On June 6, 2024, the US Supreme Court decided Becerra v. San Carlos Apache Tribe and Becerra v. Northern Arapaho Tribe (Nos. 23-250 and 23-253), holding that the Indian Health Service (IHS) must reimburse Native nations,...more
6/12/2024
/ Becerra v San Carlos Apache Tribe ,
Claim Procedures ,
Health Insurance ,
Indian Health Service (IHS) ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
Native American Issues ,
SCOTUS ,
Statute of Limitations ,
Tribal Government Programs ,
Tribal Governments
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 U.S. Department of Justice (DOJ) recently announced a rare criminal indictment involving the Medicare Advantage program—a contrast from DOJ’s more typical use of its civil enforcement authority to pursue similar issues...more
11/17/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Cooperation ,
Criminal Prosecution ,
Declination ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Indictments ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Medicare Part C ,
Voluntary Disclosure
On June 1, 2023, the Supreme Court decided a pair of closely watched False Claims Act (FCA) cases, U.S. ex rel. Schutte v. SuperValu Inc., No. 21-1326, and U.S. ex rel. Proctor v. Safeway, Inc., No. 22-111....more
6/5/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Materiality ,
Medicaid ,
Medicare ,
Misrepresentation ,
Objective Falsity ,
Pharmacies ,
Prescription Drugs ,
Safeco Insurance Co of America v Burr ,
Scienter ,
SCOTUS ,
Subjective Standard ,
Universal Health Services Inc v United States ex rel Escobar ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al