B. Scott McBride

B. Scott McBride

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A Tale of Two Escobars: Federal Courts Begin Grappling with Opposing Views of “Materiality”

On June 16, 2016, the U.S. Supreme Court issued a highly anticipated opinion in Universal Health Services, Inc. v. U.S. ex rel. Escobar, which for the first time expressly recognized implied certification as a viable theory...more

8/26/2016 - AstraZeneca DOJ False Claims Act (FCA) Implied Certification Motion to Dismiss Universal Health Services Inc v United States ex rel Escobar

Caution: False Claims Act Penalties Poised to Double

A preview of the effects that a provision in the Bipartisan Budget Act of 2015 will have on healthcare providers came to light this week when the Railroad Retirement Board (Board) published an interim final rule implementing...more

5/9/2016 - Bipartisan Budget DOJ False Claims Act (FCA) Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 Healthcare

DOJ Takes Aim at Responsible Individuals in Corporate Investigations

U.S. Deputy Attorney General Sally Quillian Yates recently announced new instructions for attorneys at the U.S. Department of Justice (DOJ), outlining in a memorandum the DOJ’s policies with respect to civil and criminal...more

10/12/2015 - Best Practices Corporate Investigations DOJ Enforcement Actions False Claims Act (FCA) Federal Prosecutors Health Care Providers Healthcare Misappropriation Professional Misconduct Yates Memorandum

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

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

8/14/2015 - Affordable Care Act CID Civil Investigation Demand CMS Compliance DOJ False Claims Act (FCA) Health Care Providers Healthcare Hospitals Medicaid Medicare Medicare Part A Medicare Part B Medicare Part D Overpayment Overpayment Recovery Time Limits

Federal Healthcare Fraud Enforcement Efforts Yield a 790% Return

Last week, the U.S. Department of Health and Human Services (HHS) and the DOJ jointly released a report concluding that, for every dollar spent on healthcare fraud investigations in the last three years, the government...more

2/28/2013 - DOJ Healthcare Healthcare Fraud HHS

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