News & Analysis as of

Data Mining Health Care Providers

Arnall Golden Gregory LLP

Seventh Circuit Affirms Liability in AKS-Based FCA Suit But Vacates Award of Damages

The United States Court of Appeals for the Seventh Circuit recently considered a district court’s nearly $6 million judgment in a qui tam False Claims Act (“FCA”) suit based on Anti-Kickback Statute (“AKS”) violations. The...more

Jackson Lewis P.C.

Downstream Breaches Cause Headaches for Healthcare Providers, as State AG Seeks Law Change to Require AG Notification

Jackson Lewis P.C. on

For healthcare providers and health systems covered by the privacy and security regulations under the Health Insurance Portability and Accountability Act (HIPAA), a breach of unsecured protected health information (PHI)...more

Amundsen Davis LLC

Payment For Access To Patient Data May Be A Violation Of The AKS

Amundsen Davis LLC on

Northern District of Illinois recently found that a home health care company violated the federal Anti-Kickback Statute (AKS) because the fees it paid to a community care organization for access to that company’s patient data...more

Maynard Nexsen

Is Bigger Always Better? A Closer Look at the Perils of Big Data Mining in Healthcare

Maynard Nexsen on

This article is the second in a series of three that will explore the topic of data mining and its ability to highlight potential healthcare fraud, as well as its effects on healthcare systems and medical providers. The...more

Maynard Nexsen

New Kid on the Block: The Rise of the Data Mining Whistleblower

Maynard Nexsen on

This article is the first in a series of three that will explore the topic of data mining and its ability to highlight potential healthcare fraud, as well as its effects on healthcare systems and medical providers.Data mining...more

Nossaman LLP

Death Certificate Project: A Dragnet!

Nossaman LLP on

The Medical Board of California (“MBC”) began this project in 2013 when it required coroners to inform it of deaths resulting from opioids.  The influx of coroners’ reports triggered an intense enforcement effort by the MBC...more

Bradley Arant Boult Cummings LLP

Averting Government Scrutiny in the Wake of an Opioid Prescribing Crackdown - Practical Pain Management

The scourge of opioid-related addiction and risk is a well-known story among the pain management community. In response to this federally declared public health crisis, government prosecutors are upping their game. Almost...more

Foley & Lardner LLP

Sharing and Mining Patient Data in Digital Health and Telemedicine: Laws You Need to Know

Foley & Lardner LLP on

The use of new technologies such as digital health applications, telemedicine, and information exchanges can provide game-changing benefits for providers and patients alike. However, with increased sharing comes increased...more

Polsinelli

Proposed Rule to Strengthen State Medicaid Fraud Control Units

Polsinelli on

A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs). The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of...more

McDermott Will & Emery

OIG’s 2016 Work Plan: Mixed Results for 2015 and New Data Mining and Policy Efforts in 2016

McDermott Will & Emery on

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) annual release of a new Work Plan both summarizes the results achieved last year and highlights new areas for examination in the next....more

Cooley LLP

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

Cooley LLP on

Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

Robins Kaplan LLP

PATIENT PRIVACY IN AN ERA OF SOCIAL MEDIA

Robins Kaplan LLP on

The rise of social media has introduced new opportunities and new legal challenges for companies in the health care industry. Attorneys Seth Northrop and Sharon Roberg-Perez discuss the legal issues faced by care providers,...more

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