On June 16, 2023, the United States Supreme Court issued an 8-1 decision in the case of United States, ex rel. Polansky v. Executive Health Resources, Inc., which held that the Department of Justice (DOJ) can move to dismiss...more
6/21/2023
/ Article II ,
Constitutional Challenges ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Healthcare Fraud ,
Judicial Intervention ,
Lack of Authority ,
Motion to Dismiss ,
Qui Tam ,
Regulatory Authority ,
Relators ,
SCOTUS ,
United States ex rel Polansky v Executive Health Resources Inc ,
Whistleblowers
Monaco’s and Polite’s remarks, and the DOJ’s new policies and guidance, come amid the Department’s increasingly tough on corporate crime approach and emphasis on rewarding companies that have effective compliance programs...more
3/7/2023
/ Chief Compliance Officers ,
Compliance ,
Compliance Monitoring ,
Cooperation ,
Corporate Crimes ,
Corporate Culture ,
Corporate Misconduct ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Electronic Communications ,
Enforcement Priorities ,
Executive Compensation ,
Monaco Memo ,
Self-Disclosure Requirements
Both the United States Department of Justice (DOJ) and the United States Securities and Exchange Commission (SEC) have continued their focus on anticorruption enforcement in 2015. Although there was a decline in enforcement...more
4/20/2016
/ Corporate Fraud ,
Corruption ,
Criminal Prosecution ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Foreign Corrupt Practices Act (FCPA) ,
Government Investigations ,
Securities and Exchange Commission (SEC) ,
Self-Reporting ,
Settlement ,
White Collar Crimes ,
Yates Memorandum
As of January 1, 2016, concealed license holders in Texas can now legally carry their handguns visibly in hip or shoulder holsters. This comes at a time when violence in hospitals and healthcare facilities is on the rise....more
Wage and hour lawsuits are being filed against employers under federal and state wage and hour laws at a record rate. Most wage and hour claims allege the employer failed to pay employees for off-the-clock work, failed to pay...more
Despite a decline in enforcement actions by the Securities Exchange Commission (“SEC”) and the Department of Justice (“DOJ”), the first half of 2015 has continued to highlight the relevance and ever-evolving effects of the...more
10/14/2015
/ Aerospace ,
Africa ,
Angola ,
Anti-Bribery ,
Anti-Corruption ,
Anti-Money Laundering ,
Avon ,
BHP Billiton ,
Brazil ,
Bribery ,
China ,
Clean Companies Act ,
Compliance ,
Corruption ,
Criminal Investigations ,
Criminal Prosecution ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Derivative Suit ,
DPA ,
Eli Lilly ,
Enforcement Actions ,
Federal Contractors ,
Federal Prosecutors ,
Fokker ,
Football ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Goodyear ,
Hospitality Programs ,
India ,
Indictments ,
Medicaid ,
Medicare ,
Money Laundering ,
Olympics ,
PBSJ Corporation ,
PetroTiger ,
Popular ,
Public Utility ,
Racketeering ,
Russia ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Serious Fraud Office (SFO) ,
Settlement ,
Soccer ,
Sports ,
State-Owned Enterprises ,
Subject Matter Jurisdiction ,
UK Bribery Act ,
Wal-Mart ,
Whistleblowers ,
White Collar Crimes ,
Wire Fraud ,
World Cup
In recent years, the U.S. Department of Justice (DOJ) has been criticized for failing to prosecute executives for fraud, particularly in the financial sector. In response, the DOJ has begun to more heavily emphasize...more
6/29/2015
/ Ambulance Providers ,
CEOs ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Enforcement ,
Enforcement Actions ,
Fraud ,
Healthcare Fraud ,
Home Health Agencies ,
Hospitals ,
Medicare ,
Personal Liability ,
Pharmaceutical Industry ,
Pharmacies ,
White Collar Crimes
In a recent decision, the U.S. Court of Appeals for the Third Circuit held that a physician acting as custodian of records may not withhold records subpoenaed from his professional association on Fifth Amendment...more
Physicians now appear to be more than ever at a greater risk of investigation for healthcare crimes, largely due to their “gatekeeping” function concerning a patient’s need for medical services and the government’s increased...more
Over the course of 2014, the Department of Justice (“DOJ”) and the Securities and Exchange Commission (“SEC”) have continued their aggressive enforcement of the Foreign Corrupt Practices Act (“FCPA”). This has led to critical...more
The first half of 2014 has seen several important developments in the enforcement of the Foreign Corrupt Practices Act (“FCPA”) as well as other anti-corruption laws worldwide. The FCPA has been in existence for more than 35...more
Medicare overpaid the home health industry $2 billion between January 2011 and December 2012, according to a recent report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG). The OIG’s...more
Earlier this month, the Texas Health and Human Services Commission (Commission) released a proposed rule, 1 TAC § 354.1452 that prohibits certain marketing activity by Medicaid and CHIP providers. The proposed rule has been...more
Criminal Prosecutions Expected in 2014 Related to ACA Fraud -
Last month's troubled rollout of HealthCare.gov, the federal marketplace for online health insurance enrollment under the Affordable Care Act (ACA),...more
The Ponemon Institute's recent publication of its fourth annual 2013 Survey on Medical Identity Theft (Survey) confirmed what many in the healthcare industry already knew: identity theft is a serious and often overlooked...more
In United States v. Vernon, the Eleventh Circuit Court of Appeals reversed an Alabama district court's judgment of acquittal following a jury's guilty verdict against a pharmacy executive charged with anti-kickback statute...more
Last summer, a federal judge in Houston ruled that the Wartime Suspension of Limitations Act (WSLA), found in Title 18, § 3287 of the U.S. Criminal Code, applied to a civil False Claims Act (FCA) case and suspended the...more
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
To paraphrase a famous quote, "Those who do not learn from history are doomed to repeat it," and providers who ignore the significance of the federal government's healthcare fraud enforcements efforts in 2012 do so at their...more
2/15/2013
/ Affordable Care Act ,
C-Suite Executives ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Fraud ,
Fraud and Abuse ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HITECH Act ,
Hospitals ,
OIG ,
Pharmaceutical Industry ,
Plea Agreements ,
Sunshine Act