Medicaid, Whistleblowers, Medicare

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

ArentFox Schiff on 6/3/2024

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

Are You Secure? DOJ’s Cyber-Fraud Initiative and Heightened FCA Enforcement

Cozen O'Connor on 2/27/2024

False Claims Act (FCA) enforcement has routinely targeted false information supplied to Medicare and Medicaid. A new trend in false-reporting cases is emerging under the FCA’s broad authority — cybersecurity enforcement....more

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

ArentFox Schiff on 1/15/2024

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

U.S. Reaches False Claims Act Settlement After Cardiologist Pays Millions in Kickbacks for Referrals

Harris Beach PLLC on 9/22/2023

On September 18th, the U.S. Attorney’s Office for the Southern District of New York (includes Manhattan and the Bronx) announced a settlement with a cardiologist, Klaus Peter Rentrop (“Rentrop”), and his medical practice...more

When Will a Settlement Agreement Preclude a False Claims Act Action?

Littler on 8/28/2023

A recent District of Columbia federal court ruling reminds employers that a severance agreement containing a release of claims under the False Claims Act does not guarantee dismissal of a suit on those grounds....more

Investigations Newsletter: New FCA Filings Point to Future Path Forward For Companies

ArentFox Schiff on 7/17/2023

New FCA Filings Point to Future Path Forward For Companies - The US Supreme Court recently ruled in United States ex rel. Proctor v. Safeway Inc. and United States ex rel. Schutte, et al. v. SuperValu Inc. et al. that...more

Supreme Court’s Decision in SuperValu May Benefit Defendants in False Claims Act Cases

Stevens & Lee on 7/13/2023

Last month in United States ex rel. Schutte, et al. v. SuperValu Inc. et al, the Supreme Court unanimously held (with Justice Thomas writing the opinion) that the False Claims Act’s (“FCA”) scienter element refers to a...more

U.S. Supreme Court Explains Meaning of “knowingly” Under the False Claims Act

BCLP on 7/12/2023

In its recent unanimous and significant decision in the consolidated cases of United States ex rel. Schutte v. SuperValu, No. 21-1326 (6-1-23), and United States ex rel. Proctol v. Safeway, Inc., No. 22-111 (6-1-23), the...more

Healthcare Organizations and Practitioners Receive New Protection Against Frivolous Whistleblower Lawsuits

Clark Hill PLC on 6/22/2023

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

Supreme Court’s SuperValu Decision: a Game-Changer for Assessing FCA Violations

Ballard Spahr LLP on 6/20/2023

Summary - On June 1, 2023, the Supreme Court issued a landmark decision in False Claims Act cases. In United States ex rel. Schutte v. SuperValu Inc., it unanimously held that liability under the False Claims Act depends...more

Investigations Newsletter: Supreme Court Again Tightens FCA Intent, But Tricky Questions Linger

ArentFox Schiff on 6/8/2023

The US Supreme Court brushed aside novel assertions from two pharmacy retailers on June 1 and ruled unanimously that False Claims Act liability hinges on whether defendants subjectively believed their claims were “false.” In...more

SCOTUS Pro-employer Pendulum Swings When It's the Fed's Ox Getting Gored

Sherman & Howard L.L.C. on 6/8/2023

The False Claims Act ("FCA") imposes liability on anyone who "knowingly" makes a false claim to the Federal Government. This includes making false claims for reimbursement from the government under federal programs. As part...more

FCA Complaint Filed Against Interventional Radiologist

Rivkin Radler LLP on 5/24/2023

On May 2, the U.S. Attorney’s Office for the Eastern District of Pennsylvania announced that the United States has filed a complaint under the False Claims Act (FCA) against James McGuckin, an interventional radiologist. The...more

High Court Hears Important Case on False Claims Act’s Scienter

WilmerHale on 5/9/2023

On April 18, the Supreme Court heard oral argument and what has been billed as the most important False Claims Act (FCA) case in a decade. Since the FCA was enacted in the Civil War era, it has been the primary tool for the...more

Healthcare Provider Settles with Virginia AG for $3 Million to Resolve Fraudulent Medicare Billing Allegations

Cozen O'Connor on 4/28/2023

Virginia AG Jason Miyares reached a settlement with 1st Adult & Pediatrics Healthcare Services, Inc. to resolve allegations that the company violated the False Claims Act by submitting fraudulent billing to Virginia’s...more

The Government’s Ability to Combat Fraud is on the Line in False Claims Act Supreme Court Case

Kohn, Kohn & Colapinto LLP on 4/17/2023

Oral arguments are scheduled for April 18, 2023, in the Supreme Court case combining two Seventh Circuit Court of Appeals cases U.S. ex rel. Schutte v. SuperValu, Inc. (“SuperValu”) and U.S. ex rel. Thomas Proctor v. Safeway,...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

DOJ Settles False Claims Act Allegations for $69 Million with Covenant Healthcare System and Physicians

King & Spalding on 4/6/2023

On March 29, 2023, the Department of Justice (DOJ) issued a press release announcing three related civil settlements totaling over $69 million with Covenant Healthcare System and two physicians—Dr. Mark Adams, a neurosurgeon,...more

Investigations Newsletter: DOJ Issues Corporate Self-Disclosure Policy

ArentFox Schiff on 2/27/2023

DOJ Issues Corporate Self-Disclosure Policy - The US Department of Justice (DOJ) released a Voluntary Self-Disclosure Policy that sets a consistent standard for corporate self-disclosures for all US Attorney’s Offices. The...more

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Health Care Compliance Association (HCCA) on 9/1/2022

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

Supreme Court To Consider Whether The Government Can Dismiss A False Claims Act Suit If It Opted Not To Intervene At The Outset

Morrison & Foerster LLP - Government... on 6/28/2022

The U.S. Supreme Court has agreed to consider whether the Government can dismiss a False Claims Act (“FCA”) lawsuit pursuant to 31 U.S.C. § 3730(c)(2)(A) over the Relator’s objections after initially choosing not to intervene...more

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