Articles and Blogs

NATIONAL 4 senators push CMS to tackle Medicare Advantage upcoding: Bloomberg 7 health systems with boosted outlooks 131 hospitals sue HHS over DSH cuts: 5 notes ACA plans denied 19% of in-network claims in 2024: report AHA urges CMS to limit hospital burden in fraud crackdown, calls for MA scrutiny Bipartisan bill would cap... READ MORE

Indiana Medicaid implemented significant updates for applied behavior analysis (“ABA”) therapy—one of the most widely used interventions for children with autism spectrum disorder—effective April 1, 2026. The reforms include phased cuts to reimbursement for ABA therapy, updates to member eligibility and revisions to provider qualifications. The Indiana Health Coverage Programs (“IHCP”) began covering ABA... READ MORE

Our previous article, In Defense of IGTs from Governmental Health Care Providers, noted that the Secretary of the Department of Health and Human Services (“HHS”) is required to “consult with the States” before issuing any regulations changing the treatment of intergovernmental transfers (“IGTs”). We received requests for further information about this requirement following the... READ MORE

NATIONAL 1 in 3 adults using AI chatbots for healthcare advice: KFF Academic medical models are under financial strain: 5 things to know Aetna, Elevance, Humana May Be Sued In Alleged Kickback Scheme, Judge Says AHA cautions CMS on provider ID rule implementation AHA: FBI warns of Iranian hacks via Telegram app AHA urges... READ MORE

On March 20, 2026, Federal Trade Commission (“FTC”) Chairman Andrew Ferguson announced the formation of an internal Healthcare Task Force (the “Task Force”) and, in a memorandum issued the same day, directed the FTC’s Bureaus of Competition, Consumer Protection, and Economics, along with the Office of Policy Planning and the Office of Technology, to... READ MORE

On March 24, 2026, the U.S. Department of Health and Human Services (“HHS”), through the Centers for Medicare & Medicaid Services (“CMS”), published a long‑anticipated final rule adopting national Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) standards for health care claims attachments transactions and electronic signatures (the “Final Rule”). The Final Rule... READ MORE

In a significant decision with implications for 340B enforcement and False Claims Act (“FCA”) whistleblower litigation, the United States Court of Appeals for the Ninth Circuit (the “Court”) held on March 17, 2026, that a health system (the “System”) may proceed with its qui tam action alleging that pharmaceutical manufacturers engaged in fraudulent price-inflation... READ MORE

On March 19, 2026, the U.S. Court of Appeals for the Fifth Circuit denied the Federal Trade Commission’s (“FTC”) motion for a stay pending appeal of the U.S. District Court for the Eastern District of Texas’s (the “District Court”) decision vacating the FTC’s 2024 Final Rule (the “2024 Rule”) revising the Hart‑Scott‑Rodino (“HSR”) premerger... READ MORE

NATIONAL 5 new things to know about the No Surprises Act: GAO report Amazon expands Health AI beyond the One Medical platform Amazon launches health AI agent on its website, expands free virtual care to 200M Prime members Big Pharma Gets Win in RFK Jr. Vaccine Pause, Unsure If It Lasts Bipartisan bill introduced... READ MORE

The Tenth Circuit recently issued two companion decisions confirming the Occupational Safety and Health Administration’s (“OSHA”) authority to cite employers for workplace violence hazards under the General Duty Clause of the Occupational Safety and Health Act, 29 U.S.C. § 654(a)(1) (“General Duty Clause”). In both cases, the Tenth Circuit upheld OSHA’s enforcement actions and the... READ MORE