Regulatory

Indiana Medicaid’s ABA Therapy Overhaul: What Changed on April 1, 2026

Indiana Medicaid implemented significant updates for applied behavior analysis (“ABA”) therapy—one of the most widely used interventions for children with autism spectrum disorder—effective April 1, 2026. The reforms include phased cuts to reimbursement for ABA therapy, updates to member eligibility and revisions to provider qualifications. The Indiana Health Coverage Programs (“IHCP”) began covering ABA therapy […]

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OIG Opinion Offers New Clues on ASC Succession Planning

A favorable advisory opinion from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) gives ambulatory surgery centers (ASCs) a look at how the watchdog views succession planning, family ownership transfers and physician investment under the federal Anti-Kickback Statute. In Advisory Opinion 26-04, OIG said it would not impose administrative sanctions

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After the Health Care M&A Deal, There Are Real Risks to Navigate

For prospective buyers and sellers in the private equity provider and outpatient space, deal flow is calmer and more normalized. Many PE-sponsored physician practice management, or PPM, companies passed—or are approaching —planned exit dates. PPMs and physician partners must decide whether to grow, hold or aggressively court buyers to buy their ownership stake. These decisions

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CMS Reaches $100M in Stark Self-Disclosure Settlements

The Centers for Medicare & Medicaid Services (CMS) recently released data on its 2025 settlements of voluntary self-disclosures related to past violations or potential violations of the physician self-referral law (the Stark Law). Generally, two notable items arise from our annual review of CMS’ settlement data. First, CMS has now reported aggregate settlements reaching $105,090,031.

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CMS Gives Medicare Advantage Rates a 2.48% Bump for 2027 Plan Year in Final Rule

Following significant industry outcry over a proposal to keep Medicare Advantage rates largely flat in 2027, the Trump administration has bumped payments up slightly in the final policy. The Centers for Medicare & Medicaid Services initially proposed a 0.09% increase in rates as part of the MA and Part D Advance Notice. In the final

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Washington Expands Oversight of Healthcare Ownership Transactions

In March, the Washington State Legislature enacted HB 2548, expanding state oversight of healthcare ownership transactions and requiring new disclosures when hospitals and provider organizations change hands. Washington already requires hospitals, hospital systems, and provider organizations to give the Attorney General at least 60 days’ notice before certain transactions that result in a material change.

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California AG Urges Walling Off Medical Practices from Private Equity

California’s top law-enforcement official sent an ominous message to private-equity firms as the state starts to implement a new law banning corporate influence in medicine. California Attorney General Rob Bonta last week advocated erecting a strict barrier between corporate investors such as private-equity firms and the medical practices they back. In a court filing, he

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