Insights

Boston – October 15, 2025: Jeffrey S. Gleason, an accomplished first-chair trial attorney and former leader in the Civil Fraud Section of the U.S. Department of Justice, has joined Crowell & Moring as a partner, further bolstering the firm’s fast-growing and industry-leading Health Care Group.

Washington – August 21, 2025: The 2026 edition of The Best Lawyers in America® has recognized 49 Crowell & Moring lawyers as Best Lawyers and 33 lawyers as Best Lawyers: Ones to Watch. The publication also named partner Jason Murray as Lawyer of the Year for Antitrust Law in Los Angeles.

Washington – June 26, 2025: Crowell & Moring has been recommended in eight practice areas in the 18th edition of the Legal 500 United States. In addition, partner Daniel Forman, co-chair of the firm’s Government Contracts Group, has been named to the Legal 500’s “Hall of Fame” for Government Contracts.

On August 19, 2025, the Office of Personnel Management (OPM) informed insurers participating in the Federal Employees Health Benefits or Postal Service Health Benefits programs that gender-affirming care would no longer be covered for federal workers starting in 2026. This coverage decision is the Trump Administration’s latest action stemming from Executive Order 14187 which aims to prevent certain treatments, such as gender-affirming hormone therapy, surgeries, and puberty blockers for those under the age of 19. As previously discussed, the Administration has also signaled its intent to use various law enforcement tools against gender-affirming care, including  Section 5 of the Federal Trade Commission Act to police false or unsupported claims by medical professionals about gender-affirming treatments.

On July 2, 2025, the U.S. Department of Justice (DOJ) Civil Division and the U.S. Department of Health and Human Services (HHS) jointly announced the formation of a False Claims Act (FCA) Working Group. This new initiative underscores a coordinated federal enforcement strategy focused on identifying and addressing fraud in federally funded health care programs, particularly Medicare Advantage and Medicaid managed care. The announcement comes days after Matthew R. Galeotti, Head of DOJ’s Criminal Division, announced the results of the “largest coordinated health care fraud takedown in the history of the Department of Justice”  and the creation of a “Health Care Fraud Data Fusion Center” comprised of data specialists that will “break down information silos, using coordinated data analysis to enable our investigative teams to quickly identify and dismantle emerging fraud schemes.” Taken together, these announcements demonstrate the DOJ’s effort—in both civil and criminal divisions—to strengthen its collaboration with HHS to investigate and prosecute health care fraud.

On May 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published a Final Rule that, for the first time, imposes national minimum nurse staffing requirements for nursing homes. Specifically, the standard adopted by CMS requires minimum staffing of 3.48 hours per resident day (“HPRD”), as discussed in more detail below. CMS estimates that the new requirements will cost facilities $43 billion over the next 10 years, which is more than the $40.6 billion cost that CMS estimated for Proposed Rule of 3.0 HPRD. Some industry sources estimate that less than 25% of nursing facilities across the country currently meet the full scope of staffing standards laid out in CMS’ Final Rule due to a myriad of factors including labor shortages and increasing wage pressures. Indeed, the impact and cost of these staffing requirements will vary significantly by state. For example, CMS reported that at least one state will need to increase certain staff by nearly 96% to meet the minimum standards, while other states already meet the requirements.

Changes in the health care delivery and payment system are underway to “bend the cost curve” and improve patient outcomes. However, the legal and compliance risks to any entity offering services or products paid for or reimbursed with government dollars have not abated.

Please join us for the 2018 Inova Discovery Series: Early Stage Investing in Health Technology Event on Thursday, June 21, 2018.

Our health care landscape is rapidly transforming. As the health care space has become more digitized and more reliant on technology than ever before, artificial intelligence (AI), telehealth services, data analysis, and medical devices have become drivers of our health care system. Likewise, value-based care is becoming increasingly popular among delivery systems, leaving accountable care organizations (ACOs) to adhere to changing federal compliance requirements. The burden falls on health care entities to remain up-to-date on how care is evolving as federal and state compliance regulations and privacy concerns continue to develop.

This episode is the first part in a miniseries with Crowell Health Solutions, which is a strategic consulting firm that Crowell & Moring launched earlier this year to help healthcare organizations and technology companies transform health care by improving patient care and health outcomes, advancing health equity, and lowering health care costs through solutions like digital health innovations and value-based healthcare models.

In this episode, hosts Payal Nanavati and Joe Records talk to Troy Barsky and Roma Sharma about their reflections on the first year of implementation of new regulations implementing the major fraud and abuse statutes — the Stark Law and Anti-Kickback Statute (AKS) — including discussing challenges, opportunities, and outstanding questions about the new exceptions and safe harbors for value-based care.

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Payal Nanavati and Joe Records talk with Troy Barsky and Alice Hall-Partyka about how recent litigation challenging the constitutionality of the Affordable Care Act may impact providers and payers. The discussion focuses on the authority for innovative health care models and important fraud and abuse provisions that were enacted in the ACA.