Podcast - Discussing a DOJ Lawsuit Under the Civil-Fraud Initiative
Episode 340: DOJ Updates Evaluation of Corporate Compliance Programs
The Labor Law Insider - Whistleblower Breaks Details of NLRB Mail Ballot Election Abuse – Part II
Episode 335 -- The New DOJ Whistleblower Program
#WorkforceWednesday®: New DOJ Whistleblower Program - What Employers Must Know - Employment Law This Week®
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
Innovation in Compliance: Alan Saquella on Navigating The Complexities of Corporate Whistleblowing and Compliance
Common Scenarios Triggering False Claims Act Violations, Part 1: Gov. Contracts and Cybersecurity
The Justice Insiders Podcast: DOJ’s Cacophony of Whistles
The Presumption of Innocence Podcast: Episode 37 - Vintage or Trendsetting? The SDNY's Whistleblower Pilot Program
Episode 321 -- Review of the EU Whistleblowing Directive wih Alex Cotoia and Daniela Melendez
FCA Uncovered: Mitigating Risk in the Regulatory Spotlight — Regulatory Oversight Podcast
Corruption, Crime and Compliance: NAVEX’s 2024 Whistleblower Report — More Reports, Higher Substantiation Rates
False Claims Act Insights - Are We Done Here? The Unique Dynamics of FCA Settlements
Understanding the Whistleblower Pilot Program in the Southern District of New York
Corruption, Crime & Compliance: DOJ Adopts New Whistleblower Bounty Program and Encourages Voluntary Self-Disclosure
False Claims Act Insights - Think You Know Whistleblowers? Think Again.
FCPA Compliance Report: Mary Inman on DOJ Whistleblower Bounty Program
Navigating the SEC's Whistleblower Enforcement Wave: A Guide for Financial Institutions — The Consumer Finance Podcast
How One Hospice Owner Got Convicted of Healthcare Fraud and How You Can Avoid That Fate
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
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
Last month, on April 22, the Centers for Medicare & Medicaid Services (CMS) issued its Minimum Staffing Standards for Long-Term Care Facilities final rule, which will apply to any long-term care (LTC) facilities that receive...more
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
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
Qui tam relators and the U.S. Department of Justice continue to expand usage of the False Claims Act....more
The U.S. Department of Justice (DOJ) announced that it initiated a record-high 500 new False Claims Act (FCA) cases in Fiscal Year 2023. The government and whistleblowers (qui tam relators) were party to 543 settlements and...more
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
Like most industries, the health care sector is grappling with the uses of artificial intelligence (AI) and what AI means for the future. At the same time, many health care companies already have integrated algorithms and AI...more
The False Claims Act (FCA) saw quite a bit of action at the Supreme Court in its most recent completed term. In this fourth and final installment of PilieroMazza’s blog series “The FCA at the Supreme Court,” we examine active...more
Earlier this month, the White House released the National Cybersecurity Strategy Implementation Plan outlining specific “high impact initiatives” that the federal government will carry out to achieve its cybersecurity...more
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
On June 16, the U.S. Supreme Court issued its opinion in U.S. ex rel. Polansky v. Executive Health Resources, a closely watched case about the government’s power to dismiss a False Claims Act (FCA) qui tam lawsuit over a...more
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
What does it mean to “knowingly” or “recklessly” violate the law when that law consists of highly complex and ever-changing regulations, which may be open to interpretation? The U.S. Supreme Court recently agreed to review...more
On Sept. 9, 2020, the United States Attorney for the Western District of North Carolina announced that it had settled a whistleblower lawsuit alleging False Claims Act violations by two former managers and the owner of a now...more
How is today’s volatile healthcare environment impacting litigation—and how can you protect your organization? Learn the answer at a new Manatt webinar. Healthcare is facing a tidal wave of change—from tightening False...more
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
Healthcare Management Associates (HMA) settled criminal and civil charges with the Justice Department for illegal fraud and kickback schemes. HMA billed federal government healthcare programs for inpatient services that...more
I have a tendency to sound like a “broken record” (an odd phrase in these days of digital music). The government’s most powerful enforcement tool continues to be – drumroll please, the False Claims Act. ...more
Health care providers are under constant threat of lawsuits brought by whistleblowers under the federal civil False Claims Act, 31 U.S.C. §§ 3729, et seq. (FCA), the statute under which the government obtains most judgements...more
Prompt Payment Discounts Not an Anti-Kickback Statute Violation - In United States of Am. et al. ex rel. Ruscher v. Omnicare, No. 15-20629, 2016 WL 6407128 (5th Cir. Oct. 28, 2016), the court of appeals affirmed summary...more
Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk...more
Chief compliance officers face an overwhelming level of risk in the healthcare sector. I do not mean to belittle the risks of corruption, AML, sanctions and other risks typically associated with global companies. Healthcare...more