An effective defense for fraud allegations begins with proactive compliance controls tailored to healthcare operations. Federal and state authorities increasingly scrutinize billing patterns, documentation and financial relationships under the False Claims Act, 31 U.S.C. § 3729 et seq., the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, and related regulations. As a healthcare executive, you must...
The behavioral healthcare and addiction treatment industry in Florida is facing a critical challenge. Addiction treatment providers, who deliver essential care to individuals seeking recovery, are now confronted with a development that threatens the sustainability of their services. In August 2025, detox and residential treatment facilities throughout Florida contracted with Ambetter, Centene’s...
FDA’s “Green List” for GLP-1 Ingredients On September 5, 2025, the U.S. Food and Drug Administration (FDA) announced a new “green list” import alert for active pharmaceutical ingredients (APIs) used in GLP-1 medications such as semaglutide and tirzepatide. The green list will include GLP-1 APIs from facilities the agency has inspected or evaluated that appear to be in compliance with the FDA’s...
The most prevalent type of defense investigations in healthcare are those related to Medicare or Medicaid fraud. Agencies such as the Department of Justice (DOJ) and the Department of Health and Human Services Office of Inspector General (HHS-OIG) rigorously investigate billing patterns that suggest excessive claims, duplication of services, or medically unnecessary procedures. Such...
As corporate practice of medicine (“CPOM”) restrictions continue to tighten across multiple states, stakeholders in the healthcare industry particularly those involved in multi-state operations must navigate a shifting legal landscape. These evolving regulatory frameworks increasingly limit the degree of control non-physicians may exert over medical practices. Yet, amid this national trend,...
Maintaining your healthcare license is the cornerstone of your professional career as a healthcare provider. Whether you are a physician, pharmacist, nurse, or a clinic administrator, ensuring unwavering compliance and safeguarding your license is not merely an option but a critical imperative. The regulatory landscape, marked by complex state and federal mandates, means that even highly...
