New Changes to Stark Law and Anti-Kickback Statutes
Written by: Jordan Johnson, Esq. and Leanne Livingston, Esq. The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently revised the federal self-referra
Texas District Court Rules That Providers Must Exhaust Patient’s Administrative Remedies to Preserve ERISA Standing
In Mission Toxicology, LLC v. UnitedHealthcare Insurance Company, the Western District of Texas ruled against several lab companies seeking enforcement of the right to payment under ERISA for lab services provided at certain Texas hospitals...
Major Health Insurer Forced to Amend Claim Processing Guidelines Due to Violation of Fiduciary Duties Under ERISA
The Northern District of California recently handed down remedies against United Behavioral Health (“UBH”), a subsidiary of UnitedHealth Group, related to violations of its fiduciary duties owed to its insureds...
New Developments in AI Technology Offer a Glimpse of the Future of Long Term Care: Balancing Resident Care with Safety in Light of Necessary Pandemic Precautions
Written by: Laura Hall Cartner, Esq. and Anthony Petrozza, Esq. COVID-19 has disproportionately impacted long term care facility residents and staff. While most of us take pause to reflect on the sheer tragedy of the effect this virus has had on
Revisions to Georgia’s Medicaid Application Process for Providers during the Public Health Emergency
COVID-19 continues to affect applicants for Georgia Medicaid. Based on the PHE declaration in March 2020, DFCS altered its verification process for the Medical Assistance Program...
Federal Judge Rules Against Trump’s Non-Immigrant Visa Proclamation
Written by: Ashik Jahan, Esq. Judge Jeffrey S. White of the U.S. District Court of Northern California granted a preliminary injunction filed by several associations that had challenged the validity of President Trump’s Proclamation 10052, wh
The Georgia Department of Community Health Extends Deadline for Fingerprint Background Checks for Existing Staff
In May 2018, Georgia passed the Georgia Long-term Care Background Check Program, which required fingerprint criminal background checks of applicants for employment and direct access employees...
Georgia DPH Revises Guidance to Long-Term Care Facilities
Written by: Brittany H. Cone, Esq. and Jordan Johnson, Esq. On September 21, 2020, the Georgia Department of Public Health revised its September 15, 2020 Administrative Order to reflect certain portions of the most recent guidance from the Cente
Since the Celebration at Studio 417, it has been Mudpie in the Sky for COVID-19 Business Interruption Claimants
Written by: Jacob Raehn, Esq. In the final days of summer, Federal District Courts from every corner of The United States have laid down orders both for, and mostly against, allowing plaintiffs’ COVID-19 business interruption claims to continu
The Georgia Department of Public Health Issues Reopening Guidance to Long-Term Care Facilities
On September 15, 2020, Georgia Governor Brian Kemp issued another COVID-19 related Executive Order with significant impact on Long-Term Care Facilities, including nursing facilities and assisted living communities...