Compliance Stuff

In  Neurological Surgery Practice of Long Island, PLLC v. US Department of Health and Human Services et al. , the court dismissed a provider’s challenge to the federal agencies’ implementation of the independent dispute resolution entity (IDRE) selection procedures under the NSA. Providers should be aware of the court’s deference to agency discretion, the limitations on judicial remedies, and the ongoing regulatory developments that may impact future IDR proceedings. In the  case , a private neurosurgery practice in New York brought suit against the US Departments of Health and Human Services, Treasury, and Labor, alleging that the agencies’ procedures for selecting IDREs under the NSA were unlawful . The court reviewed the statutory framework of the NSA, which requires that providers and payers jointly select an IDRE within a three-business-day window. If the parties cannot agree, the agencies’ regulations provide that the initiating party (typically the provider) proposes a...

On May 9, President Trump issued a new Executive Order ( EO ) titled “Fighting Overcriminalization in Federal Regulations” to address criminal enforcement of regulatory offenses, particularly strict liability offenses where the offender need not have had a culpable state of mind to be convicted. On the whole, the EO discourages the criminal enforcement of regulatory offenses except “where a putative defendant is alleged to have known his conduct was unlawful.” The impact of the EO is not yet clear, but it could have wide-ranging implications. The  EO  is meant to tackle what it deems an “absurd and unjust” system in which people are not always aware that their conduct could criminally violate federal regulations due to the “drastically overregulated” system of government . According to the EO, the Code of Federal Regulations (CFR) contains over 48,000 sections and 175,000 pages, which is “far more than any citizen can possibly read, let alone fully understand.” As a resul...