Under the False Claims Act (FCA), relators, commonly known as whistleblowers, are individuals with non-public information who bring qui tam claims against companies that fraudulently obtain government funds. Generally, relators are incentivized to bring qui tam claims because they receive a “bounty” reward if the claim is successful. However, a recent decision by a…Read More
Providers will have until April 2026 to comply with recently announced changes to the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations, better known as Part II regulations, that better align Part II regulations with privacy protections found in other laws. Part II sets privacy standards for records generated by the treatment of SUDs,…Read More
On April 23, 2024, the Federal Trade Commission (FTC) issued a final rule banning most non-compete agreements entered into by for-profit businesses. The final rule is very similar to the proposed rule initially issued by the FTC in April 2023. The rule is an outgrowth of President Biden’s 2021 Executive Order on Promoting Competition…Read More
The Maryland General Assembly’s 2024 legislative session concluded with the enactment of many health care laws that will impact health care facilities, providers, insurers, and health care related licensees in the State. Here are some of the highlights from the 2024 session. Consumer Health Data Privacy The Maryland Online Data Privacy Act of 2024 regulates…Read More
In 2022, the United States Congress passed the Inflation Reduction Act (IRA) which gave Medicare the authority to negotiate certain prescription drug prices with manufacturers for the first time. The intent of this law is to reduce the cost of some of the most expensive drugs and increase access to patients through Medicare Part B…Read More
In the Spring of 2023, the Sixth Circuit, which is the federal appellate court with jurisdiction for Kentucky, Michigan, Ohio and Tennessee, issued an unprecedented opinion in Martin v. Hathaway, holding for the first time by a federal appellate court that “remuneration” in the federal Anti-Kickback Statute (AKS) means “just payments and other transfers of value”…Read More
This is the third part of a several part series of articles pertaining to limited liability company operating agreements. This third installment addresses capital calls, covenants not to compete and fiduciary duties. Many medical practices and other health care enterprises operate as limited liability companies (LLCs), and are, therefore, governed by the LLC’s “operating agreement.”…Read More
The No Surprises Act (NSA), effective January 1, 2022, generally protects patients from receiving unanticipated bills for emergency care rendered by providers who do not participate with the patient’s insurance coverage (out-of-network providers), and includes a prohibition on certain out-of-network providers balance billing patients. The law also requires that the patient’s insurer reimburse the out-of-network…Read More