Category: Administrative Procedure Act

Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount

Texas Medical Association v. U.S. Department of Health and Human Services, No. 23-40605, ___ F.4th ___, 2026 WL 2322331 (5th Cir. Aug. 11, 2026) (en banc) (per curiam) | Texas Medical Association v. U.S. Department of Health and Human Services, 120 F.4th 494 (5th Cir. 2024), reh’g en banc granted, opinion vacated, 138 F.4th 961 […]

CONTINUE READING Payor-Provider Alert: The Fifth Circuit Holds En Banc What Can and Can’t Be Included in the No Surprises Act’s Qualifying Payment Amount 16 min read

Healthcare Case Spotlight: The D.C. Circuit Joins the Broad Reading of the Anti-Kickback Statute — and Strikes OIG’s Advisory-Opinion Timing Rules

Vertex Pharmaceuticals Incorporated v. United States Department of Health and Human Services, No. 25-5133, ___ F.4th ___, 2026 WL 2617588 (D.C. Cir. Sept. 4, 2026) | affirming in part and reversing in part Vertex Pharms. Inc. v. U.S. Dep’t of Health & Hum. Servs., 774 F. Supp. 3d 211 (D.D.C. 2025) Healthcare / Anti-Kickback Statute […]

CONTINUE READING Healthcare Case Spotlight: The D.C. Circuit Joins the Broad Reading of the Anti-Kickback Statute — and Strikes OIG’s Advisory-Opinion Timing Rules 11 min read