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Jan 23, 2025 | 
openlegalblogarchive.org | Jon Zucker
A Special Fraud Alert has been issued by the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), warning that certain marketing arrangements relating to Medicare Advantage beneficiary referrals could potentially result in “abusive arrangements.” Jon Zucker explains. The post Referral Payments Targeted in New Special Fraud Alert appeared first on GoodLifeSci.
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Jan 22, 2025 | 
goodlifesci.sidley.com | Jon Zucker
A Special Fraud Alert has been issued by the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), warning that certain marketing arrangements relating to Medicare Advantage beneficiary referrals could potentially result in “abusive arrangements.” Jon Zucker explains. U.S. government agencies — including HHS-OIG — have shown an increased interest in Medicare Advantage plan activity and provider marketing arrangements.
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Dec 17, 2024 | 
today.westlaw.com | Jaime Jones |Meenakshi Datta |Brenna Jenny |Jon Zucker
(January 16, 2025) - Sidley Austin partners Jaime Jones, Meenakshi Datta, Brenna Jenny and Jon Zucker discuss a rare Special Fraud Alert from the Department of Health and Human Services, Office of Inspector General cautioning against paying for referrals of Medicare Advantage beneficiaries.
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Apr 9, 2024 | 
lexology.com | Jon Zucker |Jaime L.M. Jones |Francesca R. Ozinal |George Maliha M.D |Taylor Andelman
The U.S. Centers for Medicare and Medicaid Services (CMS) published a final rule on April 4, 2024 that overhauls the regulations governing insurance agent and broker compensation rates and agreements for Medicare Advantage Plans (MAPs) and Medicare Part D Plans (PDPs). The final rule, which adopts the majority of the changes from the proposed rule that we previously discussed here, is intended to establish additional guardrails to protect beneficiaries and support competition within the industry.
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Jan 24, 2024 | 
fcablog.sidley.com | Jaime Jones |Jon Zucker |Lauren McBride
A recent False Claims Act settlement between the Department of Justice, a New Jersey hospital, and the hospital’s investors also included a novel Federal Debt Collection Practices Act (“FDCPA”) settlement with the investors, highlighting the government’s continued efforts to pursue investors in the healthcare industry.
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Jan 24, 2024 | 
lexology.com | Jaime Jones |Jon Zucker |Lauren McBride
A recent False Claims Act settlement between the Department of Justice, a New Jersey hospital, and the hospital’s investors also included a novel Federal Debt Collection Practices Act (“FDCPA”) settlement with the investors, highlighting the government’s continued efforts to pursue investors in the healthcare industry.
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Nov 21, 2023 | 
lexology.com | Jon Zucker |Meenakshi Datta |Taylor Andelman
The U.S. Centers for Medicare and Medicaid Services (CMS) published a proposed rule on November 15, 2023 that would overhaul the regulations governing insurance agent and broker compensation rates and compensation agreements for Medicare Advantage plans (MAPs) and Medicare Part D plans (PDPs). The proposal follows CMS’ final rule revising the regulations governing marketing by MAPs issued on April 5, 2023, which we covered in a prior Sidley Update here.
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Nov 9, 2023 | 
medcitynews.com | Jon Zucker
Investor interest in telehealth surged during the Covid-19 pandemic. While the healthcare industry’s widespread adoption of telehealth was driven by necessity due to social distancing practices, such expansion would not have been possible without federal and state governments waiving many legal and regulatory requirements that had previously hindered such telehealth growth.
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Apr 12, 2023 | 
lexology.com | Jon Zucker |Meenakshi Datta |Taylor Andelman
The U.S. Centers for Medicare and Medicaid Services (CMS) issued a final rule on April 5, 2023, revising the regulations governing marketing by Medicare Advantage plans (MAPs) and Medicare Part D plans (PDPs). These changes follow CMS’s October 2022 memo expressing concern regarding MAP and PDP marketing practices, and the proposed rule issued on December 14, 2022. The changes are applicable for all contract year 2024 marketing and communications beginning September 30, 2023.
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Feb 15, 2023 | 
lexology.com | Jon Zucker |Meenakshi Datta |Sama Kahook
The U.S. Centers for Medicare & Medicaid Services (CMS or the Agency) has released a significant proposed rule (the Proposed Rule) that would require Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities (collectively, Nursing Facilities) to disclose additional information related to their ownership and management structures.
