs and thefts from federally funded pandemic assistance programs. Some of the defendants, in California, New…
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NYS Budget Aims to Keep Network of CDPAP Fiscal Intermediaries Intact
April 19, 2022 | Mary Connolly | Home Health | Legislation and Public Policy | Medicare and Medicaid

In December 2019, the New York State Department of Health (DOH) issued a Request for Offers (RFO) from fiscal intermediaries (FIs) to enter into contracts with the DOH to provide FI services in the Consumer Directed Personal Assistance Program (CDPAP) for persons enrolled in Medicaid fee-for-service and Medicaid managed care…
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Rivkin Radler’s Shari Claire Lewis wrote an article, “FTC Appears Ready to Begin Enforcing Its Health Breach Notification Rule,” that was published in the New York Law Journal on April 18. The article discusses the Federal Trade Commission’s rule that requires manufacturers of connected medical devices, fitness trackers and other…
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On April 12, Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the COVID-19 public health emergency for another 90 days. The PHE had been scheduled to expire on April 16. The PHE originally went into effect in January 2020, at the onset of the pandemic. It provides…
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New Law Allows Experienced NPs to Practice Independently in NY
April 13, 2022 | Jeffrey Ehrhardt and Eric Fader | Legislation and Public Policy

New York’s 2023 state budget, signed into law on April 9, included an amendment to the state’s Education Law establishing 3,600 practice hours as a threshold beyond which nurse practitioners no longer require a collaborative agreement or a collaborative relationship with a physician to practice within their educational and clinical…
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The U.S. Department of Justice (DOJ) recently intervened in an action filed in Texas against two laboratory CEOs, one hospital CEO, and numerous other executives, employees, and recruiters, seeking civil penalties and treble damages for violations of the False Claims Act. The DOJ’s complaint, which was unsealed on April 4,…
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HHS Issues Guidance Clarifying Obligations of HIPAA Covered Entities
April 08, 2022 | Mary Connolly | Electronic Health Records | HIPAA | Legislation and Public Policy

On March 22, the U.S. Department of Health and Human Services (HHS) issued guidance clarifying the obligations of covered entities to require their business associates to comply with HIPAA Administrative Simplification requirements related to standards for electronic health care transactions, code sets, unique identifiers, and operating rules. While these requirements…
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ACO REACH Tweaks Help Smaller Group Practices, Promote Health Equity
April 06, 2022 | Rivkin Rounds Staff | ACOs | Legislation and Public Policy | Medicare and Medicaid

A March 21 article in Part B News, ACO REACH tweaks help smaller group practices, promote health equity,” discussed the Accountable Care Organization (ACO) Realizing Equity, Access and Community Health (REACH) model, which was announced on February 24 as a replacement for the CMS Global and Professional Direct Contracting (GPDC)…
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A Refresher on Form 990: Tips and Traps for Tax-Exempt Organizations
April 05, 2022 | Rivkin Rounds Staff | Hospitals | Tax/IRS

On Thursday, April 14, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Lou Vlahos and Bernadette Kasnicki will provide a refresher on preparing Form 990, the tax return for tax-exempt organizations. The program will take place from 12:00 noon to 1:00 PM Eastern…
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In a report published on March 31, the U.S. Government Accountability Office (GAO) recommended that the Centers for Medicare & Medicaid Services (CMS) begin to collect and analyze information about any effect telehealth has on the quality of care for Medicaid beneficiaries. CMS does not currently collect or analyze this…
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OCR Announces Four HIPAA Enforcement Actions
March 30, 2022 | Eric Fader | Electronic Health Records | HIPAA | Litigation

On March 28, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced four new enforcement actions against healthcare providers for HIPAA violations. Two of the actions were part of OCR’s HIPAA Right of Access Initiative which has been ongoing since 2019. Three of the actions…
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Malpractice Statute of Limitations Doesn’t Apply to Indemnity Claim by Hospital
March 26, 2022 | Eric Fader | Hospitals | Litigation

This is outside our usual catchment area, but interesting nonetheless. The Indiana Supreme Court ruled on March 8 that the state’s Medical Malpractice Act (MMA) does not apply to claims for indemnification filed by one medical provider against another. The decision allows a contract claim by a hospital system against…
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Medical Malpractice: Unique Issues in the Defense of Non-MD Healthcare Providers in the Homecare Setting
March 17, 2022 | Rivkin Rounds Staff | Home Health | Litigation

Rivkin Radler’s Eric Strober will be a panelist at the CLM Focus conference, taking place June 15-16 in Nashville, TN. His program, entitled “Medical Malpractice: Unique Issues in the Defense of Non-MD Healthcare Providers in the Homecare Setting,” will cover the various kinds of claims that are made against non-doctor…
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At the beginning of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth nationwide, as discussed here. The $1.5 trillion omnibus spending bill signed into law by President Biden today extended the current telehealth accommodations for 151 days after the end of the federal…
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The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures over seven years, and for fraudulently obtaining two business loans under the CARES Act’s Paycheck Protection Program…
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Rivkin Radler’s Michael Sirignano wrote an article, “The Opioid Crisis: An Epidemic Exacerbated by Fraud,” that appeared in the March 3 issue of the New York Law Journal. The article discussed the various types of opioid fraud, including illegal distribution, fake prescriptions, illegal dispensing by pharmacies, and medically unnecessary procedures.…
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In a February 23 order, the U.S. District Court for the Eastern District of Texas vacated a controversial rule issued in September that implemented the independent dispute resolution (IDR) procedure under the federal No Surprises Act (NSA). The lawsuit[1] was brought by the Texas Medical Association. Numerous industry participants had…
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The U.S. Department of Health and Human Services’ Health Sector Cybersecurity Coordination Center (HC3) recently issued a report entitled “Electronic Medical Records in Healthcare” that discussed security risks applicable to electronic medical records (EMRs) and electronic health records (EHRs). EHRs and EMRs are prime targets for cyber attackers because protected health…
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On Thursday, March 10, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Chris Kutner and Ashley Algazi will discuss Compliance and Legal Considerations for Value Based Arrangements. The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom. The…
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Take the Right Steps to Speed Resolution of Malpractice Litigation
February 19, 2022 | Rivkin Rounds Staff | Litigation | Private Insurers

An article in the March issue of Healthcare Risk Management, “Take the Right Steps to Speed Resolution of Malpractice Litigation,” discussed how steps taken in the early phase of malpractice litigation can significantly affect the length of the case. Rivkin Radler’s David Richman was quoted in the article. David noted…
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We don’t often cover brand-new proposed legislation on Rivkin Rounds, generally preferring to wait until it’s closer to becoming law. However, two bipartisan bills introduced in Congress last week are worthy of mention. The Telehealth Extension and Evaluation Act would allow the Centers for Medicare & Medicaid Services to extend…
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NY to Fund New Behavioral Health Stabilization Centers
February 11, 2022 | Eric Fader | Behavioral Health | Legislation and Public Policy

New York Gov. Kathy Hochul announced on February 2 that the state will make available more than $100 million in funding over the next five years for 12 new Intensive Crisis Stabilization Centers across the state. The facilities are akin to urgent care centers for people who are experiencing an…
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EyeMed Fined $600K for 2020 Data Breach
January 31, 2022 | Eric Fader | Cybersecurity | Litigation | Private Insurers

On January 24, New York Attorney General Letitia James announced a settlement with EyeMed Vision Care LLC based on shortcomings in the company’s data security procedures. The problems were discovered during the state’s investigation of a 2020 data breach that affected 2.1 million people. EyeMed, owned by Italian eyeware giant…
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Employment Issues for 2022 – COVID Vaccines and New Laws
January 26, 2022 | Rivkin Rounds Staff | COVID-19 | Employer/Employee | Legislation and Public Policy

On Thursday, February 10, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partner John Diviney will present a review of employment laws taking effect in 2022. The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom. Some of…
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Protect Peer Review Privileges, or Risk Serious Consequences
January 21, 2022 | Rivkin Rounds Staff | Hospitals | Litigation

An article in the February issue of Healthcare Risk Management, “Protect Peer Review Privileges, or Risk Serious Consequences,” discussed the importance of the hospital peer review privilege. Rivkin Radler’s Chris Kutner was quoted in the article. Chris noted that the peer review privilege provides an opportunity for a completely candid…
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Fader Featured on LexBlog Podcast
January 20, 2022 | Rivkin Rounds Staff | COVID-19 | HIPAA | Telehealth

Eric Fader was featured on the LexBlog podcast, “This Week in Legal Blogging,” where he discussed his blog, Rivkin Rounds. The LexBlog article, “Eric Fader on his push to launch Rivkin Rounds and how it has paid off for him and his firm,” gives a brief overview of the topics…
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NJ Temporary License Program Extended for Out-of-State Practitioners
January 18, 2022 | Jeffrey Ehrhardt | COVID-19 | Legislation and Public Policy | Telehealth

At the start of the COVID-19 pandemic, the New Jersey Division of Consumer Affairs established a Temporary Emergency Reciprocity License (TERL) program to give emergency licenses to healthcare practitioners from states outside of New Jersey. The TERL program had been extended multiple times and was set to expire on January…
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On Thursday, January 13, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partner Robert Hussar will present a review of key developments in healthcare fraud and abuse, compliance and government enforcement in 2021 as well as trends and changes in the industry that…
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Rivkin Radler’s Michael Sirignano wrote an article, “An Insurance Fraud Year in Review,” that was published in the January 6 issue of the New York Law Journal. Among the many cases and settlements discussed were False Claims Act cases involving federal healthcare programs, healthcare fraud related to COVID-19 testing and…
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Provider Requirements Under the No Surprises Act
January 06, 2022 | Joseph DiBella and Eric Fader | Hospitals | Legislation and Public Policy | Private Insurers

The federal No Surprises Act, effective January 1, 2022, established new requirements for healthcare providers, facilities, and providers of air ambulance services to protect consumers from “surprise” medical bills. These requirements are in addition to applicable state laws regulating balance billing and surprise bills. If a consumer receives care from…
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On January 7, the U.S. Supreme Court will hear oral arguments pursuant to emergency requests in two cases concerning COVID-19 mandates. One case involves a challenge by a coalition of interest groups and states opposed to the Occupational Safety and Health Administration’s mandate, which requires employees of businesses with 100…
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CT DPH Suspends Licensure Requirement for Out-of-State Providers; NY Extends Waivers
December 28, 2021 | Eric Fader | COVID-19 | Legislation and Public Policy | Telehealth

On December 22, the Connecticut Department of Public Health (DPH) announced that it issued an Order temporarily suspending the requirements for state licensure, certification or registration of physicians, nurses, and certain behavioral health providers who are licensed elsewhere in the U.S. or the District of Columbia. The Order will expire…
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Many of the changes to telehealth requirements during the COVID-19 pandemic on both the federal and state levels were intended to be temporary, as previously discussed here. Recently, a bipartisan group of lawmakers in Congress introduced the Telehealth Extension Act, which would, among other things, eliminate the requirement that patients…
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NYC Clarifies Dec. 27 Vaccine Mandate for all Private Employers
December 21, 2021 | Brian Conneely and John Diviney | COVID-19 | Employer/Employee | Legislation and Public Policy

On December 15, New York City issued clarifications to its prior vaccine mandate. As we advised here, the NYC Commissioner of Health previously ordered that, commencing December 27, workers must have received at least one dose of a COVID-19 vaccine to work for a private employer at a NYC workplace.…
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NJ Printing Companies to Pay $130,000 for Alleged Violations of HIPAA and NJ Consumer Fraud Act
December 17, 2021 | Benjamin Wisher | HIPAA | Litigation | Private Insurers

The New Jersey Attorney General’s Office and Division of Consumer Affairs recently announced that two New Jersey-based printing companies, Command Marketing Innovations, LLC (CMI) and Strategic Content Imaging, LLC (SCI), agreed, pursuant to a Consent Order, to pay $130,000 in fines and penalties to settle allegations that they violated the…
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The U.S. Department of Justice (DOJ) announced that Flower Mound Hospital Partners LLC, a partially physician-owned hospital in Flower Mound, Texas, agreed to pay $18.2 million to settle its alleged violations of the False Claims Act (FCA). The DOJ alleged that the hospital knowingly violated the FCA by submitting claims…
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On December 7, the U.S. Department of Justice (DOJ) announced that it had reached a Settlement Agreement with Princeton Pathology Services P.A., a New Jersey pathology practice, regarding Princeton Pathology’s alleged violations of the False Claims Act (FCA). The DOJ contended that, from 2015 to 2020, Princeton Pathology submitted claims…
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A study recently released by the U.S. Department of Health and Human Services (HHS) found that the number of beneficiaries in the traditional Medicare program who used telehealth increased from 840,000 in 2019 to nearly 52.7 million in 2020. At the same time, the number of visits to doctors’ offices reimbursed…
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New NYC Mandates for Private Employers and Indoor Businesses
December 09, 2021 | Brian Conneely and John Diviney | COVID-19 | Employer/Employee | Legislation and Public Policy

The New York City Council just passed a new COVID vaccination bill requiring paid leave for parents per child per injection. Additionally, businesses and employees in New York City are subject to new vaccine mandates effective December 27, 2021, based on a recent announcement by outgoing Mayor de Blasio. The new bill requires New…
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An article in the December issue of HIPAA Regulatory Alert, “HIPAA Changes Coming in 2022 Might Require Policy Revisions,” discussed how proposed changes to HIPAA and the HITECH Act may affect covered entities and business associates. Rivkin Radler’s Eric Fader was quoted in the article. Eric pointed out that the…
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Second Circuit: Disclosures Made Only to the Government are not “Public Disclosures” Triggering the Public Disclosure Bar
November 30, 2021 | Jeff Kaiser | False Claims Act | Fraud and Abuse | Litigation

The Second Circuit, in United States ex rel. Foreman v. AECOM, No. 20-2756-cv, 2021 WL 5406437 (2d Cir. Nov. 19, 2021), addressed a question it had not previously decided, namely, whether disclosures made solely to the government are “public disclosures” sufficient to trigger the public disclosure bar under the False…
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