News & Analysis as of November 15, 2024

Kickbacks

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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 -

12th Annual Healthcare Fraud & Abuse Review - A Critical Resource for Healthcare Providers

Bass, Berry & Sims PLC on 2/27/2024

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

Client Alert: 2024 Holiday Gift-Giving Risks and Compliance Concerns for Health Care Providers

Shumaker, Loop & Kendrick, LLP on 12/1/2023

As we approach the Holiday Season, we all know that this is the time of year when gifts are exchanged. However, for health care providers, it can be a season of risk. Gifts to referral sources can cause unintended regulatory...more

NY Physician, Wife and Staff Admit AKS Violations

Rivkin Radler LLP on 11/29/2023

The U.S. Attorney’s Office in Trenton, NJ announced on November 22 that primary care physician Yitzchok “Barry” Kurtzer of Monsey, NY, and his wife pleaded guilty to soliciting and receiving kickbacks and bribes in exchange...more

OIG Kickback Opinion: Referring Labs Providing Technical Component Services Implicate Anti-Kickback Statute

Harris Beach PLLC on 10/11/2023

This opinion addresses a proposed agreement (“Proposed Arrangement”) between a national anatomic pathology laboratory (“Requestor”) and laboratories owned in whole or in part by physicians who may refer (“Referring...more

False Claims Act Settlements to Know from Q2 2023

Bass, Berry & Sims PLC on 7/18/2023

There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023. Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more

Sixth Circuit Defines False Claims Standards

Dickinson Wright on 4/10/2023

The Federal False Claims Act (“FCA”) imposes civil liability for presenting a false claim to the government for payment. The Federal Anti-Kickback Statue (“AKS”) prohibits medical providers from making referrals in return for...more

Federal Jury Returns $43 Million Verdict for Kickback Scheme in Violation of the False Claims Act

McDermott Will & Emery on 3/30/2023

After a rare False Claims Act (FCA) trial—especially one premised on violations of the Anti-Kickback Statute (AKS)—a federal jury in Minnesota returned a $43 million verdict against Precision Lens, a distributor of medical...more

Distributor of Ophthalmic Surgical Products Found Guilty of Paying Kickbacks and Violating the False Claims Act: May Be Liable For...

McGuireWoods LLP on 3/22/2023

On February 28, 2023, a federal jury in the District of Minnesota found the Cameron-Ehlen Group, d/b/a Precision Lens, and its founder and owner Paul Ehlen (the “Defendants”) guilty of paying kickbacks to ophthalmic surgeons...more

Trial Lost, $400+ Million Liability Looming: Quick Takeaways From a Recent False Claims Act Jury Trial

Husch Blackwell LLP on 3/13/2023

On February 27, 2023, a jury in Minnesota federal court rendered a verdict in favor of the United States and against a surgical product distributor following a False Claims Act jury trial that lasted six weeks. The jury...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

11th Annual Healthcare Fraud & Abuse Review 2022

Bass, Berry & Sims PLC on 2/13/2023

We are pleased to bring you our 11th 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

DOJ Settlement with Electronic Health Records Provider Highlights Risks Related to Exclusive Partnerships and Influencers

Bradley Arant Boult Cummings LLP on 12/14/2022

Continuing its focus on healthcare technology and electronic health records (EHR) companies, the Department of Justice announced last month a $45 million settlement to resolve a False Claims Act suit involving EHR provider...more

Modernizing Medicine Settles False Claims Act Violations for $45 Million

The Volkov Law Group on 11/16/2022

The Justice Department continues to pile up healthcare enforcement actions — false claims, anti-kickback, and fraud. DOJ is on its way to a record year....more

False Claims Act Settlements to Know from Q2 2022

Bass, Berry & Sims PLC on 7/21/2022

The second quarter of 2022 brought a number of noteworthy False Claims Act (FCA) settlements, including several of $20 million or more. This post summarizes key settlements of interest to healthcare providers....more

Eleventh Circuit Affirms Convictions Against Florida Physician, Pharmacist for Violating Anti-Kickback Statute

Burr & Forman on 6/20/2022

Prosecutions related to the submission of claims to Tricare for compounded pain creams continue. The Eleventh Circuit Court of Appeals affirmed convictions against a Florida pharmacist, physician, and Navy veteran for their...more

OIG Advisory Opinion Recognizes Legitimacy of Certain Physician-Owned Device Companies

Manatt, Phelps & Phillips, LLP on 4/28/2022

After years of government skepticism and enforcement activity targeting physician-owned medical device companies, a recent favorable advisory opinion by the Office of Inspector General for the U.S. Department of Health &...more

Marketer in Kickback Scheme Involving Compound Pharmacies Sentenced to Probation and Order to Pay $3.3 Million

Robinson+Cole Health Law Diagnosis on 4/1/2022

On March 30, 2022, the United States Department of Justice (DOJ) announced that Manual J. Bojorquez, the owner of a marketing company, was sentenced to 36 months’ probation and ordered to pay restitution of $3.3 million for...more

Court puts health care providers on notice that illegal kickbacks can trigger significant damages

Hogan Lovells on 4/5/2021

The United States Court of Appeals for the Fourth Circuit recently affirmed a $114 million judgment in a protracted, and hotly contested, suit filed under the qui tam provisions of the False Claims Act (FCA) against the owner...more

Vive La Différence? American and French Healthcare Fraud, Waste, and Abuse Laws

Pietragallo Gordon Alfano Bosick & Raspanti,... on 3/8/2021

America and France share many common ideals. The American Constitution is founded on the principle of government “of the people, by the people, and for the people.” The French Constitution embodies this same principle in the...more

Eleventh Circuit Holds “Knowingly and Willfully” Does Not Require Motive for Kickback Recipient

McGuireWoods LLP on 12/9/2020

A recent Eleventh Circuit opinion clarified the mens rea burden the Government must prove to establish criminal intent to violate the Federal Anti-Kickback Statute (“AKS”) for a recipient or payee of a kickback or bribe under...more

Attempts by Recruiters to Avoid Kickback Prosecutions Using the “Bona Fide Employee” Safe-Harbor Fail

Arnall Golden Gregory LLP on 9/1/2020

On August 6, 2020, the United States Court of Appeals for the Sixth Circuit upheld the conviction of a patient recruiter in a Medicare kickback case, finding insufficient evidence to demonstrate that the recruiter was a “bona...more

Employers Beware: Federal Court Upholds Aggressive Law Enforcement Tactics When Investigating False Claims Act Allegations

Troutman Pepper on 3/5/2020

Before the government decides whether to intervene in a qui tam action, it is obligated by statute to investigate a whistleblower’s allegations. See 31 U.S.C §?3730(a). But, in the course of that investigation, may the...more

Investigations Newsletter: Health Information Technology Developer to Pay $145 Million to Resolve Kickback Allegations

ArentFox Schiff on 2/3/2020

In the DOJ’s first-ever criminal action against an electronic health records vendor, San Francisco-based Practice Fusion Inc. agreed to pay $145 million to resolve allegations that it received kickbacks from pharmaceutical...more

Unexpected Prosecution with Unexpected Convictions - Could the Texas “Forest Park” Convictions Happen to Doctors in Arizona?

Jaburg Wilk on 11/6/2019

On April 11, 2019, in a federal court, a Dallas jury returned verdicts of guilty against seven of the defendants in the criminal case styled “United States v. Beauchamp” and commonly known as “Forest Park.” Of the original...more

Avanir Pharmaceuticals Pays More than $108 Million to Settle Kickback Violations

The Volkov Law Group on 10/23/2019

Just to repeat myself – pharmaceutical and medical device firms face extraordinary risks of enforcement under the False Claims Act. While everyone likes to write and focus on FCPA or anti-corruption risks for global drug and...more

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