RECENT HEALTH LAW NEWS

OIG Issues Favorable Advisory Opinion for Waiving Cost Sharing for Cancer Screening Test
January 30, 2026 | Ada Janocinska | FDA | Legislation and Public Policy | Medicare and Medicaid

In a recent Advisory Opinion (No. 26-01), the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) concluded that waiving cost sharing for certain commercially insured patients who receive a cancer screening test is permissible under the federal Anti-Kickback Statute. The opinion pertains to a clinical laboratory…
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The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services recently issued an unfavorable Advisory Opinion (No. 25‑12) addressing a home health care agency’s proposal to offer sign‑on bonuses to prospective employees who are in a position to refer patients (usually family members) to the…
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NYS Warns On Unlawful Activities by Med Spas
January 26, 2026 | Norton Travis and Eric Fader | Fraud and Abuse | Litigation

Earlier this month, the New York Department of State (DOS) published a warning to consumers following an extensive investigation of so-called “med spas.” The DOS’s Division of Licensing led the investigation, in which 223 businesses were inspected. The publication initially addressed the need for businesses that hold themselves out to…
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Health Law Executive Briefings: Dealing with Rapidly Changing Government Healthcare Policy Changes
January 23, 2026 | Rivkin Rounds Staff | Legislation and Public Policy

The healthcare industry is facing dramatic changes in government policy with huge consequences impacting the economics and survival of many providers. Last fall, Rivkin Radler entered into a Strategic Affiliation with Liberty Partners Group, a leading healthcare lobbying firm, to afford our clients access to key government officials and agencies.…
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OpenAI has launched ChatGPT Health, a new health‑focused capability within its generative AI chatbot that allows users to connect their medical records and wellness app data to generate more personalized health‑related responses. This feature represents a shift from using AI for general health information toward deeper, context‑aware insights grounded in…
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Gov. Hochul Seeks Increased Scrutiny, Oversight of Health Care M&A
January 16, 2026 | Norton Travis and Jeffrey Ehrhardt | Legislation and Public Policy | Mergers and Acquisitions

This week, Governor Hochul announced a proposal significantly expanding state scrutiny over corporate health care transactions. This proposal reiterates previously expressed concerns that both private equity and health system acquisitions of medical and dental practices lead to reduced access to care, declining quality and higher prices. While stopping short of requiring actual…
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In an unfavorable Advisory Opinion issued last week[1], the Office of Inspector General, U.S. Department of Health and Human Services (OIG) found that a home care agency’s plan to market sign-on bonuses to prospective employees with the intention of employing those individuals to provide services to family members could result…
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NY LLC Transparency Act Takes Effect for Non-U.S. LLCs
January 06, 2026 | Benjamin Malerba | Legislation and Public Policy

On December 19, Gov. Kathy Hochul vetoed New York Senate Bill 8432 (S8432) and its Assembly companion, A8662A. The legislation would have amended the New York LLC Transparency Act (NYLTA) to preserve beneficial ownership reporting requirements for domestic New York LLCs. The bill was intended to restore the Legislature’s original…
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NY Doctor Sentenced in TCD Kickback Scheme
December 31, 2025 | Emily Manning | Fraud and Abuse | Litigation

A New York physician was recently sentenced in federal court for receiving kickbacks in exchange for ordering medically unnecessary brain scans. Vishnudat Seodat of Mattituck had practiced for 36 years and operated three “New York Health” offices on Long Island. He announced his retirement in a letter to patients last…
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New York LLC Transparency Act to Take Effect on January 1
December 20, 2025 | Benjamin Malerba | Legislation and Public Policy

[Partially superseded; see post on January 5, 2026] New York’s Limited Liability Company Transparency Act (NYLTA), set to take effect on January 1, 2026, will require beneficial ownership reporting by certain limited liability companies. However, it’s unclear which LLCs will need to report. The NYLTA incorporates the definitions of “beneficial owner” and…
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Electronic Visit Verification: The New Frontier in Home Health Fraud Enforcement
December 19, 2025 | Jeff Kaiser | Fraud and Abuse | Home Health | Medicare and Medicaid

The 21st Century Cures Act (Cures Act) required states to adopt electronic visit verification (EVV) systems for Medicaid-covered personal care services (PCS) by January 1, 2020 and for home health care services (HHCS) by January 1, 2023. According to the Centers for Medicare and Medicaid Services (CMS), the EVV requirement was…
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OCR Issues Guidance on Parental Access to Children’s Medical Records
December 11, 2025 | Ada Janocinska | Electronic Health Records | HIPAA | Legislation and Public Policy

It was brought to the attention of the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) that healthcare providers may be violating HIPAA in certain instances where they deny parental access to a child’s medical records, or require the child to authorize the disclosure of their…
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The U.S. Department of Justice recently announced a settlement with Patients Choice Laboratories (“PCL”), a diagnostic laboratory headquartered in Indianapolis, Indiana, under which PCL will pay over $9.6 million to resolve allegations that it violated the federal False Claims Act (FCA) and Anti-Kickback Statute (AKS). The government alleged that the…
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Simensky to Present on 2025 Greater NY Dental Meeting Panel
November 23, 2025 | Rivkin Rounds Staff | Dentistry | Mergers and Acquisitions

On Sunday, November 30, from 2:00 PM to 5:00 PM, Rivkin Radler partner Sean Simensky will present the program “Buying Smart: What You Need to Know About Acquiring a Dental Practice,” at the 2025 Greater NY Dental Meeting alongside Mohamed Abdullah of Bank of America, Robert Malandruccolo of Bank of…
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Westside Behavioral Care Inc., a Colorado mental health clinic, recently sued Kaiser Foundation Health Plan of Colorado for prematurely terminating its participation agreement. Kaiser terminated the agreement in an effort to increase the provision of services through a less costly telehealth model. The clinic is alleging that the early termination…
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The 2025 National Health Care Fraud Takedown, announced in June, was the largest in history, with 325 defendants charged (including 96 providers) in 50 federal districts. In all, the charged schemes involved more than $14 billion in intended loss, and more than $245 million in cash, luxury vehicles, cryptocurrency and…
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Ransomware cyber attacks have been a prominent threat to the healthcare industry. In this case, First Choice Dental, a large dental practice with multiple locations across Wisconsin, was targeted by hackers in October 2023. The hackers gained access to sensitive information including patient names, dates of birth, Social Security numbers,…
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NYS Cracks Down on Medical Transportation Companies for Fraud
November 14, 2025 | Rivkin Rounds Staff | Fraud and Abuse | Litigation | Medicare and Medicaid

In October, two medical transportation companies were charged with or indicted for fraud in New York. The owner of Pearl Transit Corp. (“Pearl”), Jael Watts, was accused of running a sham transportation service that supposedly provided rides for persons with disabilities and seniors in Westchester, Putnam, Rockland, and Suffolk…
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OIG Report Exposes “Ghost Networks” Across U.S.
November 07, 2025 | Emily Manning | Behavioral Health | Legislation and Public Policy | Medicare and Medicaid

The New York Attorney General’s Office imposition of a $250,000 penalty on MVP Health Care for maintaining an inaccurate mental health provider directory riddled with “ghost” providers was recently discussed here. The problem, however, extends beyond New York. The U.S. Department of Health and Human Services’ Office of Inspector General…
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Nursing Home Appeals Power of CMS to Fine Without Jury Trial
October 21, 2025 | Benjamin Wisher | Litigation | Medicare and Medicaid | Nursing Homes

Sligo Creek Center, a Maryland nursing home, recently appealed the constitutionality of the Centers for Medicare & Medicaid (CMS) enforcing a $1.5 million fine without a jury trial. The fine related to the facility’s failure to establish and maintain an infection control program. The appeal, currently pending in the Fourth…
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The New York Office of the Medicaid Inspector General (OMIG) publishes audit protocols to “assist the Medicaid provider community in developing programs to evaluate compliance with Medicaid requirements under federal and state statutory and regulatory law.”1 Such protocols are “applied to a specific provider type or category of service in…
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As of September 30, several temporary Medicare telehealth flexibilities that were put in place during the COVID-19 pandemic officially came to an end. One of the most significant changes involves the site requirement for telehealth services. Medicare beneficiaries can now only receive telehealth services other than behavioral or mental health…
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Nursing Home Company Pays HIPAA Fine for Publicizing Patient Success Stories
October 09, 2025 | Ada Janocinska | HIPAA | Litigation | Nursing Homes

A company that runs five nursing homes in Delaware recently agreed to pay a $182,000 fine to settle an investigation for alleged HIPAA violations. The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) investigated the company, referred to collectively as the Cadia Healthcare Facilities, after it…
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Brooklyn Cardiologist Jailed for Fraudulent Office Lease Scheme
October 07, 2025 | Douglas Menikheim | Fraud and Abuse | Litigation | Medicare and Medicaid

The U.S. Attorney’s Office for the Southern District of New York announced on August 21 that Niranjan Mittal, a Brooklyn-based cardiologist, was sentenced to 37 months in federal prison. Mittal pleaded guilty to violating the federal Anti-Kickback Statute (AKS) in connection with a fraudulent scheme that lasted roughly seven years…
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Failed Restrictive Covenant Case Signals a Warning to Practices
October 07, 2025 | Rivkin Rounds Staff | Employer/Employee | Litigation

An article in the September 22 issue of Part B News, “Failed restrictive covenant case signals a warning to practices,” discussed a recent New Jersey case in which a practice sued to enforce a restrictive covenant against a physician whose employment it had terminated. Rivkin Radler’s Tamika Hardy was quoted in…
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The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) has issued a favorable Advisory Opinion for a non-profit foundation receiving donations from an affiliated company. The company in this case offers family-based therapy for children with a redacted “Disorder” (presumably autism), where the goal of the…
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New York’s Consumer Directed Personal Assistance Program (CDPAP) has long been the subject of enforcement at the New York State Attorney General’s Office (AG). Many of those enforcement actions involve caregivers who billed Medicaid for CDPAP services never provided but sometimes also implicate agencies that are responsible for processing caregiver payments…
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FTC Abandons Non-Compete Ban but Signals Continued Scrutiny
September 16, 2025 | Norton Travis and Atara Kahn | Employer/Employee | Legislation and Public Policy

The Federal Trade Commission (FTC) has formally abandoned its effort to implement a nationwide prohibition on employer non-compete agreements, marking the end of one of the most closely watched regulatory battles in recent years. While the sweeping ban will not take effect, the agency has made clear that restrictive covenant…
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How to Handle Payer Record Request and Subsequent Demand for Alleged Overpayments
September 12, 2025 | Rivkin Rounds Staff | Medicare and Medicaid | Private Insurers

On Thursday, September 18, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Chris Kutner and Ashley Algazi will present “How to Handle Payer Record Request and Subsequent Demand for Alleged Overpayments.” The presentation will provide a comprehensive review of the issues and best practices for responding to,…
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The New York Attorney General’s office recently announced an agreement with MVP Health Care under which the insurer will pay $250,000 in penalties, fees, and costs to the state for maintaining an inaccurate mental health provider directory. The settlement is the first arising out of an investigation of so-called “ghost…
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The Changing Face of New York’s Medicaid Home Care Program Cuts Deep
August 25, 2025 | Wendy Sheinberg and Mohammed Haque | Home Health | Legislation and Public Policy | Medicare and Medicaid

New York State’s Medicaid Home Care program pays for in-home personal care services. New York’s program has long been the best in the country. One underlying policy behind the program was that people should have every opportunity to remain in the community. A community focus provides two benefits: the social…
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DOJ Statement of Interest Filed Prohibiting Dysphoria Medical Coverage
August 22, 2025 | Emily Manning | Legislation and Public Policy | Litigation | Private Insurers

The U.S. Department of Justice recently issued a press release concerning a Statement of Interest that shields small businesses from being forced to provide medical coverage for gender dysphoria. In Bernier v. Turbocam et al., the Plaintiff, who identifies as a woman and has been diagnosed with gender dysphoria, claims denial…
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Is It Time for Medically Assisted End of Life?
August 15, 2025 | Patricia Marcin | Legislation and Public Policy

While a 2024 poll indicated New Yorkers’ overwhelming support for New York’s Medical Aid in Dying Act for terminally ill people (M.A.I.D.), the act had not been approved by the legislature each time it had been presented, despite support from the New York State Bar Association, the American College of…
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Flo Health Data-Sharing Case Ends in Major Jury Verdict Against Meta
August 15, 2025 | Atara Kahn | Electronic Health Records | Litigation

Meta Inc., the parent company of Facebook, Instagram and WhatsApp, has been found liable by a California federal jury for improperly using sensitive reproductive health data to run targeted ads, in a case involving the popular Flo Health period-tracking app. Eight women brought the lawsuit on behalf of a class…
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Aspen Dental Settles Data-Sharing Class Action
August 13, 2025 | Sean Simensky | Dentistry | Electronic Health Records | Litigation

Dental service organization (DSO) Aspen Dental has agreed to pay $18.7 million to resolve claims that it secretly shared web user data with Meta and Google, without obtaining users’ consent or informing them. The claims are part of a class action lawsuit brought against Aspen Dental in Illinois State Court,…
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On September 18, Rivkin Radler’s Jeff Kaiser will participate on a panel at Practising Law Institute’s Life Sciences 2025: Navigating Legal Challenges in Drug and Device Industries. Jeff’s panel is entitled “Enforcement Trends Impacting the Drug and Device Industries.” Held at PLI’s NY Conference Center, located at 1177 Avenue of…
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The federal government has demonstrated that it is more than willing to use the United States criminal code to prosecute home care agencies that pay unlawful financial inducements to generate referrals in violation of the Anti-Kickback Statute (AKS). In a superseding indictment unsealed in March 2025, the United States Attorney’s…
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An article in the August issue of Healthcare Risk Management, “DOJ Targeting Healthcare for False Claims Act Enforcement,” discussed recent enforcement activity by the U.S. Department of Justice (DOJ) under the False Claims Act (FCA). Rivkin Radler’s Jeff Kaiser was quoted in the article. Jeff predicted that the FCA will continue…
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The epidemic of out-of-control generative artificial intelligence in litigation filings has metastasized to a False Claims Act (FCA) lawsuit against a group of Utah anesthesiologists. On July 25, Mountain West Anesthesia, LLC and individual defendants in the case moved to bar the testimony of a medical billing expert whose report…
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NY Medical Transport Owner Sentenced for Medicaid Fraud
July 18, 2025 | Emily Manning | Fraud and Abuse | Litigation | Medicare and Medicaid

The owner of Sublime Medical Transportation in Schenectady County, New York was recently sentenced to three to nine years in state prison for orchestrating a large Medicaid fraud scheme. Muhammed Adnan Saeed netted over $700,000, along with more than $60,000 in unemployment benefits to which he was not entitled. Between…
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On July 2, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the formation of the DOJ-HHS False Claims Act Working Group to strengthen “their ongoing collaboration to advance priority enforcement areas” in combating healthcare fraud. The two agencies cited the long history of…
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Cigna filed a lawsuit on June 24 in Manhattan federal court accusing Bristol Myers Squibb of unlawfully blocking generic versions of its blood cancer drug, Pomalyst, from entering the market. The suit also names Celgene, a Bristol Myers subsidiary that originally developed and marketed the drug. Cigna alleges that Celgene…
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The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has announced another settlement for alleged violations of HIPAA. OCR investigated BayCare Health System, which serves central Florida, after a patient complained to OCR in 2018 that her medical record was accessed by an unauthorized individual. The…
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Tennr’s AI Platform Targets Referral “Black Holes” with $101 Million in New Funding
June 26, 2025 | Atara Kahn | Artificial Intelligence

Tennr, a healthcare technology company focused on streamlining healthcare operations, recently announced the receipt of $101 million in funding. While the investment signals growing confidence in AI-enabled administrative tools, Tennr’s real innovation lies in the technology it has developed to address one of healthcare’s most persistent inefficiencies: the referral process.…
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Long Island Doctor Charged with Grand Larceny for Benefits Scam
June 25, 2025 | Chris Kutner | Fraud and Abuse | Litigation | Medicare and Medicaid

The Nassau County District Attorney recently charged Joseph Golyan, a Great Neck gastroenterologist, with collecting Social Security and other government benefits over a four-year period, while simultaneously billing Medicare for care he was providing to Medicare beneficiaries. He allegedly collected over $100,000 in disability benefits, while billing Medicare over $700,000,…
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RECENT HEALTH LAW NEWS

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