Healthcare Regulatory Audit Bulletin – April 2024 Summary | McDermott Will and Emery

This issue of McDermott’s Healthcare Regulatory Check-Up discusses regulatory actions in April 2024. We discuss several U.S. Department of Health and Human Services (HHS) agency actions, including Medicare Advantage (MA) capitation rates for calendar year (CY) 2025 and a portion C and Part D Payment Rules published by the Centers for Medicare and Medicaid Services (CMS), new final rules for nursing home staffing, access to Medicaid and the Children’s Health Insurance Program (CHIP), and new final regulations from the Food and Drug Administration (FDA) laboratory testing (LDT) policies. 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).