Legal & Regulatory Issues

Seven Texas physicians and a hospital CEO have agreed to pay more than $1.1 million to resolve allegations that they violated the Anti-Kickback Statute and Stark Law by accepting illegal monetary benefits in exchange for ordering laboratory tests, the Justice…

HHS' reaffirmation of the ACA's requirement that payers cover FDA-approved contraceptives is the first of many necessary steps to ensure insurers stop skirting around coverage requirements, Martha Nolan, senior policy advisor at nonprofit HealthyWomen, wrote in a Jan. 13 op-ed…

More than 120 organizations — including payers, businesses and advocacy groups — have signed on to a coalition that opposes proposals that would enact and fund a single-payer healthcare system in California. 

HCA Healthcare, a for-profit hospital operator based in Nashville, Tenn., is facing a federal antitrust case in Florida concerning the orthopedic surgery market. 

Four former employees of Boston Children's Hospital are suing the organization over allegations including that it did not fully disclose the expenses associated with its $1.1 billion retirement plan, according to court documents obtained by Becker's.

CMS may enforce its COVID-19 vaccination mandate nationwide after a federal court on Jan. 19 dismissed a lawsuit filed by the state of Texas, Bloomberg Law reported. 

Following CMS's preliminary decision to limit the coverage of Biogen's Alzehimer's disease treatment Aduhelm, advocates are calling on the agency to broaden its coverage or risk the future of similar drugs, according to a Jan. 17 Politico report. 

Two groups representing payers — America's Health Insurance Plans and the Blue Cross Blue Shield Association — filed amicus briefs supporting HHS against a lawsuit challenging parts of the No Surprises Act. 

Sartell, Minn.-based Center for Pain Management is challenging Blue Cross and Blue Shield of Minnesota's decision to terminate its network contract, according to the St. Cloud Times. 

More than 30 lawmakers penned a letter to CMS Administrator Chiquita Brooks-LaSure Jan. 18 asking her to reevaluate the proposed 14.5 percent increase to Medicare Part B premiums in 2022.