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Summer Fraud and Abuse Roundup

The federal government was busy over the summer when it came to decisions and settlements under the Stark Law, anti-kickback law and federal False Claims Act. This article revisits recent developments with respect to...more

One Of The Country’s Largest Hospital Organizations to Pay $98.15 Million Settlement on False Claims Act Allegations

On Monday, August 4, 2014, The Department of Justice announced that Community Health Systems (“CHS”) agreed to pay $98.15 million to settle nine whistleblower lawsuits alleging that the company violated the False Claims Act. ...more

Whistleblower Receives More Than $17 Million in Omnicare Case

A decision has been made in the case against Omnicare, Inc. that will net a former Omnicare pharmacist more than $17.2 million in the ensuing settlement. The settlement with the Department of Justice orders Omnicare,...more

News from the Health Law Gurus™

Former Walmart Exec to Help Manage HHS — Leslie Dach, former Executive Vice President of Corporate Affairs for Walmart, will assume the role of Senior Counsel of the HHS, according to a press release on Wednesday. ...more

False claims by any other name: Medtronic and Omnicare cases illustrate the interplay between the False Claims Act and other...

- Government allegations of Medtronic’s alleged incentives to physicians for prescribing its medical devices lead company, while denying wrongdoing, to settle False Claims Act suit predicated on Anti-Kickback...more

Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed False Claims Act (FCA) Cases: May 2014

Trends & Analysis: ..We have identified 58 health care–related qui tam cases that have been unsealed since our last Qui Tam Update. Of those, 33 cases were initiated after the start of 2012, with the remaining 25 cases...more

First Circuit Affirms Dismissal of FCA Complaint Based on First-to-File Bar

The First Circuit recently affirmed the dismissal of United States ex rel. Wilson v. Bristol-Myers Squibb, Inc. under the False Claims Act’s (“FCA”) “first-to-file” provision, which prohibits any person “other than the...more

Settlement Agreement Silent On "Costs" Leads To Prevailing Party Award

In deSaulles v. Community Hospital of the Monterey Peninsula, 2014 DJDAR 5571 (2014), the California Court of Appeal for the Sixth Appellate District decided that a prevailing party was entitled to costs, despite the fact...more

Even The Doctor Is Not Immune

A federal jury recently awarded $350,000 in punitive and compensatory damages to three former employees of Endoscopic Microsurgery Associates, a Baltimore-area medical practice, who were subjected to unwanted sexual advances...more

U.S. Supreme Court Case Could Alter Retiree Health Benefit Landscape

The U.S. Supreme Court has agreed to review a 2013 Sixth Circuit decision that could alter the way collective bargaining agreement provisions covering retiree health benefits are interpreted. In Taketts v. M&G Polymers, the...more

Halifax Pays $85 Million to Resolve Improper Physician Compensation Arrangement Claims Brought by Employee-Whistleblower

Since January 2009, the DOJ has recovered more than $13.4 billion through False Claims Act cases involving fraud against federal health care programs, and last month, Halifax Hospital Medical Center and Halifax Staffing, Inc....more

Religious Freedom, Contraceptive Services, and The ACA: The Dilemma of the Self-Certification Provision

On February 21, 2014, the Seventh Circuit Court of Appeals, in a 2-to-1 decision, denied a preliminary injunction enjoining the federal government from enforcing the self-certification provisions of the Affordable Care Act...more

ERISA (7th Cir.): Beneficiary and Attorney Who Ignore Subrogation Lien for Medical Bills Paid by ERISA Plan “Better Call Saul”

You have seen this one before: The ERISA plan pays hundreds of thousands of dollars in medical bills and secures an equitable lien. Then, the ERISA plan beneficiary settles a tort claim, but refuses to reimburse the ERISA...more

Oklahoma Supreme Court Upholds New Discrimination Damages Caps as Constitutional

In late February, 2014, the Oklahoma Supreme Court, in MacDonald v. Integris Health, 2014 OK 10, upheld November 2011 amendments to the Oklahoma Anti-Discrimination Act (OADA), which abrogated common law remedies for victims...more

Long Island Radiology Group Settles FCA Allegations That It Billed Medicaid And Medicare For Unnecessary Tests For $15.5M

A company operating diagnostic testing facilities in New York has agreed to pay $13.65 million to the federal government and $1.85 million to New York and New Jersey for a total of $15.5 million in penalties to settle claims...more

Shaking Down the Thunder from the Sky: Notre Dame’s Challenge to the Contraception Mandate

The Supreme Court will inevitably decide to what extent the Religious Freedom Restoration Act protects religiously affiliated employers from providing insurance coverage for contraceptive services, as is generally required...more

Health Care Reform: Seventh Circuit Rejects Notre Dame’s Request For Injunction Against ACA Contraception Mandate While Supreme...

A three-judge panel on the Seventh Circuit Court of Appeals rejected the University of Notre Dame’s request for a preliminary injunction that would permit the university to avoid complying with the ACA‘s contraception mandate...more

Benefits Litigation Update - January 2014

In this issue: - Will Section 510 of ERISA Restrict Workforce Structuring under the Affordable Care Act? - A New Threat to Sponsors and Fiduciaries: Equitable Remedies After Amara - First ERISA Decision...more

California Lawyer 2013 Roundtable Series: False Claims

The Federal False Claims Act — Originally Intended To Stop Fraud Against the Union Army during the Civil War — seemed destined to fade into history after 1943, when Congress limited the rewards and evidence it allowed. But...more

Does District Court Dismissal of Declined Qui Tam Threaten Future DOJ False Claims Enforcement?

The U. S. Department of Justice (DOJ) has taken the unusual step of appealing a federal district court’s dismissal of a declined qui tam brought under the federal and multiple state false claims acts (FCA). Could the...more

The Supreme Court Defers to Plan Language in U.S. Airways, Inc. v. McCutchen

Summary - In U.S. Airways, Inc. v. McCutchen, the US Supreme Court recently considered whether certain equitable defenses override the terms of a welfare plan in a plan fiduciary's suit for reimbursement under §...more

Nurse Anne Mitchell’s Whistleblowing Almost Blew Out Whistleblowing in Texas

The Winkler County nurses trials began with two nurses, Anne Mitchell and Vicki Galle, filing an anonymous complaint with the Texas Medical Board regarding the substandard care provided by Dr. Rolando Arafiles Jr. When...more

Religious Institutions Update - July 2013

Have you ever wondered how the United States Constitution came to incorporate "free exercise of religion" in the First Amendment? James Madison wrote the initial draft of the Bill of Rights. He and other Federalists initially...more

7th Circuit Rules Employee May Recover Monetary Damages In ERISA Claim For Unpaid Benefits Against Insurer Who Denied Coverage...

The Seventh Circuit’s recent decision in Kenseth v. Dean Health Plan, Inc. provides a means for employees to collect monetary relief on their claim for benefits if they can show that the terms of the plan were not clear, and...more

Tenth Circuit Rules in Favor of Religious For-Profit Corporations in Birth Control Litigation under the Affordable Care Act

In Hobby Lobby Stores, Inc. et al. v. Sebelius, et al.,1 an en banc panel of the U.S. Court of Appeals for the Tenth Circuit held that Hobby Lobby Stores Inc. and Mardel Inc., two for-profit corporations owned and operated by...more

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