Bass, Berry & Sims is pleased to announce the release of the 12th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2023. Compiled by the firm’s Healthcare Fraud & Abuse Task Force, the Review provides a comprehensive analysis of enforcement developments affecting the healthcare industry, significant court decisions involving the False Claims Act, and an overview of settlements involving fraud and abuse issues.

We began the Review over a decade ago with […]

Many medical benefit plan fiduciaries contract with pharmacy benefit managers (“PBMs”) to administer the prescription drug portion of their health plans, placing the PBM in charge of day-to-day management of the programs. Under the traditional PBM model, plan fiduciaries generally negotiate prescription drug prices with a PBM, which in turn negotiates pricing with drug manufacturers, profiting from the difference. This “spread pricing” has drawn the attention of policymakers in recent years. A proposed class […]