The New Rules of Healthcare Fraud Enforcement

The New Rules of Healthcare Fraud Enforcement

False Claims Act enforcement in healthcare is accelerating, and providers cannot afford to wait to react until the government comes calling. In this episode of "Counsel That Cares," litigation attorneys Meredith Auten [https://www.hklaw.com/en/professionals/a/auten-meredith] and Jessica Sievert [https://www.hklaw.com/en/professionals/s/sievert-jessica-rose] discuss the U.S. Department of Justice's new National Fraud Enforcement Division, record enforcement recoveries and the sectors drawing the sharpest scrutiny. They point to concrete examples already shaping the landscape involving Medicare Advantage, drug pricing, medical necessity, wound care, speaker programs and digital health. Ms. Auten and Ms. Sievert also talk about the government's expanded use of artificial intelligence and data analytics to identify fraud patterns and drive cases.

Inside Telehealth's Growth, Regulation and Access

Telehealth innovation succeeds only when compliance discipline matches the pace of growth. In this episode of Counsel That Cares, Holland & Knight healthcare regulatory attorney Shalyn Watkins [https://www.hklaw.com/en/professionals/w/watkins-shalyn-smith] and Receptive CEO Amber Gill examine how modern telehealth platforms scale nationwide while navigating fragmented regulations that can differ drastically from jurisdiction to jurisdiction. Ms. Gill explains how Receptive reduces friction for patients by separating platform infrastructure from clinical decision-making, while Ms. Watkins details how corporate practice of medicine rules, data privacy laws and controlled substance regulations require careful state-by-state analysis. The discussion delivers a clear takeaway for telehealth providers and the legal professionals advising them: In healthcare disputes and enforcement actions, licensure privacy and regulatory design often determine whether innovative care models withstand scrutiny.

Assessing the State of Healthcare Restructurings

Healthcare bankruptcy filings in the middle market dipped in 2025, yet increased costs, payer denials and tighter credit continue to pressure providers across the sector. In this episode of Counsel That Cares, Gibbins Advisors Principals and Co-Founders Clare Moylan and Ronald Winters and Holland & Knight Bankruptcy Partner Tyler Layne analyze restructuring trends in the industry and explain why filings alone can understate real-time distress. Reviewing Gibbins Advisors' annual report on healthcare bankruptcies, they assess how out-of-court workouts and receiverships, along with in-court Chapter 11 proceedings, shape outcomes, and detail how strained finances can limit options well before a filing. During the conversation, Ms. Moylan and Mr. Winters identify healthcare operational and financial indicators that depress performance: payer denials, pharmacy spending, stabilized but higher labor costs and thin margins that weaken liquidity. They evaluate why 2026 may be pivotal for organizations as policy shifts affect coverage, reimbursement and balance sheets. They then outline practical steps for healthcare leadership teams: model best and worst cases, prioritize capital, engage vendors early, strengthen denial management and time transformation investments to build resilience.

Minority Deals in Healthcare Private Equity: An Evolving Opportunity for GPs and Founders

Healthcare private equity enters 2026 seeking more creativity in deal structures and a sharper focus on operational value creation, while remaining mindful of a regulatory environment that continues to shape how transactions are executed. In this episode, Holland & Knight Healthcare attorneys David Marks [https://www.hklaw.com/en/professionals/m/marks-david] and John Arnold [https://www.hklaw.com/en/professionals/a/arnold-john] and Clairvest Group Vice President Rahil Manji discuss what's driving investment decisions in healthcare services and why minority and structured investments are gaining momentum. They break down liquidity pressure, evolving governance expectations and how sponsors are shifting from multiple arbitrage and cheap leverage toward integration, disciplined operations with technology-enabled efficiency. Rahil explains Clairvest's entrepreneur-partnership approach, including how minority deals can support growth capital, founder liquidity and long-term alignment. The group also covers key legal and regulatory considerations for founders going to market, such as state healthcare transaction reporting laws, compliance credibility and antitrust readiness, with a forward-looking view of where deal volume and valuation may head in 2026.

The Fast-Growing Wound Care Industry

Wound care is rapidly becoming one of healthcare's most closely watched – and most consequential – growth sectors, and this episode of "Counsel That Cares" gets to the heart of why. Holland & Knight Healthcare attorney Juliet McBride [https://www.hklaw.com/en/professionals/m/mcbride-juliet] and HealBridge CEO Jon Belsher to unpack the forces reshaping wound care across the continuum, especially in post-acute and skilled nursing settings where patients are often the sickest and least visible. Together, they explore what's driving investment (technology, home-based care models and tighter continuity of care), why innovation must stay tethered to evidence-based indications and outcomes, and how the boom in advanced products has triggered intense audit activity, clawbacks and regulatory scrutiny. The conversation also examines the Centers for Medicare & Medicaid Services' (CMS) shifting reimbursement approach and the risks associated with business models built on fragile payment assumptions, while emphasizing a compliance mindset centered on patient-first care backed by strong documentation and measurable results.