In our annual report, we examine health care enforcement trends, predict how health care enforcement may evolve, and offer practical guidance about what these trends and predictions mean for health care providers, payors, and...more
As government scrutiny and enforcement targeting the Medicare Advantage (Medicare Part C) program continued in 2024, the industry’s response to agency actions escalated. Last year also resulted in the first sizable Part D...more
1/17/2025
/ Administrative Procedure Act ,
Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Inflation Reduction Act (IRA) ,
Medicare ,
Medicare Advantage ,
Medicare Part C ,
Medicare Part D ,
OIG ,
Overpayment ,
Pharmacy Benefit Manager (PBM) ,
Regulatory Oversight ,
Risk Assessment ,
SCOTUS ,
Settlement
Over the past year, the Covid-19 pandemic upended many industries. While the construction industry has largely been able to operate throughout the pandemic, albeit with increased and ever-changing restrictions on jobsites,...more
The U.S. Food and Drug Administration (FDA), industry, policymakers, and consumers share a common goal of ensuring that the foods and beverages Americans eat and drink are safe, and the law has long prohibited the...more
The Seventh Circuit Court of Appeals recently decided a case that created a new standard to assess requests by the Department of Justice (DOJ) to dismiss declined qui tam (whistleblower) suits under the False Claims Act...more
8/26/2020
/ Collateral Order Doctrine ,
Department of Justice (DOJ) ,
Dismissals ,
Equal Protection ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
FRCP 41 ,
Jurisdiction ,
Motion for Summary Judgment ,
Qui Tam ,
Relators ,
The Granston Memo
United States Attorney Andrew E. Lelling recently announced that the U.S. Attorney’s Office (USAO) for the District of Massachusetts entered into a Memorandum of Understanding (MOU) with Special Inspector General Brian D....more
Leading up to a webinar on July 15, 2020, we are publishing a blog series covering the risks of enforcement against companies that received COVID-19 relief funds under the CARES Act and strategies for mitigating these risks....more
7/6/2020
/ CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Infectious Diseases ,
Natural Disasters ,
OIG ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Relators ,
Whistleblower Protection Policies ,
Whistleblowers
Over the past few years, as plaintiffs have found it increasingly harder to succeed in “say-on-pay” litigation, another type of litigation over proxy disclosures has been on the rise. These cases are generally brought as...more
On Tuesday, in Zoning Board of Appeals of Lunenburg v. Housing Appeals Committee, the Supreme Judicial Court soundly rejected a zoning board of appeals’ argument that inexpensive market-rate homes may be counted toward a...more