Brian P. Dunphy

Brian P. Dunphy

Mintz Levin

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Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: August 2016

Since our last issue, we have identified 31 recently unsealed health care-related whistleblower cases. In this Qui Tam Update, we analyze the trends and take an in-depth look at a few noteworthy cases....more

8/5/2016 - Certificates of Compliance Constructive Trusts Criminal Prosecution DEA False Billing False Claims Act (FCA) Intervenors Kickbacks Medicare Qui Tam Relators State False Claims Acts Unjust Enrichment Whistleblowers

Biodiagnostic Laboratory Services Sentenced; Another Physician Pleads Guilty

The long-running test-referral prosecution against Biodiagnostic Laboratory Services, LLC (“BLS”), a New Jersey clinical blood testing laboratory; its owner and employees; and BLS’s referring physicians recently reached...more

7/9/2016 - Anti-Kickback Statute Bribery Clinical Laboratories Criminal Prosecution Guilty Pleas Healthcare Fraud Individual Accountability Medicare Physicians Service Agreements Yates Memorandum

The Supreme Court Adopts Broad Scope of False Claims Act Liability

A unanimous Supreme Court issued its long-awaited and closely watched decision today on the scope of the False Claims Act (“FCA”), and the Court affirmed the FCA’s long reach. Universal Health Services, Inc. v. United States...more

6/17/2016 - Conditions of Payment False Claims Act (FCA) False Implied Certification Theory Federal Contractors Fraud Implied Certification Material Misrepresentation Materiality Medicaid Medicare Mental Health SCOTUS Universal Health Services Inc v United States ex rel Escobar Unlicensed Medical Providers

The Medicare Overpayment Rule: Implications for Compliance and Health Care Enforcement

As has been widely discussed, the Centers for Medicare & Medicaid Services (‘‘CMS’’) Feb. 12 published the long-awaited final rule governing the return of Medicare Part A and Part B overpayments within 60 days (the...more

3/2/2016 - Affordable Care Act CMS False Claims Act (FCA) Healthcare Fraud Look-Back Measurement Period Medicare Medicare Part A Medicare Part B Overpayment Recovery Time Limits

Government Announces Health Care Fraud “Takedown”

Earlier today, Attorney General Loretta Lynch announced the largest coordinated crackdown in the Medicare Fraud Strike Force’s eight-year history. The government brought charges against 243 individuals for approximately $712...more

6/19/2015 - Anti-Kickback Statute Health Care Providers Healthcare Fraud Home Health Care Home Healthcare Workers Medicare Medicare Fraud Strike Force Medicare Part D Nurses Physicians

Medicare Part D Data Release Continues Transparency Trend

The Centers for Medicare & Medicaid Services (CMS) recently added to the trend toward greater health care data transparency by releasing data about the prescription drugs that physicians and other health care providers...more

5/8/2015 - CMS Healthcare Information Sharing Medicare Medicare Part D Physician Medicare Reimbursements Sunshine Act Transparency

CMS Delays 60-Day Rule, But Overpayment Case Law Emerging

The Centers for Medicare & Medicaid Services (CMS) recently announced a one-year delay in finalizing the long-awaited and closely watched rule addressing the 60-day deadline to return Medicare and Medicaid overpayments (the...more

2/24/2015 - Affordable Care Act Civil Monetary Penalty CMS DHS DOJ Financial Conduct Authority (FCA) Medicaid Medicare Overpayment Physician Medicare Reimbursements Qui Tam Relators Social Security Act

PRIME Act: New Legislation to Curb Health Care Fraud

The United States Senate and House of Representatives recently introduced bipartisan legislation designed to reduce fraud, waste, and abuse in the Medicare and Medicaid programs. The legislation, entitled “Preventing and...more

6/17/2013 - CMS Fraud HHS Information Sharing Medicaid Medicare Overpayment Proposed Legislation Recovery Audit Contractors (RACs) Waste

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