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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On September 28, Rivkin Radler’s Jeff Kaiser will be a panelist at the Practising Law Institute’s program, Life Sciences 2022: Navigating Legal Challenges in Drug and Device Industries. The program is designed for attorneys and allied professionals who counsel pharmaceutical and life sciences companies. Entitled “Enforcement Trends Impacting the Drug…
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Healthcare fraud related to durable medical equipment (DME) is extremely costly to insurers, yet often continues without criminal or civil consequences. Rivkin Radler’s Michael Vanunu recently wrote an article on the topic for Law360. Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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On August 3, North Country Neurology, P.C., a physician-owned medical practice located in Watertown, NY (the “Practice”), reached a settlement with the U.S. Attorney’s Office for the Northern District of New York to pay $850,000 for submitting false Medicare claims for payment. Among other things, the Practice admitted to having…
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The U.S. Department of Justice (DOJ) recently announced that Reliance Medical Systems LLC, a Utah-based distributor of spinal implant devices, two of its individual owners, and two of its physician-owned distributorships (PODs) agreed to pay $1 million to resolve a lawsuit brought under the False Claims Act. Reliance allegedly operated…
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On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth companies. The Alert describes several types of fraud schemes that have resulted in federal investigations and…
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Amazon to Acquire One Medical for $3.9 Billion
July 22, 2022 | Rivkin Rounds Staff | Telehealth | Uncategorized

On July 21, Amazon confirmed that it intends to acquire One Medical for approximately $3.9 billion in an all-cash transaction. One Medical is a membership-based, technology-driven, primary care and telehealth organization with about 767,000 members as of the end of March 2022. The deal strengthens Amazon’s growing connections to the…
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On July 15, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally extended the COVID-19 public health emergency for another 90 days. The PHE, which originally went into effect in January 2020, provides important flexibilities for healthcare providers, including expanding the types of telehealth services that are…
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Oklahoma State University’s Center for Health Services recently paid $875,000 to settle potential HIPAA violations after a cyberattack resulted in the unauthorized access of its patients’ protected health information. A hacker installed malware on the Center’s web server which contained electronic protected health information. More than 275,000 individuals were affected…
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The Centers for Medicare & Medicaid Services’ Transparency in Coverage Final Rule took effect on July 1, following a six-month delay in implementation to allow payers to come into compliance. The Final Rule requires group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets…
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New OMIG Compliance Regulations: What You Need to Know
July 13, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid

On July 13, the New York Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention programs, and OMIG’s self-disclosure program. The proposed changes will significantly affect both payers and providers alike. In…
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Rivkin Radler’s Michael Sirignano authored a recent article for the New York Law Journal entitled “The Anti-Kickback Statute’s Role in Health Insurance Fraud Cases.” The article discussed recent lawsuits against physicians, laboratories, hospitals, and a large pharmaceutical company, McKesson Corporation, under the False Claims Act and federal Anti-Kickback Statute. Continue…
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California Corporate Practice of Medicine Lawsuit Survives Motion to Dismiss
June 28, 2022 | Eric Fader | Fraud and Abuse | Legislation and Public Policy | Litigation

On May 27, the U.S. District Court for the Northern District of California refused to dismiss a lawsuit[1] brought against Envision Healthcare Corp. alleging violations of California’s corporate practice of medicine (CPOM) prohibition, as well as state fee-splitting and kickback prohibitions. The action was brought by the American Academy of…
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On June 13, the U.S. Department of Health and Human Services (HHS) issued guidance to explain how audio-only telehealth can comply with HIPAA, while also emphasizing that this mode of telehealth services can expand healthcare access to individuals who may have limited internet and broadband capabilities. In response to the…
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NYSDA Dental Hygiene Bill Signed into Law
June 08, 2022 | Rivkin Rounds Staff | Dentistry | Legislation and Public Policy

On May 9, New York Gov. Kathy Hochul signed into law a dental hygiene bill that allows dental hygienists to use nitrous oxide and local infiltration anesthesia to assist dentists with all dental procedures. The bill, which was originally introduced in the State Senate in May 2021, amends section 6605-b…
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On Thursday, June 16, in the next installment of Rivkin Radler’s Healthcare Lunch & Learn series, firm partners Frank Izzo and Wendy Sheinberg will present a program on Addressing Patient Capacity Issues. The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom. The topics to…
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In a recent Advisory Opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) determined that an arrangement involving certain physicians who have an ownership interest in a medical device company that manufactures products that may be ordered by the physician owners (the “Company”) was not…
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Transitioning to a DSO: An Emerging Trend in Orthodontic Practice Transitions
May 31, 2022 | Rivkin Rounds Staff | Dentistry

Over the last several years, the dental services industry has become increasingly consolidated, creating significant financial opportunities for investors as well as financial and exit opportunities for dentists. This consolidation has been driven in large part by Dental Services Organizations (DSOs) formed by dentists and/or private financial investors (e.g., private…
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On May 11, New York Gov. Kathy Hochul announced the establishment of the Pharmacy Benefits Bureau within the State’s Department of Financial Services (DFS). The Bureau will handle the licensing and supervision of pharmacy benefit managers (PBMs), and in particular their impact on consumers and the cost of healthcare. The…
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Did Your Practice Get Burned Online? Reach Out — and Redirect
May 23, 2022 | Rivkin Rounds Staff | HIPAA

An article published on May 16 in Part B News, “Did your practice get burned online? Reach out — and redirect,” discussed how (or whether) professional practices should respond to negative reviews online from patients. Rivkin Radler’s Eric Fader was quoted in the article. Eric said that he advised one of…
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Prepare and Monitor: Take Extra Steps when the Patient’s a Medical Tourist
May 20, 2022 | Rivkin Rounds Staff | COVID-19 | Litigation | Uncategorized

An article published on May 16 in Part B News, “Prepare and monitor: Take extra steps when the patient’s a medical tourist,” discussed issues that U.S. medical practices can face when a patient receives medical treatment abroad. The medical tourism industry has been growing rapidly, led by a demand for…
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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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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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