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