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Read Criminal Law updates, alerts, news, and legal analysis from leading lawyers and law firms:

Can Overpayments Create Criminal Liability?

by Ruder Ware on

We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges...more

Sally Yates’ was Already Famous for Changing the Focus of Compliance Investigations - The Yates Memorandum

by Ruder Ware on

By now the whole world knows about Sally Yates. We are likely to see a lot more of her as a central figure in Congressional investigations. For some of us who deal with compliance investigations, Sally Yates was famous long...more

A “Change of Heart” in a Health Care Fraud Prosecution - Inconsistent angiogram interpretations establish reasonable doubt in...

On March 7, 2017, the U.S. District Court for the Eastern District of Kentucky reversed the October 27, 2016 criminal jury verdict against Kentucky cardiologist Dr. Richard E. Paulus, and acquitted him on all counts of health...more

Three Recent Fraud Cases Involving Dermatologists Illustrate Primary Compliance Risks in Dermatology Practices

by Ruder Ware on

Three relatively recent cases involving dermatology billing practices illustrate some of the main compliance risks faced by dermatology practices...more

This Month in Corruption: Smuggled Drugs, Bogus Billing, Tampered Equipment

by PretiFlaherty on

Wrong Way to Keep Prisoners in Line. The office of William D. Weinreb, acting U.S. Attorney for the District of Massachusetts, announced March 3 that two former corrections officers at the Essex County Correctional facility...more

AG's latest remarks signal no outright campaign against cannabis yet

by Thompson Coburn LLP on

On March 2, 2017, it seemed as if the U.S. Department of Justice was aiming to crack down on the U.S. cannabis industry in a way not seen since before the previous administration. U.S. Attorney General Jeff Sessions and White...more

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

Featured Unsealed Cases United States ex rel. Thomas v. Best Choice Home Health Care Agency, Inc., No. 2:13-cv-02209 (D. Kan.) - Complaint Filed: May 6, 2013 - Complaint Unsealed: October 24, 2016...more

President’s Budget Blueprint Increases Funds For Health Care Fraud Enforcement

The President has released a “budget blueprint” for fiscal year 2018. Although there are many aspects of the budget blueprint to digest, several budget items signal that government health care fraud enforcement remains a...more

Pharmaceutical Manufacturers and Healthcare Leaders cite Fraud and Abuse Laws as Obstacle to Value-Based Arrangements

As the healthcare industry moves towards value-based purchasing, pay-for-performance, and other payment reform models, industry leaders have identified federal fraud and abuse laws as a barrier to full implementation of such...more

Health Care FCA Decisions Applied to Criminal Case

by Bryan Cave on

False Claims Act (“FCA”) cases involving medical necessity continue to receive great attention. A March 7, 2017 opinion that overruled a jury’s criminal fraud conviction of a cardiologist demonstrates the broader implications...more

"Trends in Corporate Integrity Agreements Reflect New HHS OIG Guidance on Use of Exclusion Authority"

2016 was a year of change for the Department of Health and Human Service's Office of Inspector General's (OIG) approach to corporate integrity agreements (CIA). The OIG began to use its new model CIA format and applied its...more

DOJ Issues New Guidance on the Evaluation of Corporate Compliance Programs in Federal Fraud Investigations

On February 8th, the U.S. Department of Justice (DOJ) quietly issued new guidance on how the agency evaluates corporate compliance programs during fraud investigations. The guidance, published on the agency’s website as the...more

What Would "Greater Enforcement" Mean for Washington's Cannabis Businesses?

by Garvey Schubert Barer on

Justice Department has options to crack down, but may galvanize the push for even wider legalization - In statements that were perhaps inevitable but nonetheless surprising to the cannabis industry, White House Press...more

Atlanta Dentist Goes to Jail for Medicaid Fraud - Do You Hear Me Now on Dental Practice Compliance?

by Ruder Ware on

A few months ago, the Atlanta Journal-Constitution reported on the guilty plea of an Atlanta dentist for Medicaid fraud.  Just this week, the dentist was sentenced to serve a year and a half in federal prison....more

Recent Arizona appellate decisions of note to providers

by Snell & Wilmer on

With change, breaking news, and uncertainty dominating the legal concerns of health care providers on a federal level, it remains important to review and refresh on state-level concerns and legal rules. This is especially...more

You’re Fired: What Impact Will Sally Yates’ Departure Have on the DOJ’s Fraud Enforcement?

by Snell & Wilmer on

As most of the world now knows, President Trump fired acting Attorney General Sally Yates last week after she declined to defend the President’s travel ban. Dana Boente has replaced Ms. Yates, but he may not be long for the...more

DOJ/OIG Update on FY 2016 Health Care Fraud and Abuse Control (HCFAC) Program Recoveries

by Reed Smith on

Federal health fraud recoveries for FY 2016 totaled $3.3 billion, according to the latest HCFAC program annual report. The HCFAC program is credited with more than $31.0 billion in Medicare Trust Funds recoveries since it...more

OIG Report Indicates Areas of Hospice Fraud Vulnerability and Issues a Warning to Hospice Providers

by Ruder Ware on

The HHS Office of Inspector General recently released a report indicating deficiencies in hospice election statements and physician certification of patient eligibility for hospice care. Medicare hospice care provides help...more

Ringing in the Change

by Hassan Elhais on

The UAE legal system has always adopted globally accepted best practices when it comes to the issue of drug abuse. This approach is again witnessed in the newly effected Federal Law No. 8 of 2016, the new drug law, amending...more

POD Update: Physician Investor of Physician-Owned Distributor Sentenced to Nearly 20 Years in Prison

by Ropes & Gray LLP on

On January 9, 2017, a physician was sentenced in federal court in the Eastern District of Michigan to 19 years, 7 months in prison for his role in criminal health care fraud totaling $2.8 million. The settlement has some...more

Trends in Individual Accountability in Health Care Fraud Enforcement: Thought Leaders in Health Law Video Series [Video]

by Epstein Becker & Green on

Anjali N.C. Downs, Carrie Valiant, and Jack Wenik, Members of the Firm in the Health Care and Life Sciences practice at Epstein Becker Green, examine the government’s renewed focus on holding individual executives and members...more

[Webinar] The “Risky Business” of the Federal False Claims Act: Strategic Thinking for 2017 - December 8th, 12:00pm ET

by Williams Mullen on

Calling in-house counsel and top executives at government and defense contractors, health care and long term care providers, and manufacturing companies. On December 8 at 11:30 am ET, join Williams Mullen attorneys at this...more

When Does An Overpayment Become Fraud? How Simple Inattention Can Expose You to Penalties for Fraudulent Activities

by Ruder Ware on

If you are involved in any way in the health care system, it should be obvious by now that the government has committed ever increasing resources to the prosecution of fraud and abuse cases. Simply put, from a governmental...more

Election Results: 4 States Pass Adult Use Marijuana Ballot Initiatives, 1 State Fails; 4 States Pass Medical Marijuana Ballot...

by Dickinson Wright on

On November 8, 2016, residents in 9 states voted on ballot initiatives to legalize adult use or medicinal marijuana. Arizona, California, Maine, Massachusetts, and Nevada voted to decide whether to legalize marijuana for...more

Key Takeaways: Fourth Annual Seminar for Pharmaceutical, Biotechnology and Medical Device Companies

On October 5, 2016, Skadden hosted its Fourth Annual Seminar for Pharmaceutical, Biotechnology and Medical Device Companies. The seminar focused on the current and developing challenges facing such companies and included...more

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