Government Contracting Health

Read Government Contracting Law updates, articles, and legal commentary from leading lawyers and law firms:
News & Analysis as of

Fourth Circuit Takes a Pass on Statistical Sampling, Finds DOJ's Settlement Veto Authority Unreviewable

After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more

Health Care Fraud and Abuse in the Middle District of Florida in 2016 - a Year in Review

The United States Attorney’s Office (USAO) for the Middle District of Florida (USAO-MDFL) prosecuted several civil health care fraud matters in 2016 and issued related press releases. A review of the USAO-MDFL’s criminal and...more

Fourth Circuit Permits DOJ to Reject an FCA Settlement, But Punts Decision on Statistical Sampling

In a closely watched False Claims Act (“FCA”) case, the Fourth Circuit Court of Appeals decided that the Department of Justice (“DOJ”) has an unreviewable right to object to a proposed settlement agreement between a relator...more

False Claims Act Alert: Fourth Circuit Punts on Sampling and Extrapolation

Tuesday, the Fourth Circuit Court of Appeals ruled in the interlocutory appeal in United States ex rel. Michaels v. Agape Senior Community, Inc.. In an opinion considering two significant questions arising under the qui tam...more

Fraud and Abuse Investigations Should be Taken Very Seriously

According to the United States Government, fraud and abuse recovery has an excellent return for each investment dollar spent. According to the Health Care Fraud and Abuse Control (HCFAC) Program Report,released by the...more

CMS: Quota share reinsurance

In an abrupt change in position, the US Centers for Medicare & Medicaid Services ("CMS"), in its Advance Notice of Methodological Changes for Calendar Year (CY) 2018, the "Call Letter", published February 1, 2017, announced,...more

“Implied Certification” Theory Allowed Under the False Claims Act

The Supreme Court recently allowed liability through the implied certification theory of the False Claims Act (FCA), which was raised and upheld in Universal Health Services, Inc. v. United States ex rel. Escobar. The...more

CMS Grants Eleventh Hour Extension for Attesting to Meaningful Use

Providers participating in the Medicare Electronic Health Record (EHR) Incentive Program now have an additional thirteen days to register and attest to meeting the meaningful use requirements for 2016. The Centers for...more

The Patient Is Not Always Right: Discriminatory Staffing Requests Can Create Legal Exposure

Employer reports of bigoted or inappropriate comments made by customers to employees or other patrons have become increasingly common for employers in all industries. In the healthcare industry, this often takes the form of a...more

Final Rule Expands OIG Exclusion Authority

On January 12, 2017, less than a week before the official transition from one administration to the next, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a rule finalizing...more

Courts’ Consistent Application of Stevens to State Institutions of Higher Learning

The United States Supreme Court recently declined review of the First Circuit Court of Appeals’ ruling that the University of Massachusetts Medical School was an “arm of the state,” and thus, not subject to the federal False...more

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

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

Your Cyber Minute: Ransomware attacks and what you need to know [Video]

The conversation continues. Hogan Lovells Partner Harriet Pearson and Managing Principal of Hogan Lovells Cyber Risk Services Jeff Lolley address the threat around ransomware and the potential implications for companies that...more

Mid-Build Provider-Based Department (PBD) Attestation Filing Deadline Fast Approaching (Checklist Included)

Providers seeking to classify certain off-campus departments as “mid-build” for purposes of eligibility for Hospital Outpatient Prospective Payment System (OPPS) reimbursement must file a provider-based attestation with their...more

First Circuit Affirms Summary Judgment for Defendant, Rejecting the Use of Aggregate Data to Prove False Claims and Clarifying the...

The First Circuit has issued an opinion affirming a complete grant of summary judgment for Pfizer, Inc. in United States ex rel. Booker v. Pfizer Inc., No. 16-1805 (1st Cir. Jan. 30, 2017), a False Claims Act (“FCA”) lawsuit...more

Far-Fetched Whistleblower Claim of the Month

The hospital industry is accustomed to far-fetched whistleblower claims: allegations that a hospital knowingly submitted false or fraudulent Medicare or Medicaid claims or fired a whistleblower for trying to prevent such...more

Alleging Improper Use of Funds Legitimately Obtained from the Government Insufficient to State FCA Retaliation Claim

The U.S. District Court for the Southern District of Texas has dismissed an FCA retaliation claim brought by a nurse who claimed to have blown the whistle on misuse of funds at a hospital that received significant federal...more

CMS makes economics of primary care ACOs more appealing: Smith Anderson

As you may have read, accountable care organizations have met uneven success over the last several years. But, when they are broken down into categories, physician-sponsored ACOs have done better, particularly those with a...more

First Circuit affirms Pfizer victory in False Claims Act case

The First Circuit has rejected an appeal in United States ex rel. Booker v. Pfizer, a False Claims Act (FCA) case alleging that Pfizer engaged in off-label promotion of the antipsychotic drug Geodon. In its ruling on...more

CMS announces awardees for three rounds of redistributed slots from closed hospitals

The Centers for Medicare & Medicaid Services (CMS) on January 31 released the awardees of resident cap increases from Rounds 8, 9, and 10 of the Affordable Care Act’s (ACA, P.L. 111-148 and P.L. 111-152) Section 5506 closed...more

Materiality Under FCA: The Lower Courts Grapple With Escobar’s Meaning

The Supreme Court’s decision in Universal Health Services v. Escobar ex rel. United States sought to clarify the standard for materiality under the False Claims Act, but lower courts have already begun to adopt different...more

Failure to Plead Objective Falsity Dooms Cardiologist’s FCA Complaint

A number of recent FCA decisions have grappled with the question of objective falsity, particularly in the context of FCA claims where the alleged falsity is premised on a lack of medical necessity in connection with the...more

False Claims Act: 2016 Year-in-Review

In 2016, the Department of Justice (DOJ) continued to give high priority to False Claims Act (FCA) investigations and prosecutions. The government brought in more than $4.76 billion in settlements and judgments, nearly a...more

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: January 2017

We have identified 30 health care–related qui tam cases that have been unsealed in whole or in part. Trends & Analysis - A substantial majority of the unsealed cases had been under seal for periods well in excess of...more

First Circuit Holds That, for Original Source Exception to the False Claims Act’s Public Disclosure Bar to Apply, Information...

On June 30, 2016, the First Circuit addressed the kinds of information that a relator must provide to qualify as an original source to avoid dismissal under the False Claims Act’s (“FCA”) public disclosure bar. In United...more

1,210 Results
|
View per page
Page: of 49

Follow Government Contracting Updates on:

Popular Topics

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.
×