Health Care Counsel Blog
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On July 2, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule (CMS-1850-P).
On July 16, the Centers for Medicare & Medicaid Services (CMS) published the 2027 Physician Fee Schedule (PFS) proposed rule. Among other provisions, CMS has now proposed to convert a previously voluntary filing to a mandatory submission: requiring 340B Covered Entities to submit Part D claims data to the Medicare Part D Claims Data 340B Repository beginning in 2027.
A newly filed California suit, Winters v. OpenAI, Inc. et al., may become the first case to test whether product liability and negligence per se theories can reach a generative artificial intelligence (AI) chatbot’s design and deployment decisions, after ChatGPT-4o’s health-related guidance allegedly contributed to a plaintiff’s near-fatal medical emergency.
Headlines that Matter for Companies and Executives in Regulated Industries
Headlines that Matter for Companies and Executives in Regulated Industries
Every July, the Centers for Medicare & Medicaid Services (CMS) publishes two proposed rules, the Physician Fee Schedule (PFS) proposed rule and the Hospital Outpatient Prospective Payment System (HOPPS) proposed rule, that set Medicare reimbursement and shape the administration of the Medicare Part B program for the upcoming calendar year.
In the last year, the Massachusetts Attorney General (AG) adopted two sets of sweeping consumer protection regulations directly impacting assisted living residence (ALR) operators. These regulations significantly expand ALR obligations regarding disclosures, billing, tenancy protections, resident rights, and pricing transparency.
Headlines that Matter for Companies and Executives in Regulated Industries
Headlines that Matter for Companies and Executives in Regulated Industries
Beginning July 1, the State of Washington will require all assisted living facilities that operate memory care units — or market themselves as providing specialized dementia care — to obtain a new state certification or face state Consumer Protection Act liability. Here is what current operators and prospective applicants need to know.
Headlines that Matter for Companies and Executives in Regulated Industries
Headlines that Matter for Companies and Executives in Regulated Industries
On May 13, the Centers for Medicare & Medicaid Services (CMS) implemented two separate nationwide moratoria that halt the Medicare enrollment of new home health agencies (HHAs) and hospice providers. The moratoria took effect immediately.
Mail and telemedicine access to mifepristone — used together with misoprostol to end an early pregnancy — is in flux following a Fifth Circuit Court of Appeals ruling that restricts mail-order distribution of the medication nationwide, and the US Supreme Court’s subsequent administrative stay restoring the status quo ante on a temporary basis.
Headlines that Matter for Companies and Executives in Regulated Industries
Everyone is talking about peptides. Your doctor, your trainer, that guy at the dinner party who swears that BPC-157 rebuilt his knee — peptides have officially entered the zeitgeist. But for every breathless testimonial, there is a thicket of regulations that most market participants barely understand.
The Federal Trade Commission (FTC) is signaling that health care and life sciences companies should expect heightened regulatory scrutiny related to consumer protection and competition.
Health care enforcement targeting diagnostic and laboratory services accelerated in 2025 and shows no signs of slowing down in 2026.
In a recent ruling out of the District of Minnesota, a federal magistrate judge directed UnitedHealthcare (UHC) to turn over an expansive set of documents in the class action Estate of Lokken v. UnitedHealth Group, Inc., alleging that the health insurer used an artificial intelligence (AI) algorithm to improperly withhold post-acute care coverage from Medicare Advantage enrollees.
Headlines that Matter for Companies and Executives in Regulated Industries
Headlines that Matter for Companies and Executives in Regulated Industries
On March 9, a federal court in Connecticut issued a decision in Abira Medical Laboratories LLC v. Aetna Inc. et al. that underscores the continuing importance of clear and comprehensive assignment-of-benefits language in payer disputes.
The rapidly expanding consumer biomarker testing market — a major pillar of the longevity ecosystem — has produced its first major lawsuit between competitors.
Headlines that Matter for Companies and Executives in Regulated Industries
The Centers for Medicare & Medicaid Services (CMS) has released detailed payment amounts, performance targets, and reporting requirements for the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, applicable to care periods beginning July 5 through December 31, 2027.