News & Analysis as of

Whistleblowers Healthcare Compliance

Health Care Compliance Association (HCCA)

The compliance lessons in the wake of the Supreme Court decision in U.S. ex rel Schutte v. SuperValu, Inc.

The False Claims Act (FCA) permits private individuals to bring lawsuits in the name of the United States—called qui tam—against those they believe have defrauded the federal government: 31 U.S.C. § 3730(b). The FCA thereby...more

Bradley Arant Boult Cummings LLP

State False Claims and AKS Statutes Keep Case Alive in 2nd Circuit: Underappreciated State Laws May Present Significant Compliance...

Recent years have seen eye-popping judgments and settlements involving cases brought under the federal False Claims Act (FCA) and federal Anti-Kickback Statute (AKS). And healthcare companies have, unsurprisingly, focused...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

Health Care Compliance Association (HCCA)

FCA Lawsuit Alleges Three Hospitals Were Overpaid PRF ‘High-Impact’ Money and Kept It

Report on Medicare Compliance Volume 32, no 25 (July 2023) The former chief hospital executive of Bayonne Medical Center (BMC) in New Jersey has filed a False Claims Act (FCA) lawsuit alleging the hospital and two others...more

Bass, Berry & Sims PLC

First False Claims Act Settlement under DOJ’s Cyber-Fraud Initiative

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On March 8, the Department of Justice (DOJ) announced the first settlement under its Civil Cyber-Fraud Initiative, as Comprehensive Health Services, LLC (CHS), a global medical services provider, agreed to pay $930,000 in...more

The Volkov Law Group

Focusing on “Payments” to Healthcare Professionals (Part I of III)

The Volkov Law Group on

The United States healthcare industry poses an infinite number of risks when it comes to interactions with healthcare professionals. Given the aggressive regulation and enforcement of prohibitions against kickbacks and...more

Hogan Lovells

Government data mining leads to more aggressive investigations

Hogan Lovells on

The government is leveraging its access to big data in order to aggressively pursue healthcare investigations. Maria Durant and Gejaa Gobena, partners in our Boston and Washington, D.C. offices, discuss the steps life...more

Carlton Fields

EXPECT FOCUS: Onboard Technology, NAIC Cybersecurity, DOL, ACA Litigation, SEC Regulation (Vol. III, Summer 2015)

Carlton Fields on

In This Issue: IN THE SPOTLIGHT - - Your Data Breach Collided With My Personal Injury Coverage LIFE INSURANCE - - Phantom Injury Dooms “Shadow Insurance” Case - Latest NAIC Cybersecurity News ...more

Carlton Fields

Justice Department Recovers Nearly $6 Billion From False Claims Act Cases in 2014

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The U.S. Department of Justice (DOJ) obtained a record $5.69 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2014. This marks the first time the DOJ...more

Polsinelli

Practices, Optics and Implications: A Cautionary Tale from the North Broward Hospital District Settlement

Polsinelli on

The $69.5 million settlement by North Broward Hospital District in Fort Lauderdale, Florida to resolve False Claims Act allegations paints a cautionary tale of the importance of hospital practices and optics in connection...more

The Volkov Law Group

Healthcare Compliance Programs to Avoid a False Claims Act Case

The Volkov Law Group on

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

Faegre Drinker Biddle & Reath LLP

What’s Scarier than a Compliance Officer Turned Whistleblower? A Whole Association of Them

In U.S. ex rel. Corporate Compliance Assocs. v. N.Y. Society for the Relief of the Ruptured & Crippled the court ruled that the whistleblower failed to meet the False Claims Act’s requirement that allegations be described...more

Bradley Arant Boult Cummings LLP

False Claim Act: 2013 Year in Review

Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more

Mintz - Health Care Viewpoints

Health Care Enforcement in 2012: A Year in Review

Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more

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