RECENT HEALTH LAW NEWS

Expanded Healthcare Transaction Notice/Review Dropped from Final 2025/26 NYS Budget Bill
May 16, 2025 | Norton Travis and Jeffrey Ehrhardt | Legislation and Public Policy | Mergers and Acquisitions

We recently wrote about proposed legislation that would have substantially increased the existing reporting requirements for material healthcare transactions in NYS that have existed since Public Health Law (PHL) Article 45-A was enacted two years ago. We provided a detailed review of the current PHL 45-A here and here. The proposed legislation would…
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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…
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Practice Transitions for the Practicing Dentist
May 09, 2025 | Rivkin Rounds Staff | Dentistry | Mergers and Acquisitions

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…
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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…
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OIG Audit of MACs Finds Deficiencies
May 02, 2025 | Chris Kutner | Medicare and Medicaid

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…
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It’s more than just the money: The importance of analyzing both economic and noneconomic key issues for a successful health care transaction
April 16, 2025 | Rivkin Rounds Staff | Mergers and Acquisitions

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. Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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Unpacking NY Laboratory Regulations and Recent Enforcement Trends
April 16, 2025 | Rivkin Rounds Staff | Legislation and Public Policy | Uncategorized

On Thursday, April 24, Ada Janocinska and Mary Aperance will present the next installment of Rivkin Radler’s Health Law Executive Briefings, “Unpacking New York Laboratory Regulations and Recent Enforcement Trends.” Ben Malerba will moderate the discussion which will cover the following topics: To register, please click here. The Zoom link…
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23andMe Bankruptcy Raises Legal Concerns Over Genetic Data Privacy
April 11, 2025 | Atara Kahn | Electronic Health Records | Legislation and Public Policy

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…
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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…
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ADA Joins Coalition Seeking Tariff Exemption for Medical and Dental Supplies
April 04, 2025 | Sean Simensky | Dentistry | Legislation and Public Policy | Medical Devices and Wearables

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…
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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…
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After deported M.D. case, keep alien providers safe, especially if they travel
April 02, 2025 | Rivkin Rounds Staff | Uncategorized

An article in the March 27 issue of Part B News, “After deported M.D. case, keep alien providers safe, especially if they travel,” discussed potential concerns for U.S. medical practices that employ foreign nationals. Rivkin Radler’s Henry Mascia was quoted in the article. Henry said he has not seen immigration…
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NYS Reinforces Its Scrutiny Over Healthcare Transactions
March 27, 2025 | Norton Travis and Jeffrey Ehrhardt | Legislation and Public Policy | Mergers and Acquisitions

Overview We recently discussed increasing state regulation of healthcare mergers and acquisitions in the face of the current Administration’s clear policy of federal deregulation. We noted that 15 states had implemented oversight laws for healthcare transactions. The stated purpose of these laws is to address two key issues: (1) to…
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CTA Obligations for U.S. Companies Are No More
March 27, 2025 | Stella Lellos and Lindsay Brocki | Legislation and Public Policy

After many years of ups and downs, legal challenges, injunctions and deadline changes, the reporting obligations under the Corporate Transparency Act (CTA) have disappeared… for most. On Friday, March 21, the Financial Crimes Enforcement Network (FinCEN) issued an interim final rule eliminating the requirement that U.S. companies and persons report…
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Quality of Care Considerations in OIG’s Nursing Facility Compliance Guidance
March 25, 2025 | Rivkin Rounds Staff | Legislation and Public Policy | Nursing Homes

Rivkin Radler’s John Queenan, Mary Aperance and Jeff Ehrhardt wrote the article “Quality of Care Considerations in OIG’s Nursing Facility Compliance Guidance” for the spring 2025 issue of USLAW Magazine. Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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State Laws Target Healthcare Investments as Feds Deregulate
March 25, 2025 | Norton Travis | Legislation and Public Policy | Mergers and Acquisitions

Will the new administration’s federal deregulation be a boon for private equity investment in healthcare providers, or will the states be the “new sheriff in town”? In the short time he has been in office, President Trump has made good on his campaign promises to shrink the roles and staff…
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Lab Operator Convicted in Drug-Testing Scheme
March 24, 2025 | Chris Kutner | Fraud and Abuse | Litigation | Medicare and Medicaid

Conspiracies to rip off the Medicare system are prevalent due to the vast amounts of money flowing through the program. On February 25, Sherif Khalil of Redondo Beach, California man was convicted by a federal jury in Detroit for stealing $4 million from the Medicare program. Khalil conspired with others…
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The Status of Providing Gender-Affirming Care to Minors in NY
March 21, 2025 | Mary Aperance | Legislation and Public Policy | Litigation

In recent months, Executive Orders issued by the current Administration regarding gender-affirming care of minors have been the subject of much debate and litigation. The crux of these lawsuits is largely two Executive Orders: Executive Order 14187 (Protecting Children From Chemical and Surgical Mutilation) and Executive Order 14168 (Defending Women…
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The Evolving Opportunities to Strategically Partner or Sell Your Practice
March 18, 2025 | Rivkin Rounds Staff | Mergers and Acquisitions

On Thursday, March 27, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Rivkin Radler’s Ben Malerba will co-present with Jay Pruzansky and Rich Searles from Merritt Healthcare Advisors. The webinar, “The Evolving Opportunities to Strategically Partner or Sell Your Practice,” will discuss: The program will take place…
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Provider and Beneficiaries Conspired to Defraud Louisiana’s Medicaid Program
March 05, 2025 | Chris Kutner | False Claims Act | Litigation | Medicare and Medicaid

Healthcare fraud is prevalent within state Medicaid programs due to the massive amounts of money flowing through the system. In Louisiana, the Estate of Yolanda Burnom and her former company, Community Healthcare Solutions, LLC, recently agreed to pay $4.6 million to settle a False Claims Act lawsuit. The allegations included…
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TRICARE Administrator Pays $11 Million Under FCA for Cybersecurity Noncompliance
February 28, 2025 | Benjamin Wisher | Cybersecurity | False Claims Act | Litigation

The U.S. Department of Justice (DOJ) announced on February 18 that Health Net Federal Services, LLC and its corporate parent, Centene Corporation, agreed to pay $11,253,400 to resolve False Claims Act (FCA) claims. Health Net, a federal contractor responsible for administering TRICARE, allegedly falsely certified compliance with cybersecurity requirements in…
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DMERx, an online DME platform, served as the basis for a massive fraud against Medicare and other insurers. Gregory Schreck, a Kansas man who was the vice president of DMERx, orchestrated a sophisticated fraud scheme to bill Medicare and other insurers over $1 billion, resulting in payments of over $350…
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CTA: Clear Deadline, Unclear Future
February 24, 2025 | Stella Lellos and Lindsay Brocki | Legislation and Public Policy

[THIS INFORMATION HAS BEEN SUPERSEDED] The Financial Crimes Enforcement Network (FinCEN) has announced that beneficial ownership information (BOI) reporting requirements under the Corporate Transparency Act (CTA) are once again back in effect and the new deadline for most businesses to report is March 21, 2025. While businesses should be prepared to comply with…
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On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post highlights several areas that the OMIG will focus on, Medicaid providers should refer to…
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Welcome to the ICE Age—A New Era of Immigration Enforcement
February 14, 2025 | Rivkin Rounds Staff | Legislation and Public Policy | Uncategorized

On Thursday, February 27, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Partners Melissa Dearing, Henry Mascia and Ben Malerba will present “Welcome to the ICE Age—A New Era of Immigration Enforcement.” The presentation will focus on: The program will take place from 12 noon to 1…
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DEA Announces New Telemedicine Rules Expanding Access to Controlled Substances
February 09, 2025 | Atara Kahn | Legislation and Public Policy | Pharmaceuticals | Telehealth

On January 16, the U.S. Drug Enforcement Administration (DEA) announced three new telemedicine rules that extend prescribing flexibilities for controlled substances, following the expiration of temporary flexibilities granted during the COVID-19 pandemic. The new rules, which include both final and proposed regulations, aim to balance patient access with safeguards against…
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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…
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SCOTUS Hands Down CTA Decision — FinCEN Says Reporting Requirements Remain on Pause
January 24, 2025 | Stella Lellos and Lindsay Brocki | Legislation and Public Policy

The Financial Crimes Enforcement Network (FinCEN) announced on Friday, January 24, that reporting companies are not currently required to file beneficial ownership information (BOI) under the Corporate Transparency Act (CTA). Despite the recent decision by the Supreme Court of the United States (“SCOTUS”) to overturn the nationwide injunction of the CTA in connection with…
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The U.S. Department of Justice (DOJ) recovered $2.9 billion under the False Claims Act (FCA) in 2024, a 5% bump from 2023. This total represents the most recovered since 2021 and reaffirms the FCA’s central role in the government’s anti-fraud efforts. The DOJ entered 558 FCA settlements and judgments, the…
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Some COVID-Era Medicare Telehealth Waivers Extended through March 31
January 16, 2025 | Eric Fader | Legislation and Public Policy | Medicare and Medicaid | Telehealth

The American Relief Act, 2025, signed into law on December 21, included a short-term extension of certain telehealth waivers that went into effect in the early days of the COVID-19 Public Health Emergency. These waivers, for telehealth services provided to Medicare beneficiaries, had been set to expire on December 31,…
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2025 Healthcare Mergers & Acquisitions: What To Expect; How To Prepare; Choosing The Right Deal
January 13, 2025 | Rivkin Rounds Staff | Dentistry | Hospitals | Mergers and Acquisitions

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…
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Owners of Transportation Company Defrauded Medicaid of $3.8M
January 03, 2025 | Douglas Menikheim | Fraud and Abuse | Litigation | Medicare and Medicaid

The New York State Attorney General’s Office announced on December 5 that Muhammad Rizwan Khan, Muhammad Usman Khan and Farhan Khan and their Orange County-based transportation companies, Tristate Express NY, Inc., Meditrans NY Inc. and Empire Trans NY Inc., pleaded guilty to various felony grand larceny charges in connection with…
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CTA Enforcement Halted Again
December 27, 2024 | Atara Kahn | Legislation and Public Policy

In a new twist to the ongoing legal battle over the Corporate Transparency Act (CTA), the Fifth Circuit Court of Appeals has reinstated a nationwide injunction blocking its enforcement. The December 26 decision reverses a ruling issued just three days earlier that had briefly allowed the law to proceed, leaving…
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Fifth Circuit Resurrects CTA; New Filing Deadline 1/13/25 [SUPERSEDED – SEE THE 12/27 POST]
December 24, 2024 | Atara Kahn | Legislation and Public Policy

On December 23, the Fifth Circuit Court of Appeals lifted the stay on the Corporate Transparency Act (CTA), reinstating its enforcement nationwide. The CTA requires certain non-exempt entities to report the identities of their beneficial owners to the U.S. Treasury Department in order to combat financial crimes such as money…
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LI Doctor Pleads Guilty to $900K Fraud Scheme
December 13, 2024 | Atara Kahn | Fraud and Abuse | Litigation | Medicare and Medicaid

Kenneth Fishberger, a Long Island internist with nearly 50 years of medical experience, recently pleaded guilty to conspiracy to commit healthcare fraud. Prosecutors revealed that from 2013 to 2019, Fishberger ordered hundreds of medically unnecessary transcranial doppler (TCD) brain scans in exchange for kickbacks. In this scheme, Fishberger collaborated with…
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CTA Update: U.S. Government Appeals Injunction & FinCEN Issues Guidance
December 10, 2024 | Stella Lellos and Lindsay Brocki | Legislation and Public Policy

Amid the ongoing legal battle over the Corporate Transparency Act (the CTA), updates continue to roll in. On December 5, the U.S. government filed a notice of appeal to the U.S. Court of Appeals for the Fifth Circuit (the “Fifth Circuit”) from the decision of the U.S. District Court for the…
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HHS-OIG Issues Nursing Facility Compliance Program Guidance
December 09, 2024 | Jeffrey Ehrhardt and Mary Aperance | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes

On November 20, 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the “Nursing Facility ICPG,” an industry-specific compliance program guidance for nursing facilities. Background The Nursing Facility ICPG serves as a voluntary, nonbinding tool to assist facilities in reducing risks related to…
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Upset in the 11th Hour: Corporate Transparency Act Halted, for Now
December 05, 2024 | Stella Lellos and Lindsay Brocki | Legislation and Public Policy

The Law The Corporate Transparency Act (the CTA), a law enacted by Congress requiring certain business entities to disclose beneficial ownership information (a BOI Report) to FinCEN, went into effect on January 1, 2024, and obligates reporting companies formed before January 1, 2024, to file BOI Reports on or before…
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Million Dollar Penalty Imposed on Pain Management Practice Following HIPAA Breach
December 05, 2024 | Ada Janocinska | Electronic Health Records | HIPAA

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on December 3 that it imposed a $1.19 million penalty on Gulf Coast Pain Consultants, a pain management practice in Florida, following a security breach that affected over 34,000 individuals. Gulf Coast filed a breach notification…
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Third-party biller fraud may hook your practice, unless you protect yourself
November 27, 2024 | Eric Fader | Fraud and Abuse | Litigation

A November 25 article in Part B News, “Third-party biller fraud may hook your practice, unless you protect yourself,” discussed the federal government’s recent fraud investigation of a medical biller in New York State and healthcare providers’ obligation to ensure the accuracy of their claims billing. Rivkin Radler’s Jeff Kaiser was…
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FinCEN Engages in Outreach as CTA Deadline Looms
November 21, 2024 | Stella Lellos and Lindsay Brocki | Legislation and Public Policy

By January 1, 2025, millions of existing businesses must have filed certain information with the Financial Crimes Enforcement Network (FinCEN) to remain in compliance with the Corporate Transparency Act (CTA). As this deadline approaches, concern is growing among lawmakers. During a House Financial Services Committee hearing, committee members highlighted that…
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Telehealth for 2025: Federal and State Legal Changes and Trends
November 20, 2024 | Rivkin Rounds Staff | Legislation and Public Policy | Telehealth

On Thursday, December 12, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partner Eric D. Fader will present an update on the regulatory landscape for the provision of telehealth services, including the latest trends and recent changes to federal and state laws and…
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On October 31, Elevance Health filed suit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to challenge the 2025 Star Ratings system used for Medicare Advantage and Part D plans. CMS published the final Star Ratings to the public…
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One of the nation’s largest urine drug testing laboratories recently settled with the federal government by paying $27 million to resolve alleged violations of the federal False Claims Act (FCA) and state statutes. Precision Toxicology (d/b/a Precision Diagnostics), headquartered in San Diego, allegedly provided medically unnecessary urine drug testing and…
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On October 9, 2024, the United States Attorney’s office in the Eastern District of New York unsealed an indictment alleging that eight defendants defrauded Medicaid of approximately $68 million.1 The alleged scheme involved two adult day care programs and a home care financial intermediary, all owned and controlled by the…
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