Personal Accountability: Healthcare Qui Tam Review

Health care Fraud

The Department of Justice (“DOJ”) experienced its third highest annual recovery in False Claims Act (“FCA”) history for the fiscal year (“FY”) 2016.[1] Of the $4.7 billion in settlements obtained from the DOJ involving fraud and false civil claims, over half ($2.5 billion) were related to the health care industry. These healthcare fraud claims included… Read More

Visiting the Home Health Marketplace: Observations of the Current Transaction Environment

Home Health valuation

March 2017 A frequently cited solution to reducing rising healthcare costs is to place patients in the lowest cost setting of care.  Accordingly, home health has become a forefront discussion of the healthcare industry.  Large health systems contemplate better ways to integrate home health services into their continuum of care offerings while traditional operators (including private equity… Read More

7 Things You Need to Know About PACE Programs


 1. What is it? Program for All-Inclusive Care for the Elderly (“PACE”) provides comprehensive healthcare services for the frail and elderly. PACE serves as an alternative opportunity to allow the elderly to remain in their communities, rather than going to a nursing home or similar facility.  2. What care is provided? PACE completely covers all the participants’… Read More

Joint Venturing Your Behavioral Health Service Line? Insights and Valuation Considerations

Behavioral Health Service Market Overview The behavioral health industry has historically been a fragmented market comprised mainly of independent freestanding operators, state institutions and acute care hospital departments. Current estimates by the Federal Substance Abuse and Mental Health Services Administration indicate that approximately 64.2% of behavioral health facilities are privately owned and operated as non‐profits,… Read More

Bundled Payment Program Expansion Delayed 3 Months by CMS

Bundled Payment Program Expansion

On Tuesday March 21, 2017, the Federal Register will publish an interim final rule delaying the effective dates of a final rule regarding bundled payment programs published January 3, 2017 titled “Medicare Program; Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model”,… Read More