Read Criminal Law updates, alerts, news, and legal analysis from leading lawyers and law firms:
Spitzer: Lanny Breuer at DOJ Was a "Disaster"
Is Edward Snowden a Whistleblower?
Expect More Second Amendment Fights
Are Political Intelligence Practice Groups Too Risky?
Bill on Bankruptcy: ResCap Report, a Bargain at $83 Million
Weekly Brief: $350K in Wine Leads to $14M Lawsuit
Weekly Brief: New Round of Layoffs Hit Law Firms
SEC News - Five Year Enforcement Limitation, FCPA Charges for Foreign Nationals, More...
With Probable Cause and Drug-Sniffing Dogs, Supreme Court Would Rather Keep Things Fluid
How to Protect Your Company From Hackers
Marijuana in the Workplace
Weekly Brief: Rakoff Orders Gupta To Pay Goldman Sachs' Legal Fees
Bill on Bankruptcy: Secret Madoff Agreement May Harm Victims
Stealth Lawyer: Dawn Porter, Filmmaker, 'Gideon's Army'
N.Y. Anti-Terror Law Diminishes Pursuit of Terrorism: Lawyer
Weekly Brief: New DOJ Tact Pushes Bank Subsidiaries To Admit Guilt
What Not To Do If You Are Involved in a Federal Criminal Investigation
Weekly Brief: Courthouse Violence on the Rise
How Does Immunity Work in a Federal Criminal Case?
What Happens in a Federal Grand Jury?
In its Semiannual Report to Congress, which covers the first half of fiscal year (FY) 2013 (October – March), the OIG announced expected recoveries of $3.8 billion, consisting of more than $521 million in audit receivables...more
In This Issue: - Top News ..CMS Finalizes MLR Rule for Plans, Maintaining Application to Part D Sponsors ..Early State Filings Show Premium Reductions under ACA ..HHS Received More Than 830 Letters of...more
Mt. Hawley Insurance Company v. Richard R. Lopez, Jr. - Court of Appeal, Second District (May 1, 2013) - Insurance Code Section 533 provides that an insurer is not liable for willful acts of an insured, and thus is...more
On April 16, 2013, the United States Department of Justice (DOJ) and U.S. Attorney’s Office in the Northern District of Illinois announced the arrest in Chicago of the owner and senior executive of Sacred Heart Hospital...more
Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more
A 2007 audit initiated by a Medicare Program Safeguard Contractor (PSC) discovered that a North Carolina provider had a high incidence of inpatient billings for patients who did not stay in the hospital overnight. The PSC's...more
The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more
The Department of Health and Human Services’ Office of Inspector General (OIG) recently published two reports finding Medicare improperly paid providers millions of dollars for incarcerated beneficiaries and unlawful aliens...more
The HHS Office of Inspector General has targeted hospitals for fraud enforcement. It is one of the OIG’s most important initiatives because of the impact it could have on reducing health care costs....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
A Federal district court judge issued a February 8, 2013 order granting a delayed prosecution against Raleigh, NC-based WakeMed Health and Hospitals for allegedly submitting false inpatient bills to Medicare. The...more
The U.S. Department of Justice (DOJ) recently issued a press release related to a settlement agreement between the U.S. Attorney's Office for the District of New Jersey, the state of New Jersey and the Cooper Health System...more
The industry should take note of new California anti-fraud laws that have recently gone into effect—and the increasing challenges of compliance in a rapidly transforming industry. Even as lawmakers in Sacramento debate how...more
Legitimate joint marketing and selling arrangements have the potential to produce efficiencies. This is particularly so, for example, where the arrangement enables the participants to make or market products that they could...more
When it comes to healthcare fraud enforcement, the government knows how to target its resources. It is estimated that at least 25 percent of all claims paid by Medicare are improper. The government understands the...more
Healthcare fraudsters do not discriminate between private and public health insurance. Fraudsters use similar schemes to defraud Medicare and Medicaid and private insurance companies. ...more
The Justice Department and the Department of Health and Human Services have made healthcare fraud a number one priority – it is another example of the synergy of politics and enforcement. Congress spends more money on...more
The Department of Justice continues to trumpet its healthcare fraud program. Just last week, the Justice Department and HHS announced another nationwide sweep resulting in the arrest of 91 individuals....more
Hospital administrators should be nervous. The Justice Department and HHS are out to pressure service providers, including hospitals and doctors, to reduce costs. In Washington, hospitals and doctors are perceived to be a...more
Introduction - As the price of healthcare continues to increase, healthcare practitioners have become more innovative and creative in their attempts to keep costs affordable for their patients. One technique which has...more
Sometimes the deck is stacked against you. No matter what you do and how hard you try, you will lose. In the healthcare area, hospitals, doctors and other service providers have to feel the frustration when it comes...more
Presidential Campaign draws attention to ongoing Anti-Fraud Efforts. The Medicare Fraud Strike Force, a partnership between HHS and DOJ designed to target emerging and migrating health care fruad schemes and chronic fraud...more
Secretary Sebelius and Attorney General Holder issued a joint letter to the American Hospital Association and four other associations representing hospitals and medical centers, warning of indications that some providers are...more
The owner of a Long Island medical supply company was convicted last week on charges of a $10.7 million Medicare fraud and wrongful disclosure of private medical information under the Health Insurance Portability and...more
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