A recent False Claims Act (FCA) ruling out of Tennessee offers a pointed reminder for hospitals and health systems: physician contracts that appear compliant on paper can still create serious enforcement risk if the economics tell a different story. In denying motions to dismiss FCA claims involving Erlanger Health System (Erlanger), the federal court allowed allegations regarding physician compensation to proceed, reinforcing that these arrangements remain fertile ground for qui tam relators and the Department of Justice (DOJ). For organizations contracting with physicians, the message is clear: independent fair market value (FMV) review, rigorous documentation, regular auditing, and meaningful board oversight are essential defenses, not mere optional safeguards.
A Sliding Door to the Future of Healthcare Enforcement: Will We Soon See DEI-Based False Claims Act Settlements in Healthcare?
Posted in Fraud & Abuse & False Claims ActThe U.S. Department of Justice’s (DOJ) first False Claims Act (FCA) settlement under its new Civil Rights Fraud Initiative offers key insight for federal contractors, federal funding recipients and healthcare providers. Under the settlement reached in April 2026, International Business Machines Corporation (IBM) agreed to pay over $17 million to resolve allegations that it violated the FCA through discriminatory diversity, equity, and inclusion (DEI) employment practices. The settlement signals a new paradigm for FCA enforcement: the DOJ will use the FCA’s treble damages, statutory damages, whistleblower bounties, and anti-retaliation protections to police how federal contractors and federal funding recipients manage their workforces.
What the FTC’s Ascension/AmSurg Order Means for Nonprofit Healthcare Deals
Posted in Antitrust, Healthcare M&A, Joint Ventures, Transactions & Health VenturesThe Deal
On June 2, 2026, the Federal Trade Commission (FTC) required nonprofit health system Ascension Health Alliance to divest several ambulatory surgery centers (ASCs) as a condition of closing its proposed $3.9 billion acquisition of AmSurg LLC. The order reflects the FTC’s continued focus on competition in local outpatient markets.
Fair Warning: HHS OIG’s New FAQs Caution that Fair Market Value and Stark-Compliant Arrangements Can Nonetheless Violate the Federal Anti-Kickback Statute
Posted in Fraud & Abuse & False Claims Act, Healthcare LawFair market value arrangements and those that satisfy an exception to the physician self-referral law (Stark Law) can nonetheless violate the federal Anti-Kickback Statute (AKS). That is the message of two recent updates the U.S. Department of Health and Human Services Office of Inspector General (OIG) made to its Frequently Asked Questions (FAQs) about fraud and abuse laws.
No Remuneration, No Problem: Favorable OIG Advisory Opinion Highlights Important Guardrails for Clinical Laboratories Affiliated with Urgent Care Clinics
Posted in Fraud & Abuse & False Claims ActManagement service organizations (MSOs) with affiliated clinical labs and urgent care clinics should take note of newly identified guardrails that will facilitate their compliance with the federal Anti-Kickback Statute (AKS). Earlier this year, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion No. 26-02, a favorable opinion concluding that an MSO could own and operate an independent clinical laboratory that accepts referrals from urgent care centers managed by the same MSO without implicating the AKS.
Florida Appeals Court Rejects Rules Protecting Physician Dispensing in Workers’ Compensation Cases
Posted in Government Affairs, Licensure & Regulatory, PhysiciansA recent decision by Florida’s First District Court of Appeal (DCA) has significant implications for physicians and other practitioners who dispense medications to injured workers. In No. 1D2023-0941, 2026 WL 513788 (Fla. 1st DCA Feb. 25, 2026), the court invalidated two rules issued by the Florida Department of Financial Services (DFS) that made it harder for workers’ compensation insurers to refuse to cover medications dispensed directly by physicians and other registered dispensing practitioners. The court held that these rules are an invalid exercise of DFS’s rulemaking authority. Accordingly, workers’ compensation insurers may require injured workers to use pharmacies as opposed to receiving medications directly from their treating providers.
Self-Disclosure Decoded: DOJ’s New Corporate Enforcement Policy Creates a Uniform National Framework to Incentivize Voluntary Self-Disclosure of Corporate Misconduct
Posted in Fraud & Abuse & False Claims Act, Government Affairs, Licensure & Regulatory, Healthcare LawThe U.S. Department of Justice (DOJ) recently released its first-ever Department-wide Corporate Enforcement and Voluntary Self-Disclosure Policy (CEP) for criminal matters. The new CEP creates a uniform national policy for how the DOJ rewards companies that voluntarily self-report criminal conduct. Building on the 2025 CEP of the DOJ’s Criminal Division, the new CEP supersedes all prior corporate enforcement policies from individual DOJ components and U.S. Attorneys’ Offices. It applies to all corporate criminal matters handled by the DOJ, except for violations of the Sherman Antitrust Act.
Anti‑Kickback Statute Implications of Physician Estate Planning: OIG Approves Retirement Plan Involving ASC Ownership Transfers
Posted in Fraud & Abuse & False Claims ActOn March 9, 2026, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a favorable advisory opinion regarding a retiring physician’s transfer of ownership interests in a Medicare-certified ambulatory surgical center (ASC) as part of his retirement plan.
Sunshine State of Health: Reviewing Florida’s 2026 Healthcare Legislation
Posted in Government Affairs, Licensure & Regulatory, Health Care ProvidersDuring its recently adjourned regular session, the Florida Legislature passed several bills that affect the state’s healthcare industry, including legislation that creates a new specialty license type for Assisted Living Facilities (ALFs) providing memory care services, reestablishes the licensure and regulation of naturopathic doctors, and prohibits pharmacy benefits managers (PBMs) from requiring pharmacies to dispense drugs or biologics at a loss. The table below summarizes healthcare-related bills that the Florida House and Senate both approved, which now await the governor’s signature.
DON’T FORGET YOUR LICENSE: Florida’s New Memory Care Services Specialty License for ALFs
Posted in Government Affairs, Licensure & Regulatory, Health Care Providers, Senior LivingThe Florida Legislature has identified a regulatory gap. As Florida’s population experiences a “silver tsunami,” the number of people who currently live with Alzheimer’s disease or related dementias (collectively, Dementia) is expected to increase sharply. Lawmakers concluded that existing Assisted Living Facility (ALF) regulations are insufficient for this growing and vulnerable population that requires specialized care.
