We are pleased to bring you our 12th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more
2/27/2024
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medical Devices ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Settlement ,
Stark Law ,
Telemedicine
On February 22, the Department of Justice (DOJ) released its annual report of civil fraud recoveries for FY2023, along with a press release highlighting DOJ’s civil enforcement efforts.
Our top ten observations from...more
2/26/2024
/ Annual Reports ,
Anti-Kickback Statute ,
Controlled Substances Act ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Enforcement Statistics ,
False Claims Act (FCA) ,
Fraud ,
Fraud and Abuse ,
Healthcare ,
Opioid ,
Qui Tam ,
Relators
Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more
11/27/2023
/ Anti-Kickback Statute ,
C-Suite Executives ,
Chief Compliance Officers ,
Chief Privacy Officer ,
Continuing Legal Education ,
Criminal Liability ,
Department of Justice (DOJ) ,
Enforcement ,
Ethics ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Hospitals ,
Laboratories ,
Long-Term Care ,
MCOs ,
Mental Health ,
Physicians ,
Self-Disclosure Requirements ,
Substance Abuse ,
Webinars
Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more
11/27/2023
/ Anti-Kickback Statute ,
C-Suite Executives ,
Chief Compliance Officers ,
Chief Privacy Officer ,
Continuing Legal Education ,
Criminal Liability ,
Department of Justice (DOJ) ,
Enforcement ,
Ethics ,
Events ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Hospitals ,
Laboratories ,
Long-Term Care ,
MCOs ,
Mental Health ,
Physicians ,
Self-Disclosure Requirements ,
Substance Abuse
Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more
2/4/2021
/ Annual Reports ,
Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Criminal Investigations ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Long Term Care Facilities ,
Medical Devices ,
Medicare ,
Medicare Advantage Organizations (MAOs) ,
Nurses ,
Nursing Homes ,
OIG ,
Opioid ,
Pharmaceutical Industry ,
Pharmacist ,
Physicians ,
Qui Tam ,
Settlement Agreements ,
Stark Law ,
Telemedicine
A LOOK BACK.... A LOOK AHEAD -
Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy...more
1/31/2019
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Medical Devices ,
Opioid ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Qui Tam ,
Stark Law
Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy at the highest levels of...more
1/16/2019
/ Appointments Clause ,
Article II ,
Article III ,
Constitutional Challenges ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Dismissals ,
Drug Distribution ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Materiality ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Relators ,
Standing ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers
A LOOK BACK... A LOOK AHEAD -
While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more
3/13/2018
/ Affordable Care Act ,
Anti-Kickback Statute ,
Attorney's Fees ,
Attorney-Client Privilege ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Damages ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Discovery ,
Enforcement Actions ,
False Claims Act (FCA) ,
First-to-File ,
Food and Drug Administration (FDA) ,
Fraud and Abuse ,
Health Care Providers ,
Health Insurance ,
Healthcare Fraud ,
Home Health Care ,
Hospice ,
Hospitals ,
Individual Accountability ,
Laboratories ,
Long-Term Care ,
Managed Care Contracts ,
Manufacturers ,
Medicaid ,
Medical Devices ,
Medical Necessity ,
Medical Records ,
Medicare ,
Nursing Homes ,
OIG ,
Pharmaceutical Industry ,
Physicians ,
Pleading Standards ,
Protected Activity ,
Public Disclosure ,
Qui Tam ,
Relators ,
Retaliation ,
Reverse False Claims ,
Settlement Agreements ,
SNF ,
Specialty Healthcare ,
Stark Law ,
Universal Health Services Inc v United States ex rel Escobar
The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we...more
After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more
2/22/2017
/ Administrative Authority ,
Attorney General ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Hospice ,
Interlocutory Appeals ,
Qui Tam ,
Relators ,
Settlement ,
Statistical Sampling ,
Veto Rights