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Anti-Kickback Statute › Medicare Fraud

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 -
ArentFox Schiff

Investigations Newsletter: DOJ Secures Plea in $50 Million Medicare Fraud and Kickback Scheme

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DOJ Secures Plea in $50 Million Medicare Fraud and Kickback Scheme - On April 26, the US Department of Justice (DOJ) announced that Manishkumar Patel pleaded guilty to charges related to a $50 million health care fraud and...more

ArentFox Schiff

Investigations Newsletters: Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations

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Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations - On February 28, the US Department of Justice (DOJ) announced the guilty plea of Andrew Maloney, who, along with his clinical laboratory...more

Harris Beach PLLC

OIG December Enforcement Summary

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The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

ArentFox Schiff

Investigations Newsletter: Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims

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Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims - On September 27, 2023, Chief Judge Dennis Saylor of the US District Court for the District of Massachusetts ruled that...more

Harris Beach PLLC

HHS Office of Inspector General September 2023 Enforcement Activity

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The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country.  The enforcement actions reported...more

Harris Beach PLLC

HHS Office of Inspector General July 2023 Enforcement Activity

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Harris Beach invites you to register for its 7 Element compliance program series addressing New York’s 2020 and 2022 updates to Medicaid Compliance Program requirements. Starting on August 16th, each live program will be no...more

ArentFox Schiff

Investigations Newsletter: Government Brings FCA Action Against Laboratory Companies

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Government Brings FCA Action Against Laboratory Companies - On July 18, 2023, the US Department of Justice (DOJ) announced it has filed a complaint against multiple laboratory companies and their owner, Patrick...more

Robinson+Cole Health Law Diagnosis

Home Health Company and Two Corporate Officers Settle False Claims Act Allegations for Over $30 Million

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On October 18, 2022, the Department of Justice (DOJ) announced two settlements with CHC Holdings, LLC, an Oklahoma limited liability company doing business as Carter Healthcare (Carter), and two former senior corporate...more

Harris Beach PLLC

OIG Enforcement Summary: August 1, 2022 – August 15, 2022

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The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more

Harris Beach PLLC

OIG Enforcement Summary: July 1, 2022 – July 15, 2022

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The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country.[1]  The enforcement actions reported are...more

Wilson Sonsini Goodrich & Rosati

OIG Special Fraud Alert Lists Suspect Characteristics in Telemedicine and Telehealth Arrangements

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Based on recent enforcement actions and increased scrutiny in telemedicine, the Office of Inspector General (OIG) recently published a Special Fraud Alert regarding fraud concerns in arrangements between healthcare...more

ArentFox Schiff

OIG Warns Health Care Practitioners About Fraud Schemes With Telemedicine Companies in Special Fraud Alert

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On July 20, 2022, the HHS Office of Inspector General (OIG) issued a Special Fraud Alert cautioning physicians and other health care practitioners to use “heightened scrutiny” when entering into telemedicine arrangements that...more

Harris Beach PLLC

Summary of Fraud and Abuse Enforcement Yields Insight for Health Care Compliance and Risk Assessment

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The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more

ArentFox Schiff

Investigations Newsletter: Home Health Agency Operator Agrees to Pay $17 Million to Resolve False Claims Act Allegations

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A group of New Jersey home health care companies (collectively, the BAYADA Companies), have agreed to pay $17 million to resolve claims that they violated the False Claims Act and Anti-Kickback Statute. Home Health Agency...more

Oberheiden P.C.

CMS and DOJ are Scrutinizing Medicare Billings for Amniotic Injections

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The Centers for Medicare and Medicaid Services (CMS) and U.S. Department of Justice (DOJ) are scrutinizing health care providers’ Medicare billings for amniotic injections. These injections are only eligible for Medicare...more

Polsinelli

DOJ Telemedicine Offensive Pushes Forward with New Charges

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For the past two years, telemedicine companies, durable medical equipment suppliers, pharmacies, and individuals and entities that market to such entities have been at the center of DOJ gunsights. In 2019, the Department...more

Vinson & Elkins LLP

Fifth Circuit: “Everybody Knew” Evidence Insufficient For Willfulness

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A recent Fifth Circuit decision, United States v. Nora,1 reversed a clerical employee’s convictions for conspiring to commit health care fraud, conspiring to pay or receive illegal health care kickbacks, and aiding and...more

Rivkin Radler LLP

Gilead Reaches $97 Million FCA/AKS Settlement

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On September 23, the U.S. Department of Justice announced that pharmaceutical company Gilead Sciences, Inc. agreed to pay $97 million to resolve claims that it illegally used a foundation as a conduit to pay the copays of...more

Lowenstein Sandler LLP

A Survey of Health Care Anti-Kickback Law at the State Level

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The federal health care Anti-Kickback Statute (Federal AKS) targets bribery and corruption in the health care industry. There are two core provisions of the Federal AKS: one targeting the bribe recipient and one targeting the...more

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