April 1, 2026 Fraud & Abuse / Anti-Kickback The OIG issued a favorable advisory opinion allowing a medical device manufacturer to subsidize Medicare cost-sharing obligations for patients enrolled in a clinical trial testing an implantable device that delivers electrical pulses to baroreceptors in the carotid artery. The study will test the device in heart failure patients with left ventricular ejection fraction between 35 and 50 percent, enrolling up to 2,500 participants at up to 200 sites...
8 days ago • 10 min read
April 1, 2026 Healthcare Fraud and False Claims Aetna Inc. agreed to pay $117,700,000 to resolve allegations that it violated the False Claims Act by submitting inaccurate diagnosis codes for Medicare Advantage enrollees to inflate payments from the Centers for Medicare & Medicaid Services. The government alleged that in 2015, Aetna operated a chart review program that added diagnosis codes to obtain payments but failed to delete codes that chart reviews showed were unsupported, which would...
15 days ago • 13 min read
April 1, 2026 Healthcare Fraud Enforcement & Anti-Kickback The Office of Inspector General approved an arrangement allowing a management company affiliated with urgent care centers to establish an independent clinical laboratory without violating the Anti-Kickback Statute. OIG issued Advisory Opinion No. 26-02 on February 12, 2026, concluding that the arrangement would not generate prohibited remuneration because the laboratory and management entity provided no payments for referrals, urgent...
22 days ago • 8 min read
April 1, 2026 This week Drug & Device Emerging Tech Fraud & Abuse HIPAA & Health Tech Management Services Organizations (MSOs) Pharma & 340B Reimbursement Taxation Drug & Device The FDA issued a warning about Generation 1 Purge Cassettes in Johnson & Johnson MedTech’s Impella heart pumps after the components were linked to 4 injuries. The cassettes can leak, which may lead to low purge pressure, biomaterial ingress, pump stop, and potentially patient death. On Feb. 18, Johnson & Johnson...
29 days ago • 10 min read
April 1, 2026 No, You Can’t Just Not Take Medicare: What Every Chiropractor Needs to Know By Wade Emmert A growing number of chiropractors are moving away from insurance panels in favor of cash-pay practice models built around direct-pay patient relationships. The appeal is understandable—simplified billing, transparent pricing, and greater clinical autonomy. But this shift has created a widespread compliance problem that many chiropractors do not realize they have: an obligation to Medicare...
about 1 month ago • 5 min read
April 1, 2026 This week Antitrust Compounding Pharmacies Devices Emerging Tech Fraud & Abuse HIPAA Mergers & Acquisitions Personnel Ransomware Reimbursement Substance Abuse Disorder (Part 2) Valuations Reproductive Rights Antitrust The DOJ Antitrust Division awarded its first whistleblower payout of $1 million to an individual who exposed a bid rigging and fraud scheme at EBlock Corp.’s online vehicle auction platform. The payment stems from the DOJ Whistleblower Rewards Program, which...
about 1 month ago • 12 min read
April 1, 2026 This week Data Breach Drug & Device Fraud & Abuse HIPAA Medicare / Medicaid Management Services Organizations (MSO) Mergers & Acquisitions (M&A) Substance Use Disorder (Part 2) Telehealth Texas Medical Board Data Breach Texas Attorney has launched an investigation into what he describes as potentially the largest data breach in U.S. history, issuing Civil Investigative Demands to Blue Cross Blue Shield of Texas and Conduent Business Services LLC. The breach of Conduent’s system...
about 1 month ago • 11 min read
April 1, 2026 This week Ambulatory Surgery Centers Advisory Opinions Drug & Device Fraud & Abuse HIPAA Licensure Non-Competes Pharmacy Benefits Managers Reproductive Rights Ambulatory Surgery Centers Ambulatory surgery centers now treat patients with conditions far beyond their original design parameters. ASCs increasingly care for patients with diabetes, obesity, cardiovascular disease, arrhythmias, anticoagulation therapy, pulmonary disease, and renal impairment, often in combination....
about 2 months ago • 11 min read
April 1, 2026 This week Drug & Device Fraud & Abuse HIPAA Hospitals Labor & Employment Med Spas Medicare Reimbursement Mergers & Acquisitions Overpayments Privacy Reproductive Rights Substance Abuse - Part 2 Drug & Device Reference product exclusivity grants biological products 12 years of market protection under the Biologics Price Competition and Innovation Act, during which the FDA will not approve biosimilar applications referencing the product. The FDA may not issue licensure of a...
about 2 months ago • 10 min read