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
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.
Latest from Health Law Scan - Page 2
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…
Applied Behavioral Analysis: Key Service for Children with Autism Is Under Payment Scrutiny
By Morgan Lewis
In the past decade, there has been a significant increase in the utilization of Applied Behavioral Analysis (ABA) therapy, in large part because of expanded coverage under all Medicaid programs since 2022. Both federal and state regulators and enforcement authorities…
Double Dose of Regulation: The Impact of SB 351 and AB 1415 on California Healthcare Transactions
By Morgan Lewis
California Governor Gavin Newsom recently signed two new bills into law that formalize restrictions on medical and dental practice management platforms operated by private equity groups and hedge funds and increase the state’s oversight of certain healthcare transactions. SB 351…
Remote Control: Key Findings and Implications of HHS-OIG’s Report on Medicare Billing for RPM
By Morgan Lewis
The US Health and Human Services Office of Inspector General (OIG) recently released a report by its Office of Evaluation and Inspections highlighting significant trends and recommendations regarding billing for remote patient monitoring (RPM) in Medicare. The report acknowledges the…
Enforcement Notes from American Health Law Association’s Fraud and Compliance Forum
By Morgan Lewis
Representatives from the defense bar and the healthcare and life sciences industry recently met for the American Health Law Association’s Fraud and Compliance Forum. The conference programming covered an array of topics for practitioners, ranging from the practical risks of…
Ninth Circuit Ruling Confirms Strength of the Eliminating Kickbacks in Recovery Act
By Morgan Lewis
Since its enactment in 2018, the Eliminating Kickbacks in Recovery Act (EKRA) has rapidly gained momentum as a powerful tool against healthcare kickbacks. By 2020, the US Department of Justice (DOJ) had already secured its first EKRA conviction. This relatively…
OIG’s Advisory Opinion No. 25-08: Negative Opinion Highlights Potential Broad Reach of AKS
By Morgan Lewis
In a relatively rare move, the US Department of Health and Human Services Office of Inspector General (OIG) recently issued an unfavorable Advisory Opinion (No. 25-08) (Opinion) reinforcing the agency’s expansive view of the federal Anti-Kickback Statute (AKS).
Mass. USAO Focuses on Healthcare Fraud in Private Equity Investments, Broker Arrangements at Annual Conference
By Morgan Lewis
On May 8, 2025, the Boston Bar Association hosted its annual White Collar Crime Conference, a reoccurring theme of which was the recognition of changing times, while also maintaining that the core principles of criminal and civil fraud enforcement remain…
Courts Diverge in Challenges to CMS's Minimum Staffing Requirements for LTC Facilities
By Morgan Lewis
On May 10, 2024, the Centers for Medicare and Medicaid Services (CMS) published its Final Rule to implement minimum staffing standards for long-term care (LTC) facilities in the United States. However, as discussed in our prior blog post, the Final…