Photo of Leslie Levinson

Les Levinson is the co-chair of the Transactional Healthcare Practice Group at Robinson+Cole. His practice concentrates on transactional, regulatory, and compliance matters for healthcare and life science clients, including home care and hospice companies, other non-acute providers, physician practices, hospitals, information technology and medical device companies, healthcare equipment providers and healthcare investors, lenders, and related enterprises and he has completed over 300 M&A and financing transactions. Read his full rc.com bio here.

On March 12, 2024, the U.S. Court of Appeals for the Second Circuit issued an important decision interpreting the “willfulness” standard necessary to find a violation of the federal Anti-Kickback Statute (AKS). The decision provides important guidance for health care and pharmaceutical organizations on what constitutes a knowing violation of the AKS and for counsel

In a prior blog post, we noted the trend of states enacting legislation implementing reporting requirements for certain healthcare transactions. On March 13, 2024, Indiana joined this trend as Indiana Governor Eric Holcomb enacted Senate Enrolled Act No. 9 (the Act). The Act mandates that, effective July 1, 2024, Indiana health care entities involved

On June 22, 2023, New York State Public Health Law § 2802-b, added a Health Equity Impact Assessment (HEIA) to the Certificate of Need (CON) process for certain health care facilities. The new requirement comes as part of larger legislative changes to the Public Health Laws passed in 2021. The new HEIA requirement applies to any CON applications submitted on or after June 22, 2023, except there is a partial carve out for Diagnostic and Treatment Centers whose patient population is 50 percent or more Medicaid eligible or uninsured. The Department of Health also issued regulations on June 29, 2023 (10 NYCRR 400.26). The purpose of the HEIA is to understand the health equity impact on a specific project, the impact it may have on medically underserved groups and to ensure community input and assessment are considered. The Department of Health has expressed that their vision is “to have health equity considerations meaningfully impact the planning and execution of health care facility projects.” (NYSDOH, Health Equity Impact Assessment, Webinar Series: Program Documents, September 14, 2023.)Continue Reading New York Implements Health Equity Impact Assessment as New Requirement for Certificate of Need Process

On Wednesday, November 1, the Center for Medicare & Medicaid Services (CMS) released its Home Health Prospective Payment System Rate Update final rule for CY 2024 (the Final Rule). The Rule estimates that the aggregate increase to Medicare home health payments for 2024 will be 0.8 percent, or $140 million. This 0.8 percent increase results from the combined effects of three forecasted rate changes: (1) a 3.0 percent increase to home health payments, (2) a 2.6 percent decrease based on the permanent behavior assumption adjustment, and (3) a 0.4 percent increase resulting from an update to the fixed-dollar loss ratio, which is used to determine outlier payments. The 0.8 percent increase is a departure from the Proposed Rule, which estimated a cut in payments of up to 3 percent.Continue Reading CMS Announces 0.8 Percent Aggregate Home Health Payment Increase in 2024

On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Proposed Rulemaking entitled Ensuring Access to Medicaid Services (Proposed Rule) which would, among other things, establish requirements for the amount of Medicaid payment going towards home care worker compensation.Continue Reading CMS Proposes New Rule that Would Require 80 Percent of Payment to Go Toward Home Care Worker Compensation

On May 2, 2023, legislators approved the $229 billion New York State FY 2023-2024 Budget Bill (“the Budget”), which was signed by Governor Hochul on May 3, 2023. Article VII of the Budget touches almost every aspect of the New York healthcare system, including home health, hospitals, laboratories, and reproductive health. It contains wide-ranging provisions that expand access to care, allow clinicians to provide more services, and allocate needed resources to providers. It targets Medicaid in multiple ways, including an extension of the Medicaid Global Cap on system-wide spending growth through FY 2025.[i] Here, we outline some of the key provisions that this Budget contains.Continue Reading New York Enacts Long Negotiated Budget Bill with Sweeping Implications for Health Care

The Illinois House of Representatives recently voted in favor of passing HB 2222 (“the Bill”), which, if enacted, would amend the Illinois Antitrust Act to add new reporting requirements for certain transactions, including mergers, acquisitions, and contracting affiliations. These heightened requirements would impact healthcare facilities and provider organizations starting on January 1, 2024. The Bill is currently under consideration in the Illinois Senate and would need to be passed by the Illinois Senate and then signed by Illinois Governor J.B. Pritzker in order to be enacted into law.Continue Reading Pending Illinois Legislation Could Heighten Merger Requirements for Health Care Facilities

On March 22, 2023, Kentucky Governor Andy Beshear signed House Bill 200, referred to as the “Kentucky Healthcare Workforce Development Act” (“the Bill”), into law. The Bill was enacted in response to current healthcare workforce shortages. In an effort to mitigate these workforce shortages, the Bill allocates funds for health care training programs across a wide range of professions, including home health and nursing. The intent of this investment is to remove the financial barriers that discourage many potential students from seeking health care training, and to add new incentives for high-performing health care training programs.  The Bill further adds a requirement that all public health care training programs review the cost of attendance against the earning potential of their graduates.Continue Reading Kentucky Governor Signs Bill Aimed at Mitigating Healthcare Workforce Shortages: Beginning of a Trend?

Proposed legislation from the New York State Executive Budget for 2024 includes significant changes to the state’s regulatory approach and authority over healthcare transactions.  New York is following a trend on the state level regarding concern over the consolidation of the healthcare marketplace and investor-backed practices and how such transactions should be reviewed.  Such proposal follows states like California, Oregon, and Washington.  The proposal creates a new statutory article to review “material transactions” and has made changes to the certificate of need process for new and existing entities. Continue Reading New York Proposes Regulatory Overhaul for HealthCare Transactions with a Focus on Investor-Backed Healthcare Transactions

On June 30, 2022, Governor Gavin Newsom signed the 2022-2023 California state budget, which included a trailer bill, Senate Bill 184 (the Bill) which makes numerous statutory revisions impacting health programs and consumers. The Bill establishes the Office of Health Care Affordability (OHCA) within the Department of Health Care Access and Information to combat rising health care costs. California will join other states such as Massachusetts, Oregon, and Nevada in implementing a health care cost commission.Continue Reading California Governor Signs Trailer Bill to State Budget Increasing Oversight of Health Care Entities Statewide