News & Analysis as of

Department of Health and Human Services (HHS) False Claims Act (FCA) Whistleblowers

ArentFox Schiff

Investigations Newsletter: Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits

ArentFox Schiff on

Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits - Daniel Hurt, the prior owner and operator of Fountain Health Services LLC, Verify Health, Landmark Diagnostics LLC, First Choice...more

American Conference Institute (ACI)

[Event] FCPA & Anti-Corruption for the Life Sciences Industry - May 9th - 10th, New York, NY

Hosted by the American Conference Institute, the 19th Annual FCPA & Anti-Corruption Conference for the Life Sciences Industry returns for another exciting year with carefully researched programming based on critical findings...more

Venable LLP

Federal Efforts to Incentivize States to Promulgate False Claims Statutes

Venable LLP on

The federal False Claims Act (FCA) is widely regarded as a powerful tool to punish fraud against the federal government. Since 1986, the federal government has recovered more than $75 billion from FCA settlements and...more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

ArentFox Schiff

Investigations Newsletter: Clinical Laboratory and CEO To Pay Over $13 Million to Settle False Claims Act Allegations

ArentFox Schiff on

Clinical Laboratory and CEO To Pay Over $13 Million to Settle False Claims Act Allegations - A New Jersey-based laboratory, RDx Bioscience Inc. (RDX), and its owner and CEO, Eric Leykin, agreed to pay $10,315,023 to the US...more

Health Care Compliance Association (HCCA)

OIG: COVID-19 UIP Overpaid Providers $784M; HRSA Will Recoup Money

Hospitals and other providers should brace for recoupment of possibly hundreds of millions of dollars they were reportedly overpaid for services provided under the COVID-19 uninsured program (UIP) in the wake of new audit...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

Dickinson Wright

Sixth Circuit Defines False Claims Standards

Dickinson Wright on

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

ArentFox Schiff

Investigations Blog: Government Wins $43 Million Verdict in False Claims Act Case

ArentFox Schiff on

Headlines that Matter for Companies and Executives in Regulated Industries- Government Wins $43 Million Verdict in False Claims Act Case - On February 28, 2023, a federal jury in Minnesota handed down a $43 million...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2022

Bass, Berry & Sims PLC on

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

Health Care Compliance Association (HCCA)

Hospital Settles FCA Case Filed by CO Over Modifiers; Make Sure People ‘Feel Heard’

Report on Medicare Compliance 30, no. 32 (September 13, 2021) - John Peter Smith (JPS) Hospital in Fort Worth, Texas, agreed to pay $3.3 million to settle false claims allegations in a case with a hot risk area, a...more

Sheppard Mullin Richter & Hampton LLP

Sutter Health Settles Medicare Fraud Case For $90 Million: The Largest Settlement For Medicare Advantage Fraud

A major California-based health care system, Sutter Health, and several of its medical practice foundation affiliates have agreed to pay a total of $90 million to settle allegations that they violated the False Claims Act...more

Cozen O'Connor

Razors Raise Antitrust Worries | $86 Million Mortgage Servicing Settlement | Creative Alleged Tax Avoidance

Cozen O'Connor on

2020 AG Elections- Maine AG Aaron Frey was reelected to a second two-year term by a joint convention of the Maine House and Senate. California AG Xavier Becerra was nominated by President-Elect Joe Biden to lead the...more

Miles & Stockbridge P.C.

Disregard Compliance at Your Peril: Compliance Officer Paid As Whistleblower

Miles & Stockbridge P.C. on

A medical device manufacturer learned what might seem an obvious lesson when it paid $18 million to settle a False Claims Act lawsuit brought by its former Compliance Officer: don’t ignore your compliance officer. The federal...more

Cozen O'Connor

COVID-19 Drug Availability | Federal Banking Rule vs. State Usury Laws | Kickbacks For Pain Meds

Cozen O'Connor on

COVID-19- Bipartisan Group of Attorneys General Seeks to Expand Production of Antiviral Drug- A bipartisan group of 34 AGs, led by California AG Xavier Becerra and Louisiana AG Jeff Landry, sent a letter urging the U.S....more

BCLP

What Recipients of Provider Relief Fund Payments Can Do to Mitigate Whistleblower Risk

BCLP on

We previously discussed how recipients of payments from the Provider Relief Fund (PRF) are at risk for allegations of fraud and specifically addressed how these recipients may become targets of False Claims Act (FCA)...more

ArentFox Schiff

Investigations Newsletter: SEC Adopts Aggressive Approach to COVID-19 Fraud

ArentFox Schiff on

SEC Adopts Aggressive Approach to COVID-19 Fraud - The US Securities and Exchange Commission has already initiated multiple investigations into companies seeking to illegally profit from the global coronavirus pandemic...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 2. News Briefs: January 2020 #2

Report on Medicare Compliance 29, no. 2 (January 20, 2020) - - The HHS Office of Inspector General has updated its Work Plan, which includes an item on early discharges from inpatient rehabilitation facilities to home...more

ArentFox Schiff

Investigations Newsletter: Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme

ArentFox Schiff on

Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme - Two individuals pled guilty in Pennsylvania federal court to conspiracy to defraud the Pennsylvania Medicaid program and commit...more

The Volkov Law Group

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

The Volkov Law Group on

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

ArentFox Schiff

Investigations Newsletter: Pharmaceutical Company Agrees to Pay $15.4 Million to Resolve Alleged False Claims Act Violations

ArentFox Schiff on

NY Ambulette Owners Plead Guilty to $8.6 Million Health Care Kickback Scheme - On September 5, the Department of Justice announced that two New York ambulette owners pleaded guilty to one count of conspiracy to offer and...more

Bass, Berry & Sims PLC

Settlement Shows FCA Risks Posed by Non-Traditional Relators

Bass, Berry & Sims PLC on

On July 19, 2019, Myriad Genetics disclosed a $9.1 million settlement agreement to resolve a False Claims Act (FCA) qui tam lawsuit alleging that it engaged in a scheme to fraudulently bill Medicare for certain hereditary...more

McDermott Will & Emery

[Webinar] 2019 Q2 Health Care Enforcement Roundup Webinar - August 12th, 1:00pm ET

McDermott Will & Emery on

Frequent regulatory and policy changes, increasing government scrutiny and private whistleblower activity pose greater risks to health care organizations more than ever before. McDermott’s Q2 Health Care Enforcement Roundup...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Year End Review: A Look Back…A Look Ahead

Bass, Berry & Sims PLC on

Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy at the highest levels of...more

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