Health Care Regulatory Audit Bulletin | April 2024 Summary

This is McDermott’s edition Health care regulation audit highlights regulatory activity for April 2024. We discuss several U.S. Department of Health and Human Services (HHS) agency actions, including the Medicare Advantage (MA) capitation rates for calendar year (CY) 2025 and the Part C and Part D payment rules published by the Centers Medicare and Medicaid Services (CMS), new final rules on nursing home staffing, access to Medicaid and the Children’s Health Insurance Program (CHIP), and new Food and Drug Administration (FDA) final rules on laboratory testing (LDT). We also review a ruling by the Federal Trade Commission (FTC) that provides a potential ban on most non-compete agreements. Additionally, we discuss one favorable advisory opinion from the Office of the Inspector General (OIG) and several criminal and civil prosecutions related to health care fraud, including alleged violations under the False Claims Act (FCA), the federal anti-kickback statute (AKS), and physician autonomy -Law of referral (Stark’s law).