News & Analysis as of

Anti-Kickback Statute

The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The... more +
The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -
Quarles & Brady LLP

Legal Marketing Tactics or an Illegal Kickback Scheme? The Seventh Circuit’s Impending Decision on the Expansiveness of the...

Quarles & Brady LLP on

On December 4, the U.S. Court of Appeals for the Seventh Circuit heard oral arguments in USA v. Mark Sorensen, case number 24-1557, and it is now taking under advisement a case that could have widespread effects as to what...more

Fox Rothschild LLP

OIG Publishes Special Fraud Alert on Medicare Advantage Marketing Arrangements

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On December 11, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) published a Special Fraud Alert warning against suspect payment arrangements involving the Medicare Advantage (“MA”) program...more

Proskauer - Health Care Law Brief

OIG Releases Special Fraud Alert About Suspect Payments in Marketing Arrangements Related to Medicare Advantage and Providers

Proskauer - Health Care Law Brief on

On December 11, 2024, the Office of Inspector General for the U.S. Department of Health and Human Services (“OIG”) issued a special fraud alert warning about certain marketing schemes that involve questionable payments and...more

Mintz - Health Care Viewpoints

Key Takeaways from the OIG’s New Compliance Program Guidance for Skilled Nursing Facilities

Mintz - Health Care Viewpoints on

As part of its Modernization Initiative, the Department of Health and Human Services’ Office of Inspector General (OIG) recently published its first industry-segment specific Compliance Program Guidance, which focuses on...more

Bass, Berry & Sims PLC

OIG Issues Special Fraud Alert on Medicare Advantage Marketing Arrangements

Bass, Berry & Sims PLC on

On December 11, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Special Fraud Alert (SFA) on what it refers to as “suspect” marketing schemes involving “questionable payments and...more

Rivkin Radler LLP

LI Doctor Pleads Guilty to $900K Fraud Scheme

Rivkin Radler LLP on

Kenneth Fishberger, a Long Island internist with nearly 50 years of medical experience, recently pleaded guilty to conspiracy to commit healthcare fraud. Prosecutors revealed that from 2013 to 2019, Fishberger ordered...more

Ropes & Gray LLP

OIG Issues Special Fraud Alert on Medicare Advantage Marketing Arrangements

Ropes & Gray LLP on

On the heels of recent scrutiny of health care professional (“HCP”) arrangements with brokers and agents and Medicare Advantage Organization (“MAO”) arrangements with providers, including through the U.S. Department of...more

ArentFox Schiff

FCA Enforcement & Compliance Digest — Fall 2024 False Claims Act Newsletter

ArentFox Schiff on

Welcome to the Fall 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and compliance...more

Arnall Golden Gregory LLP

OIG Approves Municipality’s Plan to Bill Insurance and Waive Co-Pays for Treatment-in-Place Emergency Medical Services

Arnall Golden Gregory LLP on

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-09 (the “Opinion”) to a municipal corporation (the “Requestor” or...more

Rivkin Radler LLP

HHS-OIG Issues Nursing Facility Compliance Program Guidance

Rivkin Radler LLP on

On November 20, 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the “Nursing Facility ICPG,” an industry-specific compliance program guidance for nursing facilities....more

Proskauer - Health Care Law Brief

Arrangements Involving Intraoperative Neuromonitoring Continue to be Scrutinized under the Federal Anti-Kickback Statute

Proskauer - Health Care Law Brief on

This week, the U.S. Attorney’s Office for the District of Colorado (“USAO”) announced that it entered into a series of interrelated settlement agreements with companies that provide intraoperative neuromonitoring (“IONM”)...more

ArentFox Schiff

Investigations Newsletter: Seventh Circuit Considers When Legal Marketing Transforms Into Illegal Kickbacks

ArentFox Schiff on

Seventh Circuit Considers When Legal Marketing Transforms Into Illegal Kickbacks - On December 4, the US Court of Appeals for the Seventh Circuit heard oral arguments regarding whether the January 2023 jury conviction of...more

Health Care Compliance Association (HCCA)

[Event] 2025 Board & Compliance Committee Conference - February 24th - 25th, Phoenix, AZ

Health Care Compliance Association (HCCA) on

The Board & Compliance Committee Conference is designed specifically to educate board members on best practices and recommendations for establishing and maintaining an effective compliance program. The OIG-HHS will discuss...more

Husch Blackwell LLP

HHS Publishes Nursing Facility ICPG

Husch Blackwell LLP on

In November 2024, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published the Industry-Specific Compliance Program Guidance for Skilled Nursing Facilities and Nursing Facilities (Nursing...more

King & Spalding

OIG Issues Nursing Facility Compliance Guidance

King & Spalding on

On November 20, 2024, OIG released new compliance program guidelines for nursing facilities titled, “Nursing Facility Industry Segment-Specific Compliance Program Guidance” (the Nursing Facility ICPG or the Guidance). The...more

Burr & Forman

A Reminder for All Health Care Providers When Forming Business Arrangements

Burr & Forman on

According to a federal district judge in Mississippi, a cancer center’s investors bought themselves a lawsuit because of a conscious decision not to structure the ownership arrangement in compliance with a safe harbor. A...more

Foley & Lardner LLP

Episode 35: Let’s Talk Compliance: Physician Compensation Plans and Trends of 2024

Foley & Lardner LLP on

In this episode, Let’s Talk Compliance Hosts Jana Kolarik a partner of Foley’s Health Care Practice Group and PYA principal Angie Caldwell, discuss physician compensation plans and the latest trends in physician compensation...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | October 2024 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for October 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged violations under the False...more

Holland & Knight LLP

DOJ Scrutinizes Financial Arrangements of Florida Physician Practice

Holland & Knight LLP on

The U.S. Department of Justice (DOJ) announced in a Nov. 12, 2024, press release that an ophthalmology practice with offices located in West Central Florida (the Provider) entered into an approximately $1.3 million settlement...more

Venable LLP

Event in Review: Major Fraud and Abuse Laws: Anti-Kickback and Self-Referral Prohibitions and False Claims

Venable LLP on

Investment in the healthcare industry requires careful consideration, as it involves numerous distinct areas of the law. Venable's Private Equity Investment in Healthcare webinar series explores the unique issues and timely...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - January 27th - 30th, Orlando, FL

Health Care Compliance Association (HCCA) on

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

Whiteford

Understanding IRS Encouragement of PLRs for Healthcare Entities and Assessing Healthcare Corporate and Tax Structure For Tax...

Whiteford on

The IRS has recently been urging healthcare entities, particularly those involving physicians and private investors, to seek private letter rulings (PLRs) to clarify the tax implications of their ownership structures. This...more

ArentFox Schiff

Investigations Newsletter: Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties

ArentFox Schiff on

Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties - A Connecticut Superior Court judge found Assured Rx, LLC, a Florida-based pharmacy, liable for violating the Connecticut...more

Cozen O'Connor

Connecticut’s $39 Million Award a Bitter Bill for Pharmacy to Swallow

Cozen O'Connor on

Connecticut AG William Tong obtained a judgment in his favor in his office’s lawsuit against Assured Rx, LLC (“Assured”), which alleged that the pharmacy engaged in a kickback scheme in violation of state false claims and...more

Husch Blackwell LLP

False Claims Act Insights - Reality Checks: How to Approach Healthcare Transactions Without Triggering FCA Liability

Husch Blackwell LLP on

Host Jonathan Porter is joined by Husch Blackwell partner Hal Katz to discuss healthcare transactions in the context of the False Claims Act (FCA) and other regulatory frameworks applicable to the healthcare industry. As...more

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