News & Analysis as of

Medicare Healthcare Department of Justice (DOJ)

PilieroMazza PLLC

Florida Federal Court Strikes Major Blow to FCA Whistleblowers: Key Takeaways for FCA Defendants

PilieroMazza PLLC on

In a prior blog, PilieroMazza discussed the Supreme Court’s decision in United States ex rel. Polansky v. Executive Health Resources, Inc. In that case, in his dissenting opinion, Justice Clarence Thomas referred to the qui...more

ArentFox Schiff

Investigations Newsletter: Precision Lens Pays $12 Million to Resolve FCA and AKS Violations

ArentFox Schiff on

Precision Lens Pays $12 Million to Resolve FCA and AKS Violations - Late last week, Precision Lens and the estate of its former principal agreed to pay $12 million to resolve allegations regarding violations of the False...more

Robinson+Cole Health Law Diagnosis

DOJ Charges 36 Defendants in Connection with Telemedicine and Clinical Laboratory Fraud and Abuse Schemes

On June 27, 2024, the Department of Justice (DOJ) announced its 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants for alleged participation in various health care...more

Quarles & Brady LLP

DOJ Enforcement:  Urine Drug Testing

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On April 11, 2024, a jury convicted Northern Kentucky Center for Pain Clinic owner Dr. Timothy Ehn (who was not a medical doctor) and medical director, Dr. William Lawrence Seifert, for their roles in a scheme that defrauded...more

ArentFox Schiff

Investigations Newsletter: Big Baby’s Big Foul: Former NBA Star Glen 'Big Baby' Davis Sentenced to 40 Months for Healthcare Fraud...

ArentFox Schiff on

Big Baby’s Big Foul: Former NBA Star Glen 'Big Baby' Davis Sentenced to 40 Months for Healthcare Fraud Scheme - On May 9, former Boston Celtics forward Glen “Big Baby” Davis was sentenced to 40 months in prison following...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

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With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

Mintz - Health Care Viewpoints

DOJ Releases COVID-19 Fraud Enforcement Task Force Report Touting Its Successes and Urging Lawmakers to Enact New Legislation

The government’s continued dedication of resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs appears to have borne fruit according to the results of the COVID-19 Fraud Enforcement Task...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - April 2024

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Foley & Lardner LLP

Private Equity: Proposed Health Over Wealth Act -What This Means for You

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On April 3, 2024, Senators Edward Markey (D-Mass.) and Elizabeth Warren (D-Mass.), chaired a Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Primary Health and Retirement Security field hearing titled,...more

Husch Blackwell LLP

Arizona Physician Pleads Guilty to Healthcare Fraud over Improper “Incident To” Billings

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“Incident to” billing is widely practiced, and its regulations are generally well-known. But one Arizona physician recently found himself pleading guilty in federal court on April 3, 2024, to a criminal healthcare fraud...more

NAVEX

Healthcare Organizations are Facing Increased Scrutiny – Here's What You Need to Know

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2024 is shaping up to be a very active year for regulatory and enforcement developments in the healthcare industry – developments that concern not just hospitals and nursing facilities, but many non-healthcare companies as...more

ArentFox Schiff

Investigations Newsletter: Cooperation Spares Former NBA Shooting Guard From Prison

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Cooperation Spares Former NBA Shooting Guard From Prison - Former National Basketball Association (NBA) shooting guard, Antoine Wright, was sentenced to time served after he pled guilty to conspiracy and aggravated...more

McDermott+

McDermottPlus Check-Up: March 8, 2024

McDermott+ on

Appropriations Update. On March 3, Congress released bill text for the CAA, 2024, which includes funding for six of the 12 appropriations bills: Agriculture-FDA, Military Construction-VA, Energy-Water, Transportation-HUD,...more

Ballard Spahr LLP

Key Takeaways From the 2024 J.P. Morgan Healthcare Conference

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Ballard Spahr attorneys from the firm’s Life Sciences and Health Care Industry Teams were on the ground for the 42nd Annual J.P. Morgan Healthcare Conference (JPM24) from January 7-10. While still less crowded than...more

ArentFox Schiff

Investigations Newsletter: Health Care Network Settles False Claims Act Allegations for $345 Million

ArentFox Schiff on

Health Care Network Settles False Claims Act Allegations for $345 Million - Community Health Network Inc. (CHN) has agreed to pay $345,000,000 to settle allegations that it violated the False Claims Act (FCA) for knowingly...more

The Volkov Law Group

DOJ Declines Prosecution Applying Corporate Enforcement Program in Healthcare Fraud Case

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The Justice Department’s Corporate Enforcement Policies and Program applies to prosecutions outside of the FCPA context.  The impact of DOJ’s new approach, encouraging voluntary disclosures, applies to other federal criminal...more

Paul Hastings LLP

SuperValu and Executive Health Resources: What to Know About the FCA Following the 2023 Term

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As we take stock of the Supreme Court’s 2023 term, two landmark decisions shift our understanding of scienter and government intervention as it relates to the False Claims Act (“FCA”), 31 U.S.C. § 3729. First, on June 1,...more

Health Care Compliance Association (HCCA)

News Briefs: August 14, 2023

Report on Medicare Compliance Volume 32, no 29 (August 2023) In a new Medicare transmittal (12,202), CMS introduced a new place of service (POS) code (27) for “Outreach Site/Street.” POS 27 is defined as “a non-permanent...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | June 2023 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for June 2023. We discuss several civil enforcement actions involving false claims, the Anti-Kickback Statute (AKS) and...more

The Volkov Law Group

Telehealth: A New Opportunity for Fraudsters

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Whenever new technologies emerge or new pots of government funds for assistance are available, you can count on one thing (as the sun rises and sets) – fraudsters will figure out a way to steal money from innocent persons and...more

Paul Hastings LLP

Finance in Five Minutes: Healthcare Finance Checkup

Paul Hastings LLP on

While mergers and acquisitions, and attendant financings may not be at a blistering pace globally, the prognosis for deal activity in the healthcare sector remains healthy, in particular as the consolidation of providers, the...more

Carlton Fields

7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

Carlton Fields on

On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...more

Bradley Arant Boult Cummings LLP

COVID-19 Fraud Enforcement Remains Priority for Federal Law Enforcement

On April 20, 2023, the Department of Justice announced criminal charges against 18 defendants in nine federal districts, alleging over $490 million in alleged theft from federally funded COVID-19 relief programs. This clearly...more

Kohn, Kohn & Colapinto LLP

The Government’s Ability to Combat Fraud is on the Line in False Claims Act Supreme Court Case

Oral arguments are scheduled for April 18, 2023, in the Supreme Court case combining two Seventh Circuit Court of Appeals cases U.S. ex rel. Schutte v. SuperValu, Inc. (“SuperValu”) and U.S. ex rel. Thomas Proctor v. Safeway,...more

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