[This blog post was originally published on Proskauer’s Government Contractor Compliance & Regulatory Update blog here.]

The U.S. Department of Justice (the “DOJ”), Civil Division, has started issuing Civil Investigative Demands (“CIDs”) to federal contractors and grant recipients, seeking detailed information about their diversity, equity, and inclusion (“DEI”) practices. This move is part…

On May 27, 2025, Blue Cross Blue Shield Healthcare Plan of Georgia (“BCBSGA”) sued several emergency physician groups and their billing agent, Halo MD, alleging abuse of the No Surprises Act’s (“NSA”) independent dispute resolution (“IDR”) process.  The complaint claims the providers submitted ineligible claims, made false attestations, and inundated…

Last month, the United States Department of Justice (“DOJ”) issued its “Civil Division Enforcement Priorities” memorandum, memorializing a shift from its predecessor administration’s policy on gender‑affirming healthcare (“DOJ Memo”). The DOJ Memo portends a significant rise in government investigations and False Claim Act (“FCA”) liability for suppliers and providers…

In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”).  In a much-anticipated decision, the Fifth Circuit has held that the NSA does…

The U.S. District Court for the District of Connecticut has become the latest court to weigh in on whether Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”) are enforceable.  In a recent decision, the District Court has held that providers may sue to enforce arbitration…

Over the past 3 years, as chronicled in several Proskauer alerts, an increasing number of states have sought to regulate physician practice management (“PPM”) and private equity transactions in the health care sector, including California, New York, Washington, and Illinois.

The regulation of health care transactions remains an evolving…

The Department of Justice’s (“DOJ”) May 19, 2025 “Civil Rights Fraud Initiative” memorandum, issued by Deputy Attorney General Todd Blanche (the “Initiative”), marks a consequential policy shift for False Claims Act (“FCA”) enforcement. The Initiative instructs every U.S. Attorney’s Office to “aggressively pursue” compliance with federal civil rights laws, as those laws have been interpreted by the Supreme Court under the 2023 Harvard admissions decision. The effect of this order is to treat a recipient’s knowing violation of federal civil rights laws as a “false claim” whenever that recipient has certified, impliedly or expressly, that it would comply with those laws as a condition of receiving federal dollars.

On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing efforts with respect to Medicare Advantage (“MA”) plans.

For newly initiated audits of MA plans, CMS will audit all eligible MA contracts for each payment year. Additionally, for audits already initiated…

On May 15, 2025, the New York State Department of Health (“DOH”) announced the launch of the electronic Material Transaction Reporting Form for health care transactions (“Electronic Form”). To assist reporting entities in preparing their submissions, the DOH has also released a list of all questions included in the Electronic…

The U.S. Supreme Court has issued a significant ruling affecting hospitals that serve low-income Medicare beneficiaries, narrowing the interpretation of the Disproportionate Share Hospital (“DSH”) payment formula.  In Advocate Christ Medical Center v. Kennedy, the Court determined that only Medicare patients who were eligible to receive a cash Supplemental…

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