By DARIUS TAHIR

Bill Curry, 65, raises cattle on the same land in rural Oklahoma once owned by his father and generations before him. Each quarter, for several years, he has made the 2½-hour drive to Oklahoma City for an epidural in his spine to treat his back pain.

But this year, because of a new Medicare program, Curry has traveled a little more often.

In February, during one trip, he was told unexpectedly that he needed preapproval for the procedure. Then he went again a month or so later to get the injection, for a total of 10 hours on the road. His clinic wanted him to come in a third time, [Read More]

By DUAA ELDEIB

They entered the world the way babies should, with piercing cries announcing their arrival. They passed their newborn screening tests. Some made it to their 2-week wellness visits without concern.

Then, without warning, their systems began to shut down. A 7-week-old boy in Maryland developed sudden seizures. An 11-pound girl in Alabama stopped breathing for 20 seconds at a time. A baby boy in Kentucky vomited before becoming lethargic. A brown-haired girl in Texas, not yet 2 weeks old, bled around her belly button.

Desperate to save them, records show, doctors inserted tubes into their airways and hooked them up to IVs. They ordered blood transfusions. They spent half an [Read More]

By ROLF LOWE
Wachler & Associates, P.C.

In  2023, the Centers for Medicare and Medicaid Services introduced a new enforcement tool, Provisional Period of Enhanced Oversight (PPEO), specifically aimed at newly enrolled hospice providers. PPEO was implemented under the Social Security Act and is intended to apply enhanced oversight to new providers in high-risk categories. The PPEO program was developed due to CMS’ concerns about program integrity in the hospice program including potential fraud (criminal and civil), improper claim submissions and delivery of services that do not meet Medicare’s requirements for medically reasonable and necessary services.

The PPEO program was initially rolled out in Arizona, California, Nevada and Texas on September 17, 2024. [Read More]

By RALPH LEVY
Dickinson Wright 

In a prior article in this publication, I provided guidance for physicians and other medical professionals on how to compare the taxes payable under competing offers to join practice groups.  I pointed out that these taxes will vary depending on several factors, including whether the offer includes equity ownership and whether the group is organized as a professional corporation (PC) or a professional limited liability company (PLLC).  Although it appears that a recent decision by the 5^th Circuit Court of Appeals on the self-employment taxes payable by a limited liability limited partnership could affect this guidance, on a closer look at this decision, it does not [Read More]

Supremes Decline State’s Appeal In Benton Harbor Drinking Water Lawsuits

Lawsuits against the Department of Environment, Great Lakes & Energy (EGLE) arising out of elevated lead levels in Benton Harbor water stand after the Michigan Supreme Court declined to hear the state’s appeal.

Justice Brian Zahra would have granted the appeal, but he didn’t explain why in the court’s order.

In a January per curiam opinion, the Michigan Court of Appeals panel held the Court of Claims “properly concluded” that the state’s evidence didn’t eliminate factual questions arising from residents’ claims.

Separate lawsuits – led by Jennifer Janssen-Rogers, Daretha Braziel and Oliver Kavanaugh – argued, in part, that the city violated residents’ rights to bodily integrity by not doing [Read More]

By SAMANTHA LISS

Millions of people who apply for Medicaid in the coming years will have to prove they’ve been working, going to school, or volunteering for at least a month before they can gain or retain health insurance through the government program.

But Republican lawmakers in some states think the new rules — part of the GOP’s One Big Beautiful Bill Act, signed last July by President Donald Trump — don’t go far enough.

Indiana is leading that charge, with a new law that requires applicants to prove they’ve been working or participating in a similar activity for three consecutive months to get benefits.

Meanwhile, residents in many other states will have to [Read More]

By SAM WHITEHEAD

Katie Crouch says calling her state’s Medicaid agency to get information about her benefits can feel like a series of dead ends.

“The first time, it’ll ring interminably. Next time, it’ll go to a voicemail that just hangs up on you,” said the 48-year-old, who lives in Delaware. “Sometimes you’ll get a person who says they’re not the right one. They transfer you, and it hangs up. Sometimes, it picks up and there’s just nobody on the line.”

She spent months trying to figure out whether her Medicaid coverage had been renewed. As of late March, she hadn’t been reapproved for the year for the state-federal program, which provides health [Read More]

By SHANIYA RAHEJA
Wachler & Associates, P.C.

Over the past year, Medicare providers have increasingly felt the harsh effects of a shifting federal enforcement landscape. CMS has adopted a more assertive program‑integrity posture across all of its operations, signaling a renewed focus on payment accuracy and fraud‑prevention initiatives. This broader regulatory trend is reflected in the 2025 Marketplace Integrity and Affordability Final Rule, where CMS emphasized its intent to “strengthen program integrity standards,” “promote accurate eligibility determinations,” and “improve oversight and reduce vulnerabilities to fraud and abuse” across federally administered programs (CMS Marketplace Integrity and Affordability Final Rule Fact Sheet, 2025). Although the rule governs marketplace operations, it reflects the same enforcement [Read More]

By LEE G. PETRO

As artificial intelligence (AI)‑driven tools proliferate across clinical care, diagnostics, and health insurance operations, the U.S. regulatory landscape is shifting rapidly in 2026. Absent a comprehensive federal AI statute, healthcare organizations face a patchwork of federal oversight (primarily through the FDA, CMS, and HHS) layered with a growing number of state AI health laws.

Federal Framework Shaping AI In Healthcare:

At the federal level, existing authorities and recent policy signals are converging to regulate AI in healthcare without yet creating a standalone “AI Act.” The most important federal AI actors are:

• FDA: The FDA continues to emphasize premarket review for higher-risk systems (e.g., AI‑assisted radiology tools, ECG or pathology [Read More]
  

By CELINE GOUNDER
Photos by ERIC HARKLEROAD

President Donald Trump will soon nominate a permanent director for the Centers for Disease Control and Prevention, its acting chief, National Institutes of Health Director Jay Bhattacharya, told agency employees at a Wednesday staff meeting.

According to a recording obtained by KFF Health News, Bhattacharya at one point suggested to CDC staff that Trump could name a new leader for the agency as soon as Thursday. “But if not, I don’t think much will change,” he said.

Though his official position as acting director was set to expire Wednesday, Bhattacharya will continue to lead the agency until the top spot is filled. Meanwhile, news outlets including Axios and  [Read More]