The Second Circuit Court of Appeals recently issued a decision with significant implications for healthcare companies and providers facing allegations of violations of the Anti-Kickback Statute (AKS), 42 U.S.C. §...more
5/24/2024
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Former Employee ,
Health Care Providers ,
Intent ,
Pharmacies ,
Relators ,
Safe Harbors ,
Suppliers ,
Willful Misconduct
In October, the U.S. Department of Justice announced a rare criminal indictment involving the Medicare Advantage program — a contrast from the DOJ's more typical use of its civil enforcement authority to pursue similar issues...more
The Department of Health and Human Services Office of Inspector General (OIG) recently issued an advisory opinion that explored the limits of a relatively new safe harbor to the federal Anti-Kickback Statute (AKS) that aims...more
The Department of Health and Human Services Office of Inspector General (OIG) recently issued an advisory opinion highlighting two important—if easy to overlook—areas that health care companies and providers should remain...more
The Centers for Medicare & Medicaid Services (CMS) proposed a rule late last year that would impose standards on healthcare providers and suppliers to report and return overpayments from Medicare that mirror aspects of the...more
The Biden Administration is expected to devote significant resources to investigating fraud and abuse in the health care industry. Not only will the Biden Administration likely continue investigating traditional health care...more
3/18/2021
/ Biden Administration ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
EHR ,
Enforcement Programs ,
Executive Orders ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Nursing Homes ,
Opioid ,
Skilled Nursing Facility ,
Telehealth
As recent developments in corporate enforcement indicate, the United States Department of Justice (DOJ) continues to emphasize transparency, cooperation, and the importance of a strong compliance program. Enforcement trends...more
11/20/2020
/ Chief Compliance Officers ,
Compliance ,
Cooperation ,
Corporate Culture ,
Corporate Integrity Agreement ,
Department of Justice (DOJ) ,
Enforcement ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Strategic Enforcement Plan
Last week, the United States Department of Justice (“DOJ”) announced the creation of the National Rapid Response Strike Force (“NRR Strike Force”) within the DOJ’s Health Care Fraud Unit. The announcement was made in...more
When Riordan, Lewis & Haden Inc. (RLH), a private equity firm, found itself ensnared in a False Claims Act (FCA) litigation for its role in a prescription drug kickback scheme orchestrated by one of its portfolio companies,...more
12/11/2019
/ Best Practices ,
Board of Directors ,
Corporate Governance ,
Corporate Liability ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Kickbacks ,
Motion to Dismiss ,
Pharmaceutical Industry ,
Portfolio Companies ,
Prescription Drugs ,
Private Equity Firms ,
Risk Management ,
Settlement ,
TRICARE
On October 9, 2019, the Department of Health and Human Services (HHS) announced proposals for a number of new and revised exceptions to the Stark Law and safe harbors for the Anti-Kickback Statute (AKS) that are intended to...more
10/15/2019
/ Anti-Kickback Statute ,
Comment Period ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
Exceptions ,
Fee-for-Service ,
Health Care Providers ,
OIG ,
Physicians ,
Proposed Rules ,
Safe Harbors ,
Stark Law