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Read need-to-know updates, commentary, and analysis on Health issues written by leading professionals.

Yates Memo's Influence Felt in DOJ Health Care Enforcement

by Jones Day on

In September 2015, Deputy Attorney General Sally Yates issued a memorandum titled "Individual Accountability for Corporate Wrongdoing." In it, she stressed that one of the most effective ways to combat corporate misconduct is...more

Seven Takeaways from the ABA National Institute On Health Care Fraud

On May 17, 2017 the American Bar Association convened its 27th National Institute on Health Care Fraud. I have attended many of the past annual meetings, and always enjoy the presentations and the opportunity to network with...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

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

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

[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

Insights Conversations: How Government Health Care Investigations May Be Shifting

The Department of Justice (DOJ) has long had the advantage when investigating False Claims Act (FCA) cases against health care companies. However, recent changes in the courts, including a unanimous U.S. Supreme Court...more

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: August 2016

by Mintz Levin on

Since our last issue, we have identified 31 recently unsealed health care-related whistleblower cases. In this Qui Tam Update, we analyze the trends and take an in-depth look at a few noteworthy cases....more

OIG Issues Revised Policy Statement Regarding Permissive Exclusion

by King & Spalding on

On April 18, 2016, the Office of Inspector General of the United States Department of Health and Human Services (“OIG”) issued a revised policy statement containing the new criteria that OIG intends to use in implementing its...more

"New HHS OIG Criteria to Guide Resolution of Health Care Investigations"

The Office of Inspector General of the Department of Health and Human Services (OIG) has issued updated guidance on the use of its so-called permissive exclusion authority under Section 1128(b)(7) of the Social Security Act...more

Health Care Enforcement in 2016: A Look Back on 2015 and Forecasting the Year Ahead

by Mintz Levin on

2015 was a year of transition for the U.S. Department of Justice (“DOJ”), with the installation of a new Attorney General, Deputy Attorney General, and several other high-level officials. In January 2015, Andrew Weissmann...more

Danger Ahead? The Yates Memo and Some Strategic Considerations for Corporations and Individuals

by Baker Ober Health Law on

If you are a corporate executive or employee, the U. S. Department of Justice has a message for you: Investigating you for potential misconduct is clearly a top priority. Recently, the DOJ issued a policy memorandum...more

California Lawyer 2015 Roundtable Series: White-Collar Defense

by Morrison & Foerster LLP on

The latest developments in white-collar criminal law include a gamechanging decision on insider trading, new sentencing guidelines for fraud convictions, more options for filing charges under the bank fraud statutes, and a...more

Hospital’s Extortion & Fraud Too Quick to Violate RICO

by Faegre Baker Daniels on

Danielle Bennion and her co-plaintiffs filed a RICO (Racketeer Influenced & Corrupt Practices Act) action alleging that Mountain View Hospital and co-defendants engaged in a plan of extortion and wire fraud for the purpose of...more

Hodgson Russ Helps Clients in Largest-Ever False Claims Act Settlement In Risperdal Lawsuits Against Johnson & Johnson

by Hodgson Russ LLP on

The Justice Department announced that Johnson & Johnson will pay $1.273 billion to the federal government and most states to settle a civil False Claims Act investigation into its off-label marketing of its antipsychotic drug...more

Former ArthroCare CEO and CFO Charged with Securities Fraud, Wire Fraud

On July 16, 2013, the U.S. Department of Justice (DOJ) indicted Michael Baker and Michael Gluk, the former CEO and CFO, respectively, of ArthroCare Corp. – a Texas-based publicly traded surgical device company. Baker and...more

Medicare Strike Force Team Charges 107 Individuals for Approximately $452 Million in False Billing

by King & Spalding on

On May 2, DOJ and HHS announced charges against 107 individuals, including doctors, nurses and other licensed medical professionals, across the country for allegedly participating in Medicare fraud schemes totaling $452...more

Health Care Enforcement: 2012 Trends Quarterly Review — Part IV in a Continuing Series on Health Care Enforcement

Introduction Mintz Levin’s Health Care Fraud Enforcement Defense group has published a series of “Year in Review” articles discussing its observations about health care fraud enforcement trends in 2011 and its opinions...more

Abbott Labs to Pay $1.6 Billion to Settle Consumer Protection and Misbranding Claims

Abbott Laboratories (Abbott), an Illinois company, will pay over $1.6 billion in penalties to the federal government and several states related to its alleged illegal promotion of the prescription drug Depakote for off-label...more

Medicare Fraud Strike Force Bust Involves Highest Amount of False Billings in a Single Takedown

2012 is already a record-breaking year in health care fraud enforcement. This week Attorney General Eric Holder and Secretary of the Department of Health and Human Services (HHS) Kathleen Sebelius announced the biggest...more

Senate Committee Holds Hearing on Health Care Fraud Enforcement

A hearing titled Anatomy of a Fraud Bust: From Investigation to Conviction held by the Senate Committee on Finance (Committee) on April 24th allowed federal health care agencies to both tout their fraud-fighting successes,...more

DOJ Escalates Its War on Health Care Fraud: GlaxoSmithKline Agrees to Pay Record-setting $3 Billion to Settle U.S. Investigations

by Morrison & Foerster LLP on

British pharmaceutical company GlaxoSmithKline (GSK) announced on November 3, 2011, that it had reached an agreement in principle with the United States government to resolve multiple federal investigations regarding the...more

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