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Florida’s False Claims Act – Did You Know It Changed Last Year?

In June 2013, Florida’s legislature significantly amended Florida’s False Claims Act, Fla. Stat. §§ 68.081-68.092 (“FFCA”), effective July 1, 2013. Although these amendments have not received much publicity or commentary,...more

DOJ Obtains Settlement In FHA False Claims Act Case

On February 4, the DOJ announced the filing and simultaneous settlement of a complaint by the U.S. Attorney for the Southern District of New York (SDNY) against a mortgage lender alleged to have violated the False Claims Act...more

People ex rel. Farmers Insurance Exchange, et al v. Maurice Hale, M.D., et al

People ex rel. Farmers Insurance Exchange, et al v. Maurice Hale, M.D., et al, case No. BC515676 (California Superior Court, County of Los Angeles; filed July 18, 2013)...more

Under Construction - December 2013

Welcome to our final issue of Under Construction in 2013. We hope your year has been filled with health, happiness, peace and prosperity. We thank you for your readership, and we continue to appreciate the opportunities we...more

U.S. District Court Finds Halifax Hospital Violated the Stark Law in Summary Judgment

A United States District Court in the Middle District of Florida recently granted partial summary judgment in favor of the United States in connection with its motion against Halifax Hospital Medical Center (Halifax...more

If it Walks Like a Duck and Talks Like a Duck . . . It May Just be a Goose

If you’re involved in public works projects you know that direct contractors are required to furnish payment bonds on public works projects exceeding $25,000. Specifically, Civil Code section 9550 provides that “[a] direct...more

Eighth Circuit Adopts Novel False Claims Act Fraud-in-the-Inducement Theory Long Espoused by Government

On October 15, 2013, a divided three-judge panel of the United States Court of Appeals for the Eighth Circuit rendered a federal False Claims Act ("FCA") judgment against Bayer Healthcare Pharmaceuticals ("Bayer"), based on a...more

GAO Examines Effectiveness of Health Care Fraud and Abuse Control Program Activities

The U.S. Government Accountability Office (GAO) recently published a report analyzing the effectiveness of Health Care Fraud and Abuse Control (HCFAC) program activities titled, “Indicators Provide Information on Program...more

Second Circuit Affirms Dismissal of Qui Tam Case Based on Attorney’s Use of Confidential Information

The US Court of Appeals for the Second Circuit recently affirmed the decision of the District Court for the Southern District of New York to disqualify Fair Laboratory Practices Associates (FLPA) from its qui tam suit against...more

California Insurance Commissioner Announces Settlement with Sutter Hospitals Over False Claims Allegations

Insurance Commissioner Dave Jones announced yesterday that Sutter Health, which operates over 20 hospitals in northern California, agreed to pay $46 million and change its billing and disclosure of anesthesia charges and...more

McKesson settles with Virginia for $37 million over allegations of inflating Medicaid drug prices

After the State of Virginia declined to participate in a July 2012 settlement that McKesson reached with 29 states over allegations of federal and various state False Claims Act violations, the company has agreed to pay...more

Federal Court Refuses To Dismiss Government’s Statutory Claims against Mortgage Originators That Allegedly Defrauded HUD

A federal judge recently rejected motions to dismiss in a suit in which the U.S. government alleged that two mortgage originators and their officers defrauded the Department of Housing and Urban Development (HUD) into...more

Doc Wishes He Showed Up at the Office — But . . .

Imagimed LLC, an MRI Center, its owners and chief radiologist, agreed to pay the government $3.57 million to settle false claims allegations for MRI services. The government alleged that Imagimed billed for MRI scans...more

Under Construction - September 2013: Arizona Contractors and Design Professionals Receive Additional Protections Under Arizona’s...

For good reason, much of the focus for Arizona contractors during the recently-concluded legislative session was on transaction privilege tax (TPT) reform. That bill, HB 2111, was ultimately signed by the Governor, but only...more

Will Usual and Customary Price be the Next False Claims Act Battleground?

Recently, a federal judge held that a qui tam relator’s allegations that a pharmacy routinely reported falsely inflated “usual and customary” prices for generic medications in claims submitted to federally funded health care...more

New Municipal Redevelopment Law Signed into Law in New Jersey

New Municipal Redevelopment Law Signed into Law in New Jersey by Patrick McNamara on September 20, 2013 Gov. Chris Christie has signed legislation that will change the rules for New Jersey redevelopment projects. The...more

The Cybersecurity Framework: Administration, Congress move to incentivize private-sector cooperation, strengthen federal...

The White House has announced its eight preliminary incentives to encourage private sector owners and operators of critical infrastructure (CI) to adopt the final Cybersecurity Framework, now under development by the...more

GAO Report on Medicare Contractors

On August 22, the U.S. Government Accountability Office (GAO) released a report calling for the Centers for Medicare & Medicaid Services (CMS) to improve the efficiency and effectiveness of its Medicare program integrity...more

GAO Calls For Consistency Among Medicare Contractors Postpayment Claims Review

The U.S. Government Accountability Office (GAO) recently published the results of a study examining the effectiveness of CMS’s contractors that conduct postpayment claims reviews to identify improper payments (i.e., Medicare...more

Legislation Introduced in the House Would Amend the False Claims Act

On August 1, 2013, Reps. Howard Coble (R-N.C.) and David Scott (D-Ga.) introduced bipartisan legislation in the House that would amend the federal False Claims Act (FCA) by adding several procedural hurdles that make it more...more

ARB Issues Reconsideration Decision in OFCCP v. Florida Hospital of Orlando

On July 22, 2013, the Administrative Review Board (ARB) of the Department of Labor (DOL) held that a network participation agreement entered into by Florida Hospital with Humana Military Health Services (HMHS) for the...more

Health Insurer Settles OFCCP Retaliation Allegations for $372,000

A health insurance provider in Massachusetts has agreed to pay $372,739 to resolve an Office of Federal Contract Compliance Programs (OFCCP) investigation into claims of discrimination and retaliation....more

Arizona Legislature Adds New Limits On Indemnification In Public Construction Contracts

For many years, the Arizona Little Miller Act and the Arizona Procurement Code (A.R.S. § 34–226 and A.R.S. § 41-2586, respectively) prohibited a party from being indemnified, held harmless or defended to the extent of its own...more

OIG Publishes Audit of Outpatient Therapy Services Seeking Return of $3.1 Million in Reimbursements

In June 2013, the Department of Health and Human Services, Office of Investigator General (OIG) published a review of its audit of an outpatient therapy services provider. The OIG concluded that the outpatient therapy...more

Court of Appeals Hands Down Significant DSH Ruling

As we reported in a Payment Matters article dated February 16, 2012, early last year the United States District Court for the District of Columbia handed providers a significant victory in Catholic Health Initiatives-Iowa v....more

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