Effective January 1, 2026, the Centers for Medicare & Medicaid Services (“CMS”) implemented significant changes to the accreditation and enrollment framework for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) suppliers through the CY 2026 Home Health Prospective Payment System Final Rule (“Final Rule”). CMS adopted these changes in response to what it describes as long-standing program integrity vulnerabilities in the DMEPOS sector and acknowledged that the reforms will increase compliance costs and operational burdens for suppliers and accrediting
Continue Reading 36-Month Rule Applies to DMEPOS Suppliers Effective January 1, 2026
Hall, Render, Killian, Heath & Lyman, P.C. Blogs
Latest from Hall, Render, Killian, Heath & Lyman, P.C.
Federal Courts Signal Frustration with Perpetual FCA Litigation
Federal courts are showing diminishing tolerance for perpetual False Claims Act (“FCA”) litigation. Years-long seal periods, one-sided discovery and serial amendments are wearing thin. The Fifth Circuit’s recent decision in United States ex rel. Gentry v. Encompass Health Rehabilitation Hospital of Pearland, L.L.C., 157 F.4th 758 (5th Cir. 2025) (“Gentry“) reflects this shift and offers a blueprint for courts confronting repeated motions to amend.
The Gentry Decision
In Gentry, a terminated sales representative (the “Relator”) sued Encompass Health Rehabilitation
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Weekly Hospital Real Estate Briefing
Indiana Court of Appeals Reaffirms Holistic Approach to Grave Disability Determinations
The Indiana Court of Appeals (the “Court”) recently affirmed a trial court’s finding of grave disability, reiterating two settled principles: (1) no single fact can establish grave disability; and (2) courts must evaluate the totality of the circumstances. The Court also confirmed that past conduct with a nexus to the patient’s current condition may have evidentiary value. In re: Civil Commitment of K.M., 270 N.E.3d 506 (Ind. Ct. App. 2025).
Background
K.M., who has a documented history of mental
Continue Reading Indiana Court of Appeals Reaffirms Holistic Approach to Grave Disability Determinations
Federal PBM Reform Is Here: Unpacking Key Provisions of the Landmark Legislation
On February 3, 2026, after years of false starts, federal regulation of pharmacy benefit managers (“PBMs”) became reality when the Consolidated Appropriations Act, 2026 (the “Act”) was signed into law by President Trump. For the first time, the Act imposes federal requirements on PBMs related to compensation, transparency, reporting and other matters to be addressed via contracting requirements between PBMs and plan sponsors. This landmark piece of federal legislation follows years of increased state regulation of PBMs, and has
Continue Reading Federal PBM Reform Is Here: Unpacking Key Provisions of the Landmark Legislation
CMS Issues New Guidance Letter for State Directed Payments
On February 2, 2026, the Centers for Medicare & Medicaid Services (“CMS”) released a new guidance letter (“February 2 Letter”) regarding state directed payments (“SDPs”) as governed by Section 71116 of Public Law 119-21 (which CMS refers to as the “Working Families Tax Cuts” or “WFTC legislation”). Per CMS, its previous September 9, 2025, guidance letter (“September 9 Letter”) has been rescinded.
The February 2 Letter largely repeats everything in the September 9 Letter. For example, the preprint-related criteria
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CMS Issues Health Care-Related Tax Final Rule
On February 2, 2026, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule, effective April 3, 2026, that targets a perceived “loophole” in the current regulatory statistical test applied to State proposals for health care-related tax waivers. The test is intended to make certain that non-uniform or non-broad-based health care-related taxes, authorized under a waiver granted by CMS, are “generally redistributive.” CMS claims the loophole impermissibly allowed some health care-related taxes to be imposed at
Continue Reading CMS Issues Health Care-Related Tax Final Rule
Key Considerations for the Upcoming National Resident Matching Program
The upcoming National Resident Matching Program is expected to be affected by several recent immigration-related developments under the Trump administration that employers should incorporate into their match planning strategy, including nationality-based travel restrictions, the U.S. Citizenship and Immigration Services (“USCIS”) adjudication pause and the $100,000 fee for new H-1B petitions filed on behalf of candidates who are outside of the United States. Employers should begin preparing early to evaluate risk in the current evolving immigration landscape.
Nationality-Based Travel Restrictions
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Weekly Hospital Real Estate Briefing: Five Things to Know about Inpatient Rehabilitation Facilities
Hall Render’s Real Estate team frequently works with owners, operators and developers of specialty hospitals. One of our favorite types of specialty hospitals is the inpatient rehabilitation facility (“IRF”). Below is a summary of five things you should know about the IRF sector.
Proposed OPO Rule Signals Broad Operational and Compliance Changes Across the Donation and Transplantation System
On January 30, 2026, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule that would substantially revise portions of the Conditions for Coverage for Organ Procurement Organizations (“OPOs”) (the “Proposed Rule”). According to CMS, the Proposed Rule is characterized as building on changes in the 2020 OPO Conditions for Coverage rule aimed at increasing accountability, clarifying and strengthening re-certification standards and reinforcing public trust in organ procurement and allocation practices, and in doing so is intended
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The Effects of the OBBBA on Your 2026 Employee Handbook
On July 4, 2025, Congress enacted the One Big Beautiful Bill Act (“OBBBA”), a statute that, while primarily tax-focused, has meaningful downstream implications for wage administration and employer-provided benefits. Although the OBBBA does not amend core federal employment statutes such as the Fair Labor Standards Act (“FLSA”), Title VII or the Family and Medical Leave Act, several provisions directly affect how compensation and leave benefits are structured and reported. For health care employers that often rely on complex pay
Continue Reading The Effects of the OBBBA on Your 2026 Employee Handbook
DOJ Recouped $6.8 Billion Under FCA in 2025
On January 16, 2026, the Department of Justice (“DOJ”) announced that it recovered a record-breaking $6.8 billion in False Claims Act (“FCA”) related settlements and judgments in the 2025 fiscal year. The 2025 recovery amount more than doubles the previous year’s recovery of $2.9 billion and marks the highest recovery in a single year since the FCA was enacted. The amount of whistleblower claims continued to rise, with 1,297 qui tam complaints filed in 2025. Health care fraud remained
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Indiana Court of Appeals Reaffirms Evidence Standard for Extensions of Commitment
In a recent decision, the Indiana Court of Appeals (the “Court”) upheld a trial court’s Order for Temporary Commitment and affirmed a new mootness standard for civil commitment appeals. In re Commitment of J.F., 266 N.E.3d 268 (Ind. Ct. App. 2025).
Background
The Indiana Court of Appeals reaffirmed its standard for what evidence is required to support an order for a regular commitment of a patient. See In re Commitment of J.F., 266 N.E.3d 268, (Ind. Ct. App. 2025).
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Legislative Update: Congress Set to Resurrect Separate NPI and Attestation Requirements for Off-Campus Hospital Outpatient Departments
Congress’s fiscal year 2026 health care appropriations bill introduces a significant new statutory condition of Medicare payment for off-campus hospital outpatient departments. If enacted, effective January 1, 2028, Medicare payment would be prohibited for items and services furnished by an off-campus hospital outpatient department unless two conditions are met: (1) the department has a National Provider Identifier (“NPI”) that is separate from the hospital’s main NPI; and (2) the hospital has submitted the required provider-based status attestation.
OIG Recounts Historic Recovery Numbers in Its Latest Semiannual Report to Congress
On January 21, 2026, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) released its Semiannual Report to Congress for the six-month period ending September 30, 2025 (“Report”). OIG’s enforcement actions during this period resulted in “the largest health care fraud takedown in the Department of Justice history, involving more than $14.6 billion in intended losses,” and improved the return on investment in OIG to $12.70 in expected recoveries and receivables (money agreed to be
Continue Reading OIG Recounts Historic Recovery Numbers in Its Latest Semiannual Report to Congress
What Illinois Employers Need to Know About Changes to the Workplace Transparency Act
Amendments to the Illinois Workplace Transparency Act (“WTA”) were introduced by HB 3638 and became effective on January 1, 2026. The amendments broaden the scope of protection for employees and impose additional restrictions on employers when drafting contract provisions in a variety of employment-related agreements, including severance, settlement and arbitration agreements. Going forward, Illinois employers will have less latitude to restrict employee speech and concerted activity as it relates to reporting or disclosing unlawful conduct in the workplace.
Broader
Continue Reading What Illinois Employers Need to Know About Changes to the Workplace Transparency Act