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DOJ Announces $2.2 Billion in 2020 FCA Recoveries and Identifies 2021 Priorities

The Situation: The U.S. Department of Justice ("DOJ") published its annual report regarding False Claims Act ("FCA") recoveries for fiscal year 2020 (ending September 2020) and announced its priorities for 2021. The...more

Fourth Circuit Rejects FCA Claims on Scienter Grounds Based on Ambiguous Regulations

The Situation: Manufacturers of allergenic extracts that are injected into a patient must obtain a Food and Drug Administration ("FDA") approved license in order to ensure their products are safe for consumption. Until the...more

New Limited Remuneration Exception and Additional Tools to Ensure Compliance with the Stark Law

The Situation: On November 20, 2020, the Centers for Medicare & Medicaid Services ("CMS") released the long-awaited final rule to modernize and clarify the Stark Law. As part of this final rule, CMS reviewed stakeholder...more

DOJ Civil Division Gives Clarity on “Inability-to-Pay” Determinations in the Midst of Ongoing Pandemic

The Situation: Companies facing the twin prospects of a significant Department of Justice ("DOJ") settlement and financial distress have historically had little insight into how the DOJ evaluates an assertion by a company...more

Strategies for Successful Post-COVID-19 Telehealth Payer Contract Negotiations

The Situation: The spread of the novel coronavirus (COVID-19) pandemic has significantly impacted the delivery of health care services and increased demand for telehealth services. The Result: The pandemic has encouraged...more

Massive False Claims Act Verdict Reinstated Against a Skilled Nursing Management Company and Its Affiliates

The Situation: A jury had originally handed down a large verdict in a False Claims Act ("FCA") case that resulted in $347 million judgment. The district court threw out that verdict, however, and the relators appealed. The...more

February 2, 2020 is Here: Are Your Agreements Compliant With the Part 2 Rule?

The Situation: The two-year grace period for updating agreements of "lawful holders" (i.e., recipients named on patient consent forms obtained pursuant to the Part 2 Rule) with contractors, subcontractors, and legal...more

HHS Releases Guidance on Direct Liability for Business Associates Under HIPAA

The Situation: On May 24, 2019, the Department of Health and Human Services ("HHS") issued a new fact sheet clarifying business associates' direct liability for violations of the Health Insurance Portability and...more

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