The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would significantly limit Medicaid managed care State Directed Payments (SDPs) and certain fee-for-service payments. These changes seek to implement, and go well beyond, the relevant directives under
Health Law Scan
Health Law Scan, published by Morgan Lewis, covers legal developments and regulatory issues in the healthcare sector. The blog addresses topics such as Medicaid coverage and payment scrutiny for therapies like Applied Behavioral Analysis, state-level healthcare transaction regulations including private equity oversight, Medicare billing compliance for remote patient monitoring, and enforcement trends in healthcare fraud and compliance. It also discusses recent court rulings impacting healthcare anti-kickback statutes and the implications of emerging technologies like artificial intelligence in clinical operations. The content is aimed at healthcare providers, payers, and legal practitioners navigating the complex healthcare regulatory environment.
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Latest from Health Law Scan
DOJ Forms West Coast Strike Force to Combat Health Care Fraud
By Morgan Lewis
The US Department of Justice (DOJ) has announced a significant expansion of its health care fraud enforcement efforts with the formation of the West Coast Health Care Fraud Strike Force. This initiative is spearheaded by the newly created National Fraud…
Key Takeaways from the Boston Bar Association’s White Collar Crime Conference
By Morgan Lewis
The Boston Bar Association held its annual White Collar Crime Conference on May 7, 2026, featuring lawyers from the defense and plaintiffs’ bar and current and former prosecutors from the US Attorney’s Office for the District of Massachusetts (the Office)…
DOJ Unveils FOCUS Initiative Prioritizing Data Miner FCA Cases
By Morgan Lewis
The DOJ recently announced the Fraud Oversight through Careful Use of Statistics (FOCUS) initiative to address the growing number of False Claims Act (FCA) qui tam complaints filed by “data miners,” defined as individuals or organizations that use publicly available…
CMS Imposes Six-Month Nationwide Hospice and Home Health Medicare Enrollment Moratorium Effective May 13
By Morgan Lewis
The Centers for Medicare & Medicaid Services (CMS) on May 13, 2026 announced a nationwide temporary moratorium on new Medicare enrollments for hospices and home health agencies, representing a significant escalation in the agency’s use of front-end program integrity tools.…
Major Government Updates from AHLA Medicare and Medicaid Conference
By Morgan Lewis
From March 18–20, 2026, the American Health Law Association (AHLA) hosted its annual Institute on Medicare and Medicaid Payment Issues conference in Baltimore, Maryland, focused on the full range of risks and opportunities relating to participation in federal health care…
Favorable OIG Advisory Opinion Underscores Ongoing Scrutiny of Ancillary Service Referrals
By Morgan Lewis
The US Department of Health and Human Services Office of Inspector General (OIG) recently issued Advisory Opinion No. 26-02, concluding that a proposed arrangement under which an urgent care management entity would operate an affiliated clinical laboratory would not generate…
Virtual Direct Supervision Allowed for ‘Incident to’ Medicare Billing and Other Telehealth Updates
By Morgan Lewis
The Centers for Medicare & Medicaid Services (CMS) allows the use of real-time, two-way audio/video communications technology to satisfy the direct supervision requirement for most Medicare Part B services. This development, stemming from flexibilities first introduced during the COVID-19 public…
Medicare Advantage Agent and Broker Agreements: 2025 in Review
By Morgan Lewis
2025 was an important year for Medicare Advantage (MA) plans that pay state-licensed agents and brokers to market their plans and engage in lead generation, subject to complex federal regulations. As we previously discussed on Health Law Scan , improper…
CMS Expands Hospice Oversight to Georgia and Ohio as DEA Extends Telemedicine Flexibilities
By Morgan Lewis
Recent regulatory actions by the Centers for Medicare and Medicaid Services (CMS), the US Drug Enforcement Administration (DEA), and the US Department of Health and Human Services (HHS) highlight heightened federal scrutiny of hospice providers in higher-risk states and continued…