RECENT HEALTH LAW NEWS

2025 Healthcare Mergers & Acquisitions: What To Expect; How To Prepare; Choosing The Right Deal
January 13, 2025 | Rivkin Rounds Staff | Dentistry | Hospitals | Uncategorized

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…
Read More

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…
Read More

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…
Read More

Fifth Circuit Resurrects CTA; New Filing Deadline 1/13/25 [SUPERSEDED – SEE THE 12/27 POST]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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

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…
Read More

Eight individuals associated with two Brooklyn social adult day care centers and a home health care intermediary have been charged in an alleged $68 million Medicaid fraud scheme. The defendants, including owners and staff from Happy Family Social Adult Day Care Inc., Family Social Adult Day Care Inc., and Responsible…
Read More

The U.S. Attorney’s Office for the Southern District of California announced on October 11 that Dr. Janette Gray and her former medical practice, The Center for Health & Wellbeing in San Diego, resolved False Claims Act (FCA) allegations by agreeing to pay $3.8 million. Gray and her practice allegedly billed…
Read More

A recently issued federal court opinion confirmed that certain pre-COVID era prescribing restrictions are back in place. In July 2023, a nonprofit advocacy group, Community Oncology Alliance, filed suit against the U.S. Department of Health and Human Services (HHS) regarding provisions of the Stark Law. Stark prohibits physicians from referring…
Read More

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) imposed a $240,000 civil monetary penalty against Providence Medical Institute in connection with a ransomware attack that revealed vulnerabilities in the Institute’s systems and potential HIPAA violations. The Institute was the victim of a series of ransomware…
Read More

Lab Owner Pleads Guilty to COVID-19 Testing Fraud Scheme
October 09, 2024 | Mary Aperance | COVID-19 | Fraud and Abuse | Litigation

On October 1, the U.S. Attorney’s Office for the Northern District of Illinois announced that Zishan Alvi, the owner of a Chicago laboratory, pleaded guilty to one count of wire fraud for his role in a COVID-19 testing fraud scheme. Alvi pleaded guilty to causing claims to be submitted to…
Read More

New Consumer Protection Laws to Affect NY Healthcare Providers
October 07, 2024 | Ada Janocinska and Atara Kahn | Legislation and Public Policy

On October 20, 2024, several significant consumer protection laws will go into effect, directly affecting healthcare providers throughout New York State. Introduced through the FY 2025 Executive Budget, these new laws reshape how providers must handle patient consent to pay for medical services and the use of credit cards for…
Read More

Structuring Your Dental Practice Transaction and Elements of the Purchase Agreement
September 25, 2024 | Douglas Menikheim | Dentistry

In our previous article, we described the due diligence process, including what a buyer would look for in your practice. Once due diligence is under way, the next step is the purchase agreement, which is usually prepared by the buyer’s attorney. A purchase agreement is the main document for the…
Read More

HRSA to J&J: Cease Implementation of New 340B Rebate Model
September 23, 2024 | Mary Aperance | Hospitals | Litigation | Pharmaceuticals

As previously discussed here, Johnson & Johnson (J&J) recently announced its intention to change its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of STELARA and XARELTO. However, the Health Resources and Services Administration (HRSA) notified J&J that its rebate model was contrary…
Read More

Three Connecticut dental practices, together with their owners, have agreed with the U.S. Attorney’s Office for the District of Connecticut to pay $1.7 million to settle allegations that the practices violated federal and Connecticut False Claims Acts and the federal Anti-Kickback Statute. This and other recent settlements seem to be…
Read More

J&J Announces New Rebate Model for 340B Program, but HRSA Pushes Back
September 09, 2024 | Mary Aperance | Hospitals | Legislation and Public Policy | Pharmaceuticals

On August 23, Johnson & Johnson (J&J) announced changes to its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of two of J&J’s most popular drugs, STELARA and XARELTO. As of October 15, J&J will make a 340B discount on these drugs available…
Read More

An article in the September issue of Healthcare Risk Management’s HIPAA Regulatory Alert, “Hospital Terminates Employees for Allowing Another to Do Their Jobs,” discussed a recent incident at Mass General Brigham in Somerville, MA. Upon investigation, the hospital discovered that two employees inappropriately allowed a third person, who was not…
Read More

The U.S. Attorney’s Office for the Southern District of Texas announced on August 20 that National Interventional Radiology Partners PLLC (NIRP) and its founder and CEO will pay $8,884,091 to the United States to resolve alleged violations of the federal False Claims Act (FCA) and Anti-Kickback Statute. NIRP and Dr.…
Read More

West Coast Dental Administrative Services LLC, which operates more than 40 dental and specialist locations in Southern California, and its affiliates have paid $6.3 million to resolve alleged violations of the False Claims Act (FCA). The alleged violations were in connection with loans received by the affiliated offices pursuant to…
Read More

Biotech Company Pays $4.5 Million for Data Breach
August 21, 2024 | Benjamin Wisher | Cybersecurity | Electronic Health Records | Litigation

The Office of the New York State Attorney General announced on August 13 that Letitia James, along with the Attorneys General of Connecticut and New Jersey, fined Enzo Biochem, Inc. $4.5 million for failing to adequately safeguard its patients’ health data. Enzo conducts drug research and development, and provides diagnostic…
Read More

On September 19, Rivkin Radler’s Jeff Kaiser will participate on a panel at Practising Law Institute’s “Life Sciences 2024: Navigating Legal Challenges in Drug and Device Industries” program in New York City. Held at PLI’s NY Conference Center at 1177 Avenue of the Americas and also available to view online,…
Read More

Medical Provider to Pay $115,200 Penalty for HIPAA Right of Access Violation
August 16, 2024 | Ada Janocinska | Electronic Health Records | HIPAA | Litigation

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently announced that it ordered American Medical Response (AMR) to pay a civil monetary penalty of $115,200 for failing to comply with the patient right of access rule under HIPAA. HIPAA requires that all covered entities provide…
Read More

The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled…
Read More

NY Court Finds Unlawful Fee Splitting in Practice Acquisition
July 31, 2024 | Benjamin Malerba | Dentistry | Legislation and Public Policy | Litigation

The prohibition on fee splitting by professionals is alive and well in New York. The sale of a dental practice from one dentist to another was found to violate the state’s prohibition against fee splitting because the purchase price was to be paid, in part, based on a percentage of the…
Read More

The U.S. Department of Justice announced on July 24 that Admera Health LLC, a New Jersey-based biopharmaceutical research and clinical laboratory testing company, agreed to pay $5,389,648 to resolve kickback allegations brought by two whistleblowers under the False Claims Act (FCA). Admera provides biopharmaceutical research services for healthcare institutions and…
Read More

On July 1, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that Heritage Valley Health System, a provider in Pennsylvania, Ohio and West Virginia, agreed to pay $950,000 to resolve potential violations of the HIPAA Security Rule. Heritage Valley’s alleged violations included failure to…
Read More

FTC Bans Non-Competes: What It Means for You
July 17, 2024 | Rivkin Rounds Staff | Employer/Employee | Legislation and Public Policy

The Federal Trade Commission (FTC) recently enacted a regulation that would effectively ban non-compete agreements for almost all employers. Unless the rule is blocked by legal challenges, it will take effect on September 4. Long Island Business News hosted a webinar on June 26, which explored the ban’s viability. Ken…
Read More

On June 24, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced a final rule that establishes disincentives for certain health care providers that have committed information blocking, or any activity that is likely to hamper access, exchange, or use of electronic protected health information (PHI).…
Read More

On June 27, U.S. Attorney General Merrick Garland announced the results of a two-week nationwide law enforcement action by the Department of Justice (DOJ) in 32 federal districts against 193 defendants for their participation in a variety of healthcare fraud schemes. These federal enforcement actions also included the seizure of more…
Read More

Rivkin Radler Partner Eric Fader co-authored an article in the March-April issue of SpineLine, the magazine of the North American Spine Society (NASS). The article, “OIG Advisory Opinion Cautions Against ‘Surgeon Deals’ in Neuromonitoring,” was written with Rich Vogel, PhD, DABNM, FASNM, the current President of the American Society of…
Read More

CT New Law Alert: Medical Debt Cannot be Reported to Credit Agencies
June 13, 2024 | Ada Janocinska | Legislation and Public Policy

Connecticut Governor Ned Lamont recently signed a new bill into law that prohibits healthcare providers from reporting patients’ medical debt to credit rating agencies. The law goes into effect on July 1, 2024. In addition, any contracts signed by healthcare providers with credit rating agencies on or after July 1,…
Read More

Must You Rehire Suspended Providers Who Get Their License Back? Look to Contract
June 10, 2024 | Rivkin Rounds Staff | Employer/Employee

A May 20 article in Part B News, “Must You Rehire Suspended Providers Who Get Their License Back? Look to Contract,” discussed whether an employer must rehire a suspended provider who gets his or her license back. Rivkin Radler’s Chris Kutner was quoted in the article. Chris said that the…
Read More

On Thursday, June 13, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partner Ashley Algazi will present ”Conducting HIPAA Breach Assessments and Disclosures: Requirements and Tips for Success.” The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom.…
Read More

On May 16, the U.S. Attorney’s Office for the District of Massachusetts announced that Cape Cod Hospital agreed to pay $24.3 million to resolve alleged violations of the federal False Claims Act (FCA) for knowingly failing to follow Medicare’s requirements for certain procedures performed. Beginning in 2015, the hospital offered…
Read More

Manishkumar Patel of Pelham Manor, NY recently pleaded guilty in connection with a healthcare fraud and kickback scheme involving the sale of fraudulent prescriptions to pharmacies, durable medical equipment suppliers, and laboratories, which then obtained payments from Medicare. The scheme resulted in $50 million in fraudulent claims from 2019-22. Patel…
Read More

The U.S. Attorney’s Office for the Eastern District of Michigan announced on May 8 that Michigan Ear Care PLLC and James Aronovitz, D.O. agreed to pay over $2 million to resolve allegations that they submitted false claims to the Medicare and Medicaid programs. Aronovitz allegedly billed for ear care services…
Read More

RECENT HEALTH LAW NEWS

Subscribe