Jon Zucker
Indianapolis
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Articles by Jon Zucker
Referral Payments Targeted in New Special Fraud Alert
A Special Fraud Alert has been issued by the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), warning that certain marketing arrangements relating to Medicare Advantage beneficiary referrals could potentially result in “abusive arrangements.” Jon Zucker explains. The post Referral Payments Targeted in New Special Fraud Alert appeared first on GoodLifeSci.
Referral Payments Targeted in New Special Fraud Alert
A Special Fraud Alert has been issued by the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), warning that certain marketing arrangements relating to Medicare Advantage beneficiary referrals could potentially result in “abusive arrangements.” Jon Zucker explains. U.S. government agencies — including HHS-OIG — have shown an increased interest in Medicare Advantage plan activity and provider marketing arrangements.
HHS-OIG warns against referral payments in Medicare Advantage
(January 16, 2025) - Sidley Austin partners Jaime Jones, Meenakshi Datta, Brenna Jenny and Jon Zucker discuss a rare Special Fraud Alert from the Department of Health and Human Services, Office of Inspector General cautioning against paying for referrals of Medicare Advantage beneficiaries.
CMS Finalizes Proposal to Overhaul Medicare Advantage Broker Payments
The U.S. Centers for Medicare and Medicaid Services (CMS) published a final rule on April 4, 2024 that overhauls the regulations governing insurance agent and broker compensation rates and agreements for Medicare Advantage Plans (MAPs) and Medicare Part D Plans (PDPs). The final rule, which adopts the majority of the changes from the proposed rule that we previously discussed here, is intended to establish additional guardrails to protect beneficiaries and support competition within the industry.
Potential Liability of Investors in the Healthcare Industry Heightens as Hospital Investors Enter into Novel Settlement
A recent False Claims Act settlement between the Department of Justice, a New Jersey hospital, and the hospital’s investors also included a novel Federal Debt Collection Practices Act (“FDCPA”) settlement with the investors, highlighting the government’s continued efforts to pursue investors in the healthcare industry.
Potential Liability of Investors in the Healthcare Industry Heightens as Hospital Investors Enter into Novel Settlement
A recent False Claims Act settlement between the Department of Justice, a New Jersey hospital, and the hospital’s investors also included a novel Federal Debt Collection Practices Act (“FDCPA”) settlement with the investors, highlighting the government’s continued efforts to pursue investors in the healthcare industry.
Medicare plan marketing proposal would overhaul broker payments
The U.S. Centers for Medicare and Medicaid Services (CMS) published a proposed rule on November 15, 2023 that would overhaul the regulations governing insurance agent and broker compensation rates and compensation agreements for Medicare Advantage plans (MAPs) and Medicare Part D plans (PDPs). The proposal follows CMS’ final rule revising the regulations governing marketing by MAPs issued on April 5, 2023, which we covered in a prior Sidley Update here.
Investor Appetite For Telehealth Post-Pandemic: Opportunities Based on Medicaid and Commercial Insurance Markets
Investor interest in telehealth surged during the Covid-19 pandemic. While the healthcare industry’s widespread adoption of telehealth was driven by necessity due to social distancing practices, such expansion would not have been possible without federal and state governments waiving many legal and regulatory requirements that had previously hindered such telehealth growth.
New York Enacts New Requirement for Prior Notice of Certain Healthcare Transactions
On May, 3, 2023, New York Gov. Kathy Hochul signed into law a requirement for certain healthcare entities to notify the New York State Department of Health (NYSDOH) at least 30 days before closing certain “material transactions.” The notice requirement, which is a change from the original proposal, which required approval by NYSDOH, goes into effect on August 1, 2023.
CMS Finalizes New Medicare Marketing Requirements
The U.S. Centers for Medicare and Medicaid Services (CMS) issued a final rule on April 5, 2023, revising the regulations governing marketing by Medicare Advantage plans (MAPs) and Medicare Part D plans (PDPs). These changes follow CMS’s October 2022 memo expressing concern regarding MAP and PDP marketing practices, and the proposed rule issued on December 14, 2022. The changes are applicable for all contract year 2024 marketing and communications beginning September 30, 2023.
CMS Proposes Augmented Nursing Facility Ownership Disclosure Targeting Private Equity and REITs
The U.S. Centers for Medicare & Medicaid Services (CMS or the Agency) has released a significant proposed rule (the Proposed Rule) that would require Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities (collectively, Nursing Facilities) to disclose additional information related to their ownership and management structures.
Digital Health: A Regulatory Playbook for Private Equity Firms and Other Private Capital Investors
Private equity (PE) and other private capital investors are continuing to explore digital health technologies as a key area of investment. Investors seeking to capture the best opportunities should have a playbook to help them deftly navigate this high-growth, scalable market.
Proposed Behavioral Health Updates in Medicare Advantage and ACA Marketplace Plans Could Lead to Enhanced Access and Opportunities
Investors and practice management companies focused on behavioral health should note two recent proposed rules that, if finalized, should increase access to behavioral health services for beneficiaries enrolled in Medicare Advantage (MA) health plans and Patient Protection and Affordable Care Act (ACA) marketplace plans.
Navigating the AWS Security Ecosystem
DEMOS CONTACT SALES This is a transcript of Episode 10: Navigating the AWS Security Ecosystem from our podcast series “Navigating the Cloud Journey.” AWS has lots to offer when it comes to cloud security. In this episode, Jim talks to Ranjit Kalidasan, a senior solutions architect, who will discuss the shared responsibility model for cloud security and then review the key tools and observability use cases you need to know about to ensure your AWS cloud solution is protected.
DevOps, CloudOps, DevSecOps, GitOps, InfraOps, ModOps...Huh?
DEMOS CONTACT SALES Editor’s note: This is a transcript of Episode 9: DevOps, CloudOps, DevSecOps, GitOps, InfraOps, ModOps…Huh? from our podcast series “Navigating the Cloud Journey.” DevOps, CloudOps, DevSecOps, etc. What’s in a name? All these operational titles play a critical role in managing and securing your cloud.
Why the Release of CaaS™ Solves the iOS Updates for All Performance Marketers
Creative Creative-as-a-Subscription makes producing CTV creative simple, accessible, and perfect for performance marketers by Jon Zucker 3 Min Read Thanks to Apple’s privacy updates, it’s been a YEAR for performance marketers who rely on Facebook to drive revenue. While many marketers turned to Performance TV to deliver and measure the conversions they lost in the great iOS reset, advertisers with limited budgets for TV commercials weren’t able to fully take advantage of this new growth channel.
Gigamon Community Member Spotlight: Indera Budiman Bin Wahabi
For our latest Gigamon Community Member Spotlight, we’re getting to know Indera Budiman Bin Wahabi, Solutions Consultant for Techdata Systems Sdn Bhd. Techdata Systems is one of the world’s largest technology distributors and a trusted Gigamon partner since 2015.
Mitigating Anti-Kickback Risks Of Health Tech Stock Warrants - Law360
Law360 (April 8, 2021, 6:15 PM EDT) -- There is no shortage of startup and established companies attempting to innovate and disrupt in the health technology space. From optimizing the functionality of electronic health records to utilizing artificial intelligence to identify patients at risk for major diseases, health tech innovators and disruptors have the potential to transform the patient experience.
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