On February 22, 2021, the United States Supreme Court declined to review two False Claims Act (FCA) cases, solidifying a split that pits the Eleventh Circuit against the Third and Ninth Circuits as to whether a disagreement...more
As COVID-19 continues to ravage the United States, the Department of Justice (DOJ) has recently announced its new National Rapid Response Strike Force within the Health Care Fraud Unit to investigate and prosecute fraud cases...more
10/2/2020
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Criminal Investigations ,
Department of Justice (DOJ) ,
DOJ Strike Force ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Infectious Diseases ,
Paycheck Protection Program (PPP) ,
Pharmaceutical Industry ,
Physicians ,
Stark Law
The United States Attorney’s Office for the Southern District of Georgia has become a leader in telemedicine fraud enforcement since 2019. Yesterday’s press release by the Department of Justice, announcing a historic...more
On August 14, 2020, the Department of Justice issued a Foreign Corrupt Practices Act (“FCPA”) Advisory Opinion—the first of its kind in nearly six years. The DOJ’s opinion advised a U.S. investment company that the...more
In Philip K. Dick’s novel Ubik, the sci-fi legend warned the world of the dangers of inanimate objects that could violate our privacy. In a virtual nod to Ubik and Dick, the Fifth Circuit Court of Appeals ruled the privacy...more
Faced with the novel question of whether an individual has a Fourth Amendment privacy interest in the records of their Bitcoin transactions, the Fifth Circuit found that Bitcoin data is akin to bank records and not subject to...more
7/10/2020
/ Bitcoin ,
Child Pornography ,
Coinbase ,
Criminal Investigations ,
Digital Currency ,
Financial Transactions ,
Fourth Amendment ,
Money Transfer ,
Online Platforms ,
Popular ,
Reasonable Expectation of Privacy ,
Search Warrant ,
Third-Party
Recently, the United States Supreme Court added United States v. Van Buren to its merits docket for next term. The Court will seek to resolve a circuit-split over whether a person who is authorized to access information on a...more
On Thursday, AseraCare, a national hospice care provider, announced that it had settled a long-standing Medicare billing dispute with the DOJ, a case that has garnered nationwide attention in healthcare since 2008. At issue...more
3/5/2020
/ Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Government Investigations ,
Health Care Providers ,
Healthcare Fraud ,
Hospice ,
Medicare ,
Medicare Billing Privileges ,
Settlement Agreements ,
Statistical Sampling
On Tuesday, former New York State Assembly Speaker Sheldon Silver received a welcomed victory, albeit partial, in the Government’s long running prosecution accusing him of fraud, extortion and money laundering....more
1/24/2020
/ Bribery ,
Corruption ,
Criminal Convictions ,
Criminal Prosecution ,
Extortion ,
Fraud ,
Government Investigations ,
Governor McDonnell ,
Honest Services Fraud ,
McDonnell v US ,
Money Laundering ,
Official Act ,
Public Corruption ,
Public Officials ,
Statutory Interpretation ,
White Collar Crimes
The U.S. Department of Justice released guidelines on October 8, 2019 that aim to provide federal prosecutors with more guidance on how to approach claims by white collar defendants that they are unable to pay fines or...more
In a one-two punch during the first half of September 2019, the Department of Justice confirmed that its focus on prosecuting telemedicine companies and physicians engaged in health care fraud shows no sign of slowing...more
9/24/2019
/ Criminal Conspiracy ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Guilty Pleas ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Physicians ,
Telemedicine
Since the Department of Justice filed charges in April 2019 against 24 telemedicine and durable medical equipment (“DME”) company executives and physicians for their alleged participation in a $1.2 billion healthcare fraud...more
Recently, Assistant Attorney General Makan Delrahim announced the Department of Justice, Antitrust Division’s new policy for incentivizing corporate antitrust compliance. For the first time in DOJ history, this new policy...more
Telemedicine permits two-way, real time interactive communication between health professionals and patients. Its recent expansion has dramatically improved patient health by providing new access to health care for rural...more
7/11/2019
/ Bribery ,
Corruption ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Government Investigations ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Physicians ,
Telecommunications ,
Telemedicine ,
White Collar Crimes
Over the last several months, the immigration landscape in the U.S. has changed significantly. Consequently, the risk for employers related to hiring practices has increased. ...more
11/1/2018
/ Business Interruption ,
Department of Justice (DOJ) ,
Deportation ,
Employer Liability Issues ,
Employment Eligibility Verification ,
Enforcement Actions ,
Form I-9 ,
Hiring & Firing ,
Immigration and Customs Enforcement (ICE) ,
Immigration Enforcement ,
Immigration Procedures ,
Immigration Reform ,
Raids ,
Trump Administration ,
Undocumented Immigrants
In a surprise announcement, the Department of Justice (DOJ) announced that the government will move to dismiss a qui tam action brought under the False Claims Act when it determines that the case has no merit. ...more
A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs).
The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of...more
11/7/2016
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Data Mining ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Investigations ,
Medicaid ,
OIG ,
Prosecutorial Discretion
The Supreme Court of the United States in Universal Health Services, Inc. v. Escobar et al., weighed in on and embraced the implied certification theory of liability within the False Claims Act (FCA)....more
6/22/2016
/ False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
Health Care Providers ,
Implied Certification ,
Material Misrepresentation ,
Medicaid ,
Medicare ,
Mental Health ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar ,
Unlicensed Medical Providers
Good news may be in sight for businesses and health care providers.
On April 28, 2016, the House Judiciary Committee's Subcommittee on the Constitution and Civil Justice once again considered potential updates to the...more
In an important recent decision, the Sixth Circuit Court of Appeals confirmed that a qui tam relator's claim that her former husband improperly accessed electronic protected health information (e-PHI) of her and her relatives...more
The Department of Health and Human Services Office of Inspector General (HHS-OIG) recently released its FY 2016 Work Plan, in which it identified key areas of focus for the upcoming year. Consistent with its mandate to detect...more
On November, 2, 2015, President Obama signed into law the Bipartisan Budget Act of 2015 (“BBA”), a two-year budget deal that funds the government through the 2017 fiscal year. A relatively inconspicuous provision of the BBA,...more
Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”).
The Settlement...more
11/3/2015
/ Anti-Kickback Statute ,
Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Drug Testing ,
False Claims Act (FCA) ,
Federal Contractors ,
Federal Health Care Programs (FHCP) ,
Genetic Testing ,
Health Insurance ,
Healthcare ,
Kickbacks ,
Medicaid ,
Medicare ,
OIG ,
Qui Tam ,
Stark Law ,
Whistleblowers
In a potential expansion of protections afforded to whistleblowers under the federal False Claims Act (“FCA”), a federal judge in the Eastern District of Virginia reserved ruling on whether the anti-retaliation provision of...more
Following the widely criticized prosecution of the late Alaska Senator Ted Stevens, the Department of Justice (“DOJ”), understandably, took steps to learn from the mistakes made in that case by drafting and distributing a...more