On December 18, 2023, the Federal Trade Commission (“FTC”) and the Antitrust Division of the Department of Justice (“DOJ”) issued a final version of their Merger Guidelines. Initially proposed in July 2023, after five months of public commentary and feedback
Health Law Checkup
Health Law Checkup, published by Thompson Coburn, focuses on legal developments and regulatory issues affecting the healthcare industry. The blog covers topics such as healthcare mergers and antitrust enforcement, compliance program guidance updates, telehealth privacy and security, insurance claim denials involving artificial intelligence, and government enforcement actions against healthcare providers and payers. It addresses federal laws including the Anti-Kickback Statute, Stark Law, and HIPAA, and discusses practical implications for healthcare providers, payers, and related entities. The blog also highlights litigation trends, policy changes, and risk management strategies relevant to healthcare law practitioners and industry stakeholders.
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Latest from Health Law Checkup
Class Actions Highlight AI-Assisted Payer Denials
As health care payers increasingly rely on artificial intelligence (“AI”) to speed up patient claim adjudication and prior-authorization determinations, providers should be on the lookout for algorithms designed to deny claims with minimal
human oversight. Two putative class action lawsuits…
OIG Update Modernizes Compliance Program Guidance
For the first time in 15 years, the Office of Inspector General (OIG) has issued updated compliance program guidance. The release of this guidance is part of the OIG’s two-step approach to modernize its current compliance program guidance. In April…
OCR Issues New Telehealth Guidance
Last week, the Office for Civil Rights (“OCR”) released two new resources designed to assist patients in understanding the privacy and security risks to their health information associated with using telehealth, and steps that can be taken to reduce those…
FTC Challenges Decade-Long Acquisition Strategy by a Private Equity Firm and Anesthesia Provider Group Over an Alleged Anticompetitive Scheme
In an unprecedented move, the Federal Trade Commission (the “FTC”) sued U.S. Anesthesia Providers, Inc. (“USAP”) and its private equity sponsor, Welsh, Carson, Anderson & Stowe (“Welsh Carson”) alleging an anticompetitive scheme to consolidate anesthesiology practices in Texas through a…
Upcoming Changes to Various Federal Laws Impacting the Health Care Industry
Pumpkin spice is on all the shelves and the winter holidays are fast approaching. But as we enter into the final few months of 2023, the health care industry should also remember to make note of and prepare for a…
OIG Publishes New “Featured Topic” on Managed Care Oversight
By Nicole Jobe
On August 28, 2023, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) published a new “Featured Topic” webpage on managed care oversight. The OIG’s Featured Topics include compilations of the OIG’s existing work related to…
Blog Browse: Get to know the new I-9 requirements
There have been a number of changes to Form I-9 that employers should know. In a recent article, employment and immigration partner Carlos Ortiz laid out the changes and key dates relevant to Form 1-9 changes. Read more here.
Subjective Intent in False Claims Act: Navigating Ambiguity in Health Care Reimbursement Claims
At the intersection of law and business, ambiguity can present significant challenges. But one thing seems apparent under the False Claims Act (“FCA”) for health care entities submitting reimbursement claims to the government: if you
subjectively believe that your claims
subjectively believe that your claims
…
Illinois Passes Legislation Requiring Attorney General Notice of Certain Health Care Transactions
The Illinois legislature recently passed new antitrust legislation (“HB2222”) that will require advance notice to the Attorney General for health care facilities and health care provider entities engaging in certain covered transactions. If signed by the Governor, the new legislation
…