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RECENT HEALTH LAW NEWS

On April 21, in a “Hearing on Protecting Patients and Taxpayers: Cracking down on Medicare Fraud,” the House Ways & Means Committee received testimony on hospice and home health fraud from Sheila Clark, President and Chief Executive Officer of the California Hospice and Palliative Care Association,[1] and Chris Deery, the…
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Understanding Medicare Revalidation Requirements
April 23, 2026 |Emily Manning | Legislation and Public Policy | Medicare and Medicaid

In accordance with 42 C.F.R. § 424.515, all healthcare providers participating in Medicare are required to periodically revalidate their enrollment records with the Centers for Medicare & Medicaid Services (CMS) in order to maintain Medicare billing privileges. This routine process requires providers to confirm and, if necessary, update their enrollment information.…
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CMS Directs States to Audit and Revalidate Medicaid Providers
April 23, 2026 |Tim Gonzalez | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid

The federal government is escalating its crackdown on Medicaid fraud and every state has been placed on notice. On April 21, Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz announced that all 50 states will be required to submit provider revalidation plans within 30 days. Speaking during Politico’s…
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Rivkin Radler to Exhibit at the 60th Greater Long Island Dental Meeting
April 21, 2026 |Rivkin Rounds Staff | Dentistry

Rivkin Radler’s Dental Practice Counseling Group will be exhibiting at the 60th Annual Session of the Greater Long Island Dental Meeting (GLIDM) on April 26 and April 27 at the Hilton Hotel in Melville, NY. GLIDM is a premier dental conference catering to professionals in search of top-tier dental continuing…
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Medical spas continue to expand beyond traditional aesthetic services, and peptides have quickly become one of the more heavily marketed offerings in this space. While these products are often positioned as part of a broader “wellness” model, the legal framework that governs them is far less flexible. At the federal…
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On April 1, the U.S. Food and Drug Administration (FDA) clarified its policies on compounded drugs, including compounded versions of GLP-1 products. Compounders are permitted to produce copies of approved drugs only while those drugs are listed in FDA’s shortage database. GLP-1 products are used primarily for weight loss and…
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Examining the Role and Impact of Private Equity in Healthcare – A Comprehensive Analysis
April 02, 2026 |Norton Travis and Emily Manning | Mergers and Acquisitions

A recent report issued by The NYU Stern Center for Business and Human Rights entitled “Private Equity and Healthcare: Balancing Profit with Wellness” examined the expanding role of private equity in the healthcare sector, concluding that “Private Equity’s combination of legal immunity, public anonymity, and financialized ownership creates a culture…
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On March 26, the U.S. Department of Justice (DOJ) and the U.S. Attorney’s Office for the Southern District of New York filed a civil antitrust lawsuit against The New York and Presbyterian Hospital (NYP). The Complaint alleges that NYP violated Section 1 of the Sherman Act by requiring restrictive anti-competitive…
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Last month, Pinnacle MultiCare Nursing and Rehabilitation Center (Pinnacle) filed a federal action to stop the U.S. Department of Health and Human Services (HHS) from recouping tens of millions of dollars in Medicare Part A payments made to Pinnacle during the COVID-19 pandemic. According to its Complaint, Pinnacle received a…
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FTC Forms Task Force to Investigate Healthcare Transactions, Deceptive Marketing
March 26, 2026 |Norton Travis and Emily Manning | Antitrust | Legislation and Public Policy | Mergers and Acquisitions

On March 20, the Federal Trade Commission (FTC) issued a memorandum announcing the formation of a Healthcare Task Force dedicated to addressing unlawful business practices within the healthcare sector. The memorandum emphasizes that industry consolidation and anticompetitive conduct have contributed to “higher prices, decreased quality, less access and transparency, and stifled…
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Tax time approaches; check your practice-friendly deductions
March 23, 2026 |Rivkin Rounds Staff | Tax/IRS

A March 16 article in Part B News, “Tax time approaches; check your practice-friendly deductions,” provides timely information on the types of expenses and deductions that doctors and medical practice owners can claim as the April 15 tax deadline nears. Rivkin Radler’s Lou Vlahos was quoted on several different topics…
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RI Proposes CPOM Ban, Reporting Requirements
March 23, 2026 |Benjamin Malerba | Legislation and Public Policy | Mergers and Acquisitions

On February 6, Rhode Island introduced legislation that would significantly expand its corporate practice of medicine (CPOM) restrictions and impose new healthcare ownership transparency requirements. The proposal would prohibit unlicensed entities from owning medical practices or employing licensed providers, while requiring physicians to hold majority ownership and control. It also…
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NY Medicaid Program Placed Under CMS Microscope Over Fraud Concerns Involving Home Health-Related Services
March 23, 2026 |Jeff Kaiser | Fraud and Abuse | Home Health | Medicare and Medicaid

In a March 3 letter addressed to Gov. Kathy Hochul, CMS Administrator Dr. Mehmet Oz raised pointed concerns about fraud, waste and abuse (“FWA”) within New York’s Medicaid Program involving payments for home health-related services. In his letter, Dr. Oz states: Recent public reporting, federal prosecutions, and CMS analyses raise…
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NY Greenlights Greater Autonomy for Dental Hygienists
March 19, 2026 |Sean Simensky | Dentistry | Legislation and Public Policy

New York Gov. Kathy Hochul recently signed a new law that will allow registered dental hygienists in the state to practice without the direct supervision of a dentist by mid-2027, pursuant to collaborative agreements with dentists. The legislation broadens permissible practice settings to include foster care agencies, signaling a path…
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A STAT News article, “How a Texas Couple is Getting Rich Off Out-of-Network Medical Bills,” explores how entrepreneurs Scott and Alla LaRoque built profitable businesses like MPOWERHealth, an intraoperative neuromonitoring company, by finding ways to exploit the 2020 No Surprises Act—a law intended to protect patients from unexpected medical bills by out-of-network providers.…
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When does marketing cross the line? Learn from recent cases and enforcement trends reshaping anti-kickback risk for companies and counsel. On April 2, from 2:00 PM to 3:00 PM, Rivkin Radler’s Jeff Kaiser will speak on the ABA Litigation Section webinar, “Marketing or Misconduct? Trends and Hot Topics on Anti-Kickback Enforcement.”…
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Restrictive Covenants and Related Topics in the Health Care Space and Beyond
March 13, 2026 |Rivkin Rounds Staff | Employer/Employee

NEW DATE! On Wednesday, March 18, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Tamika Hardy and Syma Shulman Levine will present “Restrictive Covenants and Related Topics in the Health Care Space and Beyond.” Moderated by Ben Malerba, the presenters will report on the law related to…
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On March 11, the U.S. Department of Justice and U.S. Attorney’s Office announced that Aetna, a national health insurer, has agreed to pay $117,700,000 to settle alleged violations of the False Claims Act (FCA). The government was investigating Aetna for submitting inaccurate and untruthful diagnosis codes for its Medicare Advantage…
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OIG Issues New Compliance Guidance for Medicare Advantage
March 05, 2026 |Jeff Kaiser | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid

Last month, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) published Medicare Advantage Industry Segment-Specific Compliance Program Guidance (“Guidance”). OIG described the Guidance as “OIG’s updated and centralized source of voluntary compliance program guidance for Medicare Advantage.”[1] The impetus for creating the Guidance was “the…
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Nest Health Launches In-Home Prenatal Program for Medicaid Patients in Louisiana
February 27, 2026 |Atara Kahn | Home Health | Medicare and Medicaid

Maternal health has received increased attention in federal and state Medicaid reform efforts in recent years, particularly in states with elevated mortality and disparity metrics.[1] As Medicaid agencies and managed care organizations consider alternative ways of structuring prenatal care, some providers are expanding services beyond traditional clinic settings. Nest Health…
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Medical Aid in Dying Is Now Legal in NY
February 21, 2026 |Wendy Sheinberg | Legislation and Public Policy

On February 6, New York Gov. Kathy Hochul signed the Medical Aid in Dying Act (MAID), making New York the 13th state to adopt similar legislation along with the District of Columbia. MAID has created a new Article 28-F to the New York Public Health Law, which will be effective August…
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Expect Increase in FTC Noncompete Enforcement Despite Withdrawal of Nationwide Ban
February 21, 2026 |Jeffrey Ehrhardt and Tim Gonzalez | Employer/Employee | Legislation and Public Policy

Noncompete agreements remain in the Federal Trade Commission’s crosshairs. Although the FTC abandoned its pursuit of a nationwide ban, targeted enforcement is here, and the healthcare industry specifically has been placed on notice. The Background On September 5, 2025, the FTC announced it was walking away from its proposed national…
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On February 3, President Trump signed the Consolidated Appropriations Act, 2026 (H.R.7418), which extends certain Medicare telehealth flexibilities through December 31, 2027. These flexibilities were initially enacted by Congress in response to the COVID-19 pandemic and rising need for telehealth services. The most important aspect of these flexibilities was that…
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Last month, Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), accompanied by other CMS officials, visited with home health and hospice providers and related industry associations to discuss ways to strengthen program integrity enforcement. CMS was reacting to calls from industry stakeholders and members of…
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New York Amends Shield Law
February 05, 2026 |Emily Manning | Legislation and Public Policy | Uncategorized

The New York “Shield Law” refers to several statutes intended to protect patients and providers seeking or offering services concerning gender-affirming care or abortion. These statutes were enacted in response to certain other states increasingly criminalizing these types of healthcare services. The Shield Law prohibits state cooperation with hostile actions,…
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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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