In late July 2021, the Department of Justice announced that the federal government had decided to intervene in six pending False Claims Act (“FCA”) actions against Kaiser Permanente (“Kaiser”) for alleged Medicare Advantage risk adjustment... Read More
Articles | Life Sciences | Medicare Advantage Risk Adjustment Litigation | Pharmacy Law | Value Based Care

Physician groups contracting with government-regulated health plans such as Medicare-Advantage Organizations, Medicaid Managed Care Organizations, or ACA Marketplace Individual/Small Group Issuers often enter into capitated payment models with... Read More
Articles | Healthcare | Healthcare Law | Healthcare Litigation | Medicare and Insurance Audits | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Recent Results | Recent Successes | Value Based Care | Value Based Care

If there were ever any doubts about the seriousness of CMS’ commitment to transitioning the nation’s healthcare system from one based on volume-based to value-based compensation models, those doubts were squashed by a recent CMS blog post and... Read More
COVID-19 Resources | Healthcare Law | Pharmacy Law | Value Based Care

Value Based Care is the future of the United States healthcare system and the Office of the Inspector General (OIG) for the US Department of Health and Human Services is in full agreement. The OIG recently issued a Notice of Proposed Rulemaking that... Read More
Life Sciences | Pharmaceutical Wholesalers | Pharmacy Law | Physician Dispensing | Value Based Care