Interest in and acceptance of telehealth services continues to grow. In 2023, a key focus of the states has been addressing how to modify existing regulatory infrastructures sustaining the provision of telehealth services to support the continued use of these services in a post-public health emergency world. However, modifications to telehealth services also increase the potential for fraudulent behavior and enforcement activity. Providers need to monitor developments in federal and state laws, regulations, and policies to capitalize on telehealth opportunities while staying compliant with applicable laws.

Epstein Becker Green’s Telemental Health Laws App is easy for behavioral health providers to download and use. Through the app, providers get an overview and detailed breakdown of legal trends impacting telehealth and telemental health services. The app also includes an intuitive interface and state-by-state guides.

Download our app today – ebglaw.com/telemental-health-laws-app

The Thought Leaders in Health Law® video series tracks the latest trends in multiple areas of the health care and life sciences industries, featuring attorneys and advisors from Epstein Becker Green and EBG Advisors.

These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. THOUGHT LEADERS IN HEALTH LAW® is a registered trademark of Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.

The Inflation Reduction Act (IRA) introduces significant changes in prescription drug pricing, including the establishment of the Medicare Drug Price Negotiation Program and the Medicare Prescription Drug Inflation Rebate Program to control drug prices. The IRA includes a redesign of the Medicare Part D benefit, which began with the announcement of 10 Medicare Part D drugs open for negotiation. This video highlights the challenges and complexities during the multi-year IRA implementation and emphasizes the penalties for noncompliance with IRA provisions.

What does this mean for you?
• Drug companies will need to ensure compliance with the new regulations and reporting requirements introduced by the IRA. Noncompliance can result in penalties, which can be financially significant.
• Implementing the IRA provisions may pose operational, legal, and logistical challenges for drug companies. Companies should invest in compliance efforts, data tracking, and reporting systems.

For more information on the IRA, visit: ebglaw.com/trending-issues/inflation-reduction-act

The Thought Leaders in Health Law® video series tracks the latest trends in multiple areas of the health care and life sciences industries, featuring attorneys and advisors from Epstein Becker Green and EBG Advisors.

These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. THOUGHT LEADERS IN HEALTH LAW® is a registered trademark of Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.

Recent events, like the COVID-19 pandemic and the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women's Health Organization, have put more pressure than ever on federal and state legislators to promote access to telehealth services. However, the greater use of telehealth services also increases the potential for fraudulent behavior and enforcement activity. Behavioral health providers should continue to monitor developments in federal and state laws, regulations, and policies to capitalize on telehealth opportunities while staying compliant with applicable laws.

Epstein Becker Green’s Telemental Health Laws App is easy for behavioral health providers to download and use. Through the app, providers get an overview and detailed breakdown of legal trends impacting telehealth and telemental health services. The app also includes an intuitive interface and state-by-state guides.

Download our app today – ebglaw.com/telemental-health-laws-app/

The Thought Leaders in Health Law® video series tracks the latest trends in multiple areas of the health care and life sciences industries, featuring attorneys and advisors from Epstein Becker Green and EBG Advisors.

These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. THOUGHT LEADERS IN HEALTH LAW® is a registered trademark of Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.

The U.S. Department of Justice (DOJ) collected $5.6 billion in False Claims Act recoveries in fiscal year (FY) 2021.

That is over twice as much as 2020, and a record 90 percent of the total was collected from the health care and life sciences industries.

DOJ’s health care recoveries in government-initiated actions were also more than double the total recoveries in actions initiated by whistleblowers.

Health care enforcement targeted:

● billing for unnecessary medical services,
● solicitation or payment of kickbacks for goods or services paid for by federal health care programs, and
● risk adjustment fraud related to Medicare Advantage programs.

The record-breaking year in FY 2021 shows that the pandemic has not weakened enforcement activity, especially for the health care and life sciences industries. Comprehensive and effective compliance is more important now than ever.

To dive deeper into these stats and their impact on health care companies, read more from attorneys George Breen, Erica Sibley Bahnsen, Daniel Fundakowski, and Elizabeth Harris:

Health Law Advisor: "DOJ Releases FY 2021 False Claims Act Recoveries: A Record-Shattering Year for Health Care and Life Sciences Enforcement, with Over $5 Billion Collected" - healthlawadvisor.com/2022/02/03/doj-releases-fy-2021-false-claims-act-recoveries-a-record-shattering-year-for-health-care-and-life-sciences-enforcement-with-over-5-billion-collected/

Law360: “FCA Trends to Watch for Health, Life Sciences Companies” - ebglaw.com/insights/fca-trends-to-watch-for-health-life-sciences-cos/

Learn more: ebglaw.com/trends-FCA21

The Thought Leaders in Health Law® video series tracks the latest trends in multiple areas of the health care and life sciences industries, featuring attorneys and advisors from Epstein Becker Green and EBG Advisors.

These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. THOUGHT LEADERS IN HEALTH LAW® is a registered trademark of Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.

Is your organization ready for the No Surprises Act (NSA)? The law goes into effect January 1, 2022, and contains a new federal ban on surprise billing as well as new disclosure requirements.

The NSA applies to certain payors, providers, facilities, and ancillary service entities that support patients who receive emergency services or other non-emergency services at certain facilities, such as hospitals, hospital outpatient departments, and ambulatory surgical centers.

What does this mean for you?

• Health care businesses should design a detailed “operationalized” NSA compliance program now, but stay flexible as additional regulations are issued.
• If you have operations in multiple states, assess whether state laws may apply and how they will interact with the federal law.
• Calculate your median contracted rates for common services in each sector for billing guidance.
• Ancillary service providers, in particular, must determine how to obtain the necessary information to help determine if federal protections apply to services they provide to patients in facilities in which they are not physically located.

For more information on the NSA, visit: ebglaw.com/trending-issues/no-surprises-act/

The Thought Leaders in Health Law® video series tracks the latest trends in multiple areas of the health care and life sciences industries, featuring attorneys and advisors from Epstein Becker Green and EBG Advisors.

These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. THOUGHT LEADERS IN HEALTH LAW® is a registered trademark of Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.