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January 10, 2020

Health Law Weekly

Current Topics

Antitrust

Federal Court Declines to Block California Ban on Pay-for-Delay Drug Settlements

Sutter Health to Pay $575 Million to Resolve California Antitrust Lawsuit

Fraud and Abuse

Careful with Those Audit Results: DOJ Steps in and Signals Its Expectations Under the 60-day Repayment Rule

Department of Justice Announces More Than $3 Billion in 2019 False Claims Act Recoveries

DOJ Files FCA Action Alleging Community Health Network Violated Stark Law

Former Physician Sentenced to Two Years in Prison for Medicare Fraud, Illegal Prescribing

Husband and Wife Land in Prison for Vast Health Care Fraud Scheme

Neuromonitoring Services Provider Agrees to $2 Million Settlement

Ophthalmologists Agree to $950,000 Resolution of False Billing Allegations

Governance

The Risk Oversight Obligations of Health Care Boards

Government Reimbursement

CMS Approves Utah’s Medicaid Expansion with Work Requirement

CMS Extends Comment Period on Medicaid Fiscal Accountability Proposed Rule

CMS Proposes Changes to MA Risk Adjustment Model for 2021

CMS Reports Strong Performance in Second Year of Quality Payment Program

D.C. Circuit Holds Medicare Prescription Drug Plans Don’t Have to Pay FQHCs on Par with Non-FQHCs for Pharmacy Services

U.S. Court in Michigan Refuses to Enjoin Medicare Recoupment from Provider for Failure to Show Irreparable Harm

Health Insurance

ACA Enrollment Remains Steady at Close of 2020 Open Enrollment Period

CMS Extends Comment Period on Transparency in Coverage Proposed Rule

States, House of Representatives Ask Supreme Court for Swift Action on ACA Decision

Tenth Circuit Upholds Method for Setting ACA Risk Adjustment Payments

U.S. Court in California Blocks State Law Regulating Premium Assistance for Dialysis Patients

Health Policy and Administration

Administration Appealing Decision Striking Down Conscience Rule
Current Issue
Health Law Weekly Issue - January 10, 2020