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Health Care Providers Whistleblowers Healthcare Fraud

PilieroMazza PLLC

Florida Federal Court Strikes Major Blow to FCA Whistleblowers: Key Takeaways for FCA Defendants

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In a prior blog, PilieroMazza discussed the Supreme Court’s decision in United States ex rel. Polansky v. Executive Health Resources, Inc. In that case, in his dissenting opinion, Justice Clarence Thomas referred to the qui...more

Foley Hoag LLP - White Collar Law &...

District Court Declares FCA Qui Tam Provision Unconstitutional

On September 30, 2024, in U.S. ex rel. Zafirov v. Florida Medical Associates LLC, Judge Kathryn Mizelle in the Middle District of Florida dismissed a qui tam action under the False Claims Act (“FCA”) on the basis that the...more

The Volkov Law Group

Oak Street Health Pays $60 Million to Resolve False Claims Act Violations

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Federal whistleblowers have been exposing health care fraud for years.  The False Claims Act (“FCA”) contains robust whistleblower provisions and protections that reward whistleblowers with financial payouts. The process for...more

Kohn, Kohn & Colapinto LLP

DOJ and Whistleblowers Crack Down on Illegal Kickbacks: Major Qui Tam Settlements from July 2024

In July, the U.S. Department of Justice (DOJ) and U.S. Attorneys Offices announced several large False Claims Act (FCA) settlements stemming from qui tam whistleblower suits....more

Cozen O'Connor

Whistleblower Watch - Summer 2024

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Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

Hendershot Cowart P.C.

Whistleblower Lawsuit Results In $15 Million Settlement Over Medicare, False Claims Act Violations

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On Monday, the Department of Justice (DOJ) announced a record $15 million settlement to resolve claims that Baylor St. Lukes Medical Center, Baylor College of Medicine, and Surgical Associates of Texas were billing Medicare...more

Wiley Rein LLP

Hot Fraud Summer: DOJ’s Latest Criminal Takedown

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The U.S. Department of Justice (DOJ) Criminal Division’s Health Care Fraud Strike Force announced the results of its latest nationwide enforcement action on June 27, 2024, one year (almost to the day) since its last major...more

Oberheiden P.C.

A Handy Guide for Healthcare Whistleblowers

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The healthcare industry relies heavily on whistleblowers to bring fraudulent conduct and other forms of waste and abuse to the attention of regulators, law enforcement, and the public in general. If you have found signs of...more

Dentons

Ep. 12 - Working with Valuation Experts to Substantiate Fair Market Value Compensation

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We often work with valuation experts to ensure compensation payments between healthcare organizations and physicians are fair market value and commercially reasonable for purposes of compliance with the Stark Law and the...more

Goodwin

Charting the DOJ’s Record Breaking Year for False Claims Act Enforcement

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The US Department of Justice (DOJ) and whistleblowers were party to a record number of False Claims Act settlements and judgments in fiscal year 2023. Of the $2.68 billion recovered, more than $1.8 billion related to matters...more

ArentFox Schiff

Second Circuit: Whistleblower Must Adequately Allege Willfulness to Assert FCA Claims Based on AKS Violations

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On March 12, the Second Circuit affirmed in part and reversed in part a district court dismissal of False Claims Act (FCA) claims predicated on alleged Anti-Kickback Statute (AKS) violations. Adam Hart brought the claims...more

Dorsey & Whitney LLP

False Claims Act Settlements and Judgments Near $3 Billion in 2023

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The U.S. Department of Justice (DOJ) announced recently that settlements and judgments under the False Claims Act, 31 U.S.C. § 3729, et seq. (FCA) totaled approximately $2.7 billion in FY 2023 (October 1, 2022 – September 30,...more

Alston & Bird

DOJ Reports Record Number of New False Claims Act Matters, Recoveries for 2023

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Our False Claims Act (FCA) Team examines the Department of Justice’s increased focus on enforcement of the FCA, especially in health care matters. The DOJ initiated over 1,000 FCA matters in one year for the first time....more

Dentons

DOJ Reports Record False Claims Act Settlements & Judgments in FY 2023

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Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the...more

Jones Day

DOJ Announces Record-Breaking Year for False Claims Act Settlements and Judgments

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Qui tam relators and the U.S. Department of Justice continue to expand usage of the False Claims Act....more

K&L Gates LLP

US Department of Justice Announces US$2.68 Billion in Fiscal Year 2023 False Claims Act Recoveries

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On 22 February 2024, the US Department of Justice (DOJ) published its report (Report) announcing civil recoveries under the False Claims Act (FCA) for Fiscal Year (FY) 2023. The recoveries for FY 2023 exceeded US$2.68...more

Dentons

Ep. 5 – DOJ Reports Record False Claims Act Settlements & Judgments in FY 2023

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Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the...more

Husch Blackwell LLP

How One Hospice Owner Got Convicted of Healthcare Fraud and How You Can Avoid That Fate

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The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this episode of Hospice Insights: The Law and Beyond, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about...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

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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

Rivkin Radler LLP

Health Network Pays $345 Million for Compensating Physicians Above FMV

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Community Health Network, Inc., based in Indianapolis, Indiana, has paid $345 million to settle alleged violations of the False Claims Act (FCA). The lawsuit was initiated through a whistleblower complaint that was filed in...more

American Conference Institute (ACI)

[Event] 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement - January 23rd - 24th, New York, NY

Hosted by American Conference Institute, the 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement returns for another exciting year for lively discussions on FCA enforcement including the ramifications of two...more

Cozen O'Connor

Whistleblower Watch - A quarterly update on FCA Enforcement and Qui Tam Litigation

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Summer 2023- Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the...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

Clark Hill PLC

Healthcare Organizations and Practitioners Receive New Protection Against Frivolous Whistleblower Lawsuits

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Last Friday, the U.S. Supreme Court (SCOTUS) handed down an important ruling that will give healthcare organizations and practitioners relief against meritless whistleblower lawsuits. The ruling could result in saving...more

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