On September 30, 2024, Judge Mizelle, a federal judge in the Middle District of Florida, ruled that the False Claims Act’s (“FCA”) qui tam enforcement provision is unconstitutional, a ruling that, if followed by other courts,...more
Introduction -
Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more
4/12/2024
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Health Technology ,
Healthcare Fraud ,
Home Health Care ,
Hospice ,
Hospitals ,
Laboratories ,
Long Term Care Facilities ,
Medicaid ,
Medicare Advantage ,
Nursing Homes ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Settlement ,
Settlement Agreements ,
Skilled Nursing Facility ,
Stark Law
The United States Supreme Court recently agreed to hear a case interpreting the False Claims Act (“FCA”) that may affect the government’s involvement in pending and future matters. To resolve a circuit split, the Court will...more
6/30/2022
/ Burden-Shifting ,
Certiorari ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Healthcare ,
Healthcare Fraud ,
Inpatient Billing ,
Judicial Intervention ,
Lack of Authority ,
Motion to Dismiss ,
Outpatient Services ,
Qui Tam ,
Regulatory Authority ,
Relators ,
SCOTUS ,
United States ex rel Polansky v Executive Health Resources Inc
As we wrote on July 28, 2021, Senator Chuck Grassley has sponsored a bill (S. 2428) that would amend the False Claims Act (FCA) in several significant ways that are unfavorable to defendants. On October 28, 2021, the Senate...more
On February 22, 2021, the United States Supreme Court declined to review two False Claims Act (FCA) cases, solidifying a split that pits the Eleventh Circuit against the Third and Ninth Circuits as to whether a disagreement...more
Jody Hunt, Assistant Attorney General for DOJ’s Civil Division, and Michael Granston, Deputy Assistant Attorney General, Commercial Litigation Branch, spoke recently about False Claims Act (“FCA”) enforcement at the Federal...more
3/6/2020
/ American Bar Association (ABA) ,
Corruption ,
Department of Justice (DOJ) ,
Elder Issues ,
Electronic Medical Records ,
Enforcement Guidance ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Government Investigations ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Fraud ,
Medicare Advantage ,
Medicare Billing Privileges ,
Nursing Homes ,
Qui Tam ,
Regulatory Oversight ,
Voluntary Disclosure
On January 9, 2020, the Civil Division of the U.S. Department of Justice (DOJ) announced that it recovered over $3 billion from civil False Claims Act (FCA) judgments and settlements in the fiscal year ending September 30,...more
1/16/2020
/ Anti-Corruption ,
Corruption ,
Defense Contracts ,
Defense Sector ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Environmental Protection Agency (EPA) ,
False Claims Act (FCA) ,
Falsified Documents ,
Fraud and Abuse ,
Government Investigations ,
Health Care Providers ,
Healthcare Fraud ,
National Institute of Health (NIH) ,
Opioid ,
Pain Management ,
Pharmaceutical Industry ,
Physicians ,
Qui Tam ,
Scientific Research ,
South Korea ,
White Collar Crimes
Through two separate notices of proposed rule-making (NPRMs), the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG), seek to remove...more
11/13/2019
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Fee-for-Service ,
Health Care Providers ,
Healthcare Fraud ,
Healthcare Reform ,
NPRM ,
OIG ,
Proposed Rules ,
Risk-Based Approaches ,
Rulemaking Process ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Starting today, the industry has 75 days to provide input on the proposed rules published in the Federal Register regarding the future enforcement of the Anti-Kickback Statute (AKS). ...more
10/21/2019
/ ACOs ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Reform ,
OIG ,
Proposed Regulation ,
Regulatory Agenda ,
Rulemaking Process ,
Safe Harbors ,
Stark Law ,
Telehealth ,
Value-Based Care
The Department of Health and Human Services Office of Inspector General (HHS-OIG) recently released its FY 2016 Work Plan, in which it identified key areas of focus for the upcoming year. Consistent with its mandate to detect...more
Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”).
The Settlement...more
11/3/2015
/ Anti-Kickback Statute ,
Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Drug Testing ,
False Claims Act (FCA) ,
Federal Contractors ,
Federal Health Care Programs (FHCP) ,
Genetic Testing ,
Health Insurance ,
Healthcare ,
Kickbacks ,
Medicaid ,
Medicare ,
OIG ,
Qui Tam ,
Stark Law ,
Whistleblowers