Photo of Peter J. Eggers

Peter Eggers is an associate in the Corporate Department and a member of the Health Care Group. He regularly counsels clients on corporate matters including mergers and acquisitions, joint ventures, professional services arrangements and general business planning. He also provides legal advice on health care regulatory matters such as fraud and abuse, licensure and enrollment, Medicare reimbursement, and other compliance issues. He combines his passion for health care with an interest in each client’s business objectives to help identify opportunities for them to overcome challenges within their organizations and the health care industry.

Peter earned his J.D. with a Certificate in Health Law from the Saint Louis University School of Law. While in school, Peter served as the Editor-in-Chief of the Saint Louis University Journal of Health Law & Policy. Peter later served as an adjunct faculty member of the Center for Health Law Studies at Saint Louis University School of Law teaching Transactional Health Care Law.

Many of us have been waiting to hear the final word about what’s next from CMS for the Next Generation ACO Model. On May 21, 2021, CMS’s Innovation Center (“CMMI”) confirmed that the Next Generation ACO Model would not be extended and will conclude at the end of this year as planned. The Next Generation ACO Model has been the most advanced value-based contracting model offered by CMS with participating risk-bearing entities taking between 80%-100% upside and downside risk.  However, according to reports, the model didn’t achieve sufficient savings to justify making it a permanent CMMI program.
Continue Reading CMS to Discontinue Next Generation ACO Model as Expected but Allows Program Participants to Apply For Direct Contracting

As is the case with most new technologies or significant industry innovations, companies embracing and driving the disruptions often move very fast in a legal and political landscape that is always playing catch-up. This is very true for the fast-growing telemedicine and digital health industries. However, likely motivated by COVID-19, state governments are moving faster than they traditionally do to pass new regulations and to extend certain regulatory waivers.

COVID-19 required a shift in the delivery of medical care with the state and local lockdowns. During the pandemic, the United States Department of Health and Human Services (HHS) has issued guidance on various compliance waivers and enhanced flexibility. Governors across the country issued executive orders to help address the requirements of providing ongoing medical care while maintaining proper social distancing (e.g., New Mexico, Texas, etc.). The result was more people receiving medical care remotely. Similar to the realization by many that working from home was not only feasible but in some cases preferable, many also came to the conclusion that a trip to the doctors’ office was not necessary for the treatment of certain conditions.
Continue Reading Propelled by COVID-19, State Governments Attempt to Keep Up With Telemedicine Innovation and Digital Health Platforms

A recent Fourth Circuit decision, United States v. Mallory (988 F.3d 730), upheld damages and penalties for more than $100 million for violations of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)) (the “AKS”) and the False Claims Act (31 U.S.C. § 3729) by a blood testing laboratory and its contracted sales agents.  The Court held that commission payments made by the laboratory to its sales agents (sales companies that, in turn, hired and contracted salespeople to sell the laboratory blood tests), which were based on the percentage of revenue the sales agents generated for the laboratory through marketing services, constituted improper “remuneration” that intended to induce the sales agents to sell as many laboratory tests as possible. The defendants failed to show that the arrangements fit within an AKS Safe Harbor.
Continue Reading Developments Regarding Commission-Based Compensation Arrangements with Independent Contractors