News & Analysis as of

Department of Justice (DOJ) Compliance Medicaid

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - May 9th - 10th, San Juan, Puerto Rico

Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...more

Snell & Wilmer

Scope of FCA Liability Illustrated In Recent Actions Against Higher Education Institutions

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In the past five years, the Federal Government and “Qui Tam” Realtors have ramped up False Claims Act (“FCA”) actions against higher education institutions. These actions highlight the scope and breadth of potential FCA...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 | April 2023 Recap

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

Buchalter

Taste-Testing Cybersecurity Compliance: A Recipe for Disaster in Government Contracting

Buchalter on

The Department of Justice (DOJ) Civil Cyber-Fraud Initiative continues to raise the stakes for government contractors. This initiative uses the False Claims Act (“FCA”) to hold government contractors accountable for knowingly...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

Harris Beach PLLC

OIG Enforcement Summary: July 16, 2022 – July 31, 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

BakerHostetler

Biden's New HHS Secretary Promises "Robust Enforcement"

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Introduction - On March 18, 2021, the Senate narrowly confirmed Xavier Becerra, the former attorney general of California, as U.S. Department of Health and Human Services (“HHS”) Secretary....more

The Volkov Law Group

Universal Health Agrees to Pay $122 Million for False Claims Act Violations

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DOJ announced a False Claims Act settlement with Universal Health (“UHS”) and related companies for $122 million for billing for medically unnecessary inpatient behavioral health services, failing to provide adequate services...more

Health Care Compliance Association (HCCA)

Justice Department recovers more than $3 billion from False Claims Act cases in FY 2019

Compliance Today (March 2020) - In January, Assistant Attorney General Jody Hunt of the U.S. Department of Justice’s Civil Division announced that it “obtained more than $3 billion in settlements and judgments from civil...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 9. News Briefs: March 2020

Report on Medicare Compliance 29, no. 9 (March 9, 2020) - The U.S. Attorney’s Office for the District of Massachusetts said March 5 it has filed a False Claims Act complaint against SpineFrontier Inc., Impartial Medical...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 6. News Briefs: February 2020 #3

Report on Medicare Compliance 29, no. 6 (February 17, 2020) - Tenet Healthcare Corp. and an affiliated hospital, Desert Regional Medical Center, have agreed to pay $1.41 million to settle False Claims Act (FCA)...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

Foley Hoag LLP - White Collar Law &...

White Collar Year in Preview: False Claims Act Trends in 2020

Editors’ Note: This is the fourth in our start-of-year series examining important trends in white collar law and investigations in the coming year. Our previous entry discussed anti-corruption trends in 2020. Up next: a look...more

Jones Day

"Meaningfully Useful" Risk Mitigation Strategies for Providers Following the eClinicalWorks Settlement

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The Health Information Technology for Economic and Clinical Health Act ("HITECH Act") established financial incentives under Medicare and Medicaid for eligible health care providers that adopt, implement, and demonstrate use...more

BakerHostetler

Foreign Corrupt Practices Act 2015 Update

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Despite a decline in enforcement actions by the Securities Exchange Commission (“SEC”) and the Department of Justice (“DOJ”), the first half of 2015 has continued to highlight the relevance and ever-evolving effects of the...more

Manatt, Phelps & Phillips, LLP

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

BakerHostetler

Kane and the “60-Day Rule”: The Unforgiving World of Medicare and Medicaid Overpayments

BakerHostetler on

The Southern District of New York has spoken on one of the first issues to confront those seeking compliance with the new “60-day rule” under the Affordable Care Act (ACA), and it does not bode well for defendant hospitals...more

Polsinelli

SDNY Issues Groundbreaking Decision On False Claims Act Sixty-Day Rule

Polsinelli on

Medicare and Medicaid providers have an obligation to refund overpayments from federal health care programs. The False Claims Act (“FCA”) imposes liability for any person who “knowingly conceals or knowingly and improperly...more

The Volkov Law Group

Healthcare Compliance Programs to Avoid a False Claims Act Case

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You can always count on lawyers to ring alarm belles and warn businesses. The line between accurate reporting and fear-mongering sometimes blurs when lawyers write so-called “alerts” to inform businesses of new or increasing...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

2014—A Record-Setting Year for Whistleblowers

2014 was a record-breaking year for whistleblowers, including both the U.S. Department of Justice’s prosecution of cases under the False Claims Act (FCA) and the U.S. Securities and Exchange Commission’s prosecution of cases...more

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