News & Analysis as of October 12, 2024

Fraud

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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 -

DOJ Releases Annual Civil Fraud Recovery Statistics and Results…A Look Behind the Numbers

Bass, Berry & Sims PLC on 2/26/2024

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

EnforceMintz — DOJ’s Continued Focus on Individual Accountability

Mintz on 2/14/2024

As discussed in EnforceMintz – Significant 2022 Regulatory and Policy Developments, the Department of Justice (DOJ) issued several memoranda in late 2022 and early 2023, reinforcing DOJ’s approach to individual accountability...more

Recent False Claims Act Decisions to Know

Bass, Berry & Sims PLC on 5/1/2023

In this post, we summarize noteworthy False Claims Act (FCA) decisions so far from 2023. Each of the three circuit court opinions discussed here ruled in favor of the defendants on different aspects of the FCA: the Sixth...more

Recent FCA Settlements in Government Contracts Cases

Bass, Berry & Sims PLC on 4/20/2023

The government continues to prioritize fraud involving government contractors, as the Department of Justice’s (DOJ) most recent annual report on civil fraud recovery shows. Although the majority of government recoveries are...more

Healthcare Regulatory Check-up Newsletter | January 2023 Recap

McDermott Will & Emery on 3/9/2023

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity and developments occurring in January 2023, including several criminal and civil enforcement actions related to the federal...more

$43 Million False Claims Act Verdict in Minnesota Illustrates Ongoing Anti-kickback Statute Risks

Lathrop GPM on 3/6/2023

On February 27, a Minnesota federal court jury ruled in the favor of the U.S. Department of Justice (DOJ) in a False Claims Act (FCA) case based on allegations of Anti-kickback Statute (AKS) violations. The focus of the case...more

Healthcare Regulatory Check-up Newsletter | December 2022 Recap

McDermott Will & Emery on 2/8/2023

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity between November 21 and December 31, 2022, including recent enforcement activity and a summary of the Office of Inspector...more

OIG Alert and DOJ Enforcement Action Summary: Telemedicine Arrangements

Goodwin on 7/29/2022

The July 20, 2022 Special Fraud Alert describes findings from what OIG describes as “dozens of investigations of fraud schemes involving companies that purported to provide telehealth, telemedicine, or telemarketing services”...more

The State of EKRA: Summer 2022

Holland & Knight LLP on 6/29/2022

Enacted in 2018, the Eliminating Kickbacks Recovery Act (EKRA) remains a source of anxiety and confusion in the clinical laboratory industry. In the four years since EKRA's enactment, U.S. Department of Justice (DOJ)...more

Healthcare Fraud Settlement Showcases Government’s Additional Focus on COVID-19-Related Fraud

Dorsey & Whitney LLP on 6/1/2022

The Department of Justice (“DOJ”) last month announced a new blockbuster settlement agreement under the False Claims Act, 31 U.S.C. § 3729 et seq (“FCA”), involving alleged violations of the Stark law and other efforts to...more

Physician Ownership in Medical Device Company Will Not Trigger Anti-Kickback Statute Enforcement Action, OIG Concludes in Advisory...

ArentFox Schiff on 5/23/2022

Physician-owned companies that generate revenue from the sale of medical devices ordered by their physician owners have in recent years been the target of federal fraud and abuse enforcement actions. OIG Advisory Opinion...more

OIG Declines to Approve Lab’s Payment of Specimen Collection Fees to Hospitals

Bass, Berry & Sims PLC on 5/6/2022

On April 28, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services published Advisory Opinion 22-09, declining to approve a laboratory company’s proposal to pay hospitals a fair market...more

Government Investigations Team Insights - February 2022

Arnall Golden Gregory LLP on 2/28/2022

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. In this edition, we analyze a recent Eleventh Circuit decision addressing False Claims Act penalties and the...more

False Claims Act - 2021 Year in Review

Bradley Arant Boult Cummings LLP on 2/3/2022

The year 2021 marks the 10th anniversary of the Bradley False Claims Act Year in Review. In that decade, much has remained the same in FCA enforcement. To start with the obvious: It continues to result in billions of dollars...more

Healthcare Law Update: February 2021

Holland & Knight LLP on 2/5/2021

To date, there has been little consistency in how Health Insurance Portability and Accountability Act (HIPAA) requirements are enforced by the U.S. Department of Health and Human Services (HHS), or the amount of settlements...more

False Claims Act 2020 Year in Review

Bradley Arant Boult Cummings LLP on 2/1/2021

This year saw substantial activity in FCA settlements and litigated court cases. Although no single case or development dominated the discourse this year, several important court decisions were issued, including two that may...more

Special Fraud Alert: Speaker Programs – If It's Too Good to Be True, It Probably Is

Bass, Berry & Sims PLC on 11/25/2020

On November 16, the Department of Health and Human Services Office of Inspector General (OIG) took a shot across the bow of the healthcare industry when it published a Special Fraud Alert highlighting some of the fraud and...more

OIG Takes Aim at Speaker Programs in Special Fraud Alert

Bradley Arant Boult Cummings LLP on 11/20/2020

On November 16, 2020, the Office of Inspector General of the Department of Health and Human Services (OIG) issued a Special Fraud Alert addressing the fraud and abuse risks of speaker programs that are commonplace in the...more

Drug Pricing Concerns Drive Continued DOJ Focus on Life Sciences Companies

Skadden, Arps, Slate, Meagher & Flom LLP on 1/24/2020

In 2019, U.S. Department of Justice (DOJ) enforcement activity targeting drug and device manufacturers jumped sharply over the prior year, reflecting an increased focus on fraud and abuse in the life sciences sector. More...more

Government Continues to Closely Scrutinize Pharmaceutical Marketing Practices

Robinson+Cole Health Law Diagnosis on 9/18/2019

On September 4, 2019 the Department of Justice (DOJ) announced a $15.4 million settlement with pharmaceutical company Mallinckrodt ARD LLC (Mallinckrodt) to resolve alleged violations of the Anti-Kickback Statute (AKS) in two...more

Anti-Kickback Laboratory Enforcement Actions – Special Fraud Alert

Tucker Arensberg, P.C. on 7/11/2014

There has been significantly enhanced scrutiny of financial relationships between referring physicians by both the Office of Inspector General (OIG) and Pennsylvania authorities....more

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Anti-Kickback Statute › Enforcement Actions › Fraud

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