On January 30, 2023, President Joseph Biden announced that the public health emergency (PHE) and national emergency declaration related to the COVID-19 pandemic will finally end on May 11, 2023, after being in place for over three years. This Health Capital Topics article will discuss the changes that will take place after both declarations cease, and the implications for stakeholders.  (Read more...)

On January 13, 2023, the U.S. Supreme Court agreed to resolve a circuit split related to the False Claims Act (FCA) in granting certiorari in two lawsuits. The decision is expected to be the most significant development for the FCA in recent history, as it will finally resolve the necessary state of mind needed to violate the FCA. This Health Capital Topics article will discuss the FCA, the two cases being decided by the Supreme Court, and potential implications for stakeholders. (Read more...)

On February 7, 2023, the U.S. Department of Justice (DOJ) announced their recovery of $2.2 billion in settlements and judgments from civil cases involving the FCA for fiscal year (FY) 2022. The overall recoveries in FY 2022 were far less than the DOJ’s FY 2021 recoveries of $5.6 billion. Of the $2.2 billion recovered in FY 2022, over $1.7 billion was recouped from the healthcare industry alone (much less than the over $5 billion recovered from the industry in FY 2021), and included recoveries from drug and medical manufacturers, home health and managed care providers, hospitals, pharmacies, hospice organizations, and physicians. (Read more...) 

Clinical laboratories face a range of federal and state legal and regulatory constraints that affect their formation, operation, procedural coding and billing, and transactions. Fraud and abuse laws, specifically those related to the federal Anti-Kickback Statute (AKS) and physician self-referral laws (the “Stark Law”), may have the greatest impact on the operations of healthcare providers. The last installment in this three-part series on the valuation of clinical labs will discuss the regulatory environment in which these organizations operate. (Read more...) 
HCC’s Jessica Bailey-Wheaton, Esq. and Dr. Bhagwan Satiani of The Ohio State University College of Medicine recently spoke on “The Surgeon's Guide to Selling a Practice” for the American College of Surgeons. This module features a video and white paper that both provide tips and considerations when buying a practice.

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