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Workplace Policy Institute Insider Report — September 2016

The September edition of Littler's Workplace Policy Institute Insider Report examines what federal agencies were up to while Congress was out of session, and discusses state and local laws that advanced in the weeks leading...more

Check Up on Healthcare Fraud Prosecutions

Chief compliance officers face an overwhelming level of risk in the healthcare sector. I do not mean to belittle the risks of corruption, AML, sanctions and other risks typically associated with global companies. Healthcare...more

An Expanding Universe of Healthcare Provider Liability: The United States Supreme Court Endorses “Implied False Certification”...

Seyfarth Synopsis: In Universal Health Services Inc. v. U.S. et al. ex rel. Escobar et al., the United States Supreme Court found a healthcare provider liable under the False Claims Act (“FCA”) for material omissions on...more

Labor Laws and Federal Contracting Intersect: How Universal Health Systems Could Subject Federal Contractors to False Claims Act...

The Supreme Court has made federal contracting more treacherous by extending the reach of False Claims Act (“FCA”) liability. While the decision related to FCA liability for misrepresentations related to staffing levels, the...more

Final Blacklisting and Contractor Paid Sick Leave Rules Slated for Late Summer Publication, According to Spring Regulatory Agenda

Although this election season may feel endless, there are only six more months until voters decide the next president and members of Congress. Within this window, federal agencies are scrambling to finalize rules before the...more

Former Medicaid Auditor for D.C. Government Permitted to Proceed with FCA Retaliation Claim

The Federal District Court for the District of Columbia recently ruled that a former director of Medicaid audits in Washington D.C. can proceed with retaliation claims alleging he was fired for trying to stop his former...more

First Agency Publishes Significant Increase in FCA Penalties; Others Expected to Follow

On May 2, 2016, the Railroad Retirement Board (Board) published an interim final rule in the Federal Register amending its regulations to increase the minimum and maximum civil monetary penalty amounts under the Board’s...more

Trove of SNF Claims Data Released By CMS – Ready for Mining By Auditors and Whistleblowers

Over recent years, the Federal government has trained its sights on potential billing abuses in the Medicare Part A program for Skilled Nursing Facilities (“SNFs”) in the provision of rehabilitation therapy services. The...more

Federal Court Rejects Hospitals’ Challenge to Medicare Wage Rule 

In a decision with far-reaching implications within the health care industry, on February 22, 2016, a federal judge rejected a challenge to how Medicare reimbursement is adjusted based on local labor costs, dismissing...more

Supreme Court Seeks Meaning in Falsity and Fraud in the False Claims Act

Oral arguments were heard Tuesday, April 19th by the U.S. Supreme Court in one of the most significant False Claims Act (FCA) cases the Court has dealt with in decades on an issue with very real impact on whistleblower suits...more

Labor & Employment Issues Facing the Healthcare Industry

Public discourse on "healthcare" has focused primarily on health insurance and the significant changes made by the Affordable Care Act. But what about the providers of healthcare—the doctors, nurses, hospitals, pharmaceutical...more

"Supreme Court Permits Use of Statistical 'Representational Evidence': Implications for the FCA"

On March 22, 2016, the U.S. Supreme Court issued a decision in the Fair Labor Standards Act (FLSA) class action Tyson Foods, Inc. v. Bouaphakeo. In an opinion authored by Justice Anthony Kennedy, the majority held that class...more

Retaliation Claim Survives Though False Claim Act Claim Is False

Roxanne Perkins was employed as a clinical supervisor of prior authorizations therapy at Wellcare Health Plans. When she returned from a leave of absence, she learned that Wellcare had instituted a new practice of approving...more

Doing the Cha-Cha on Exchange Rules: CMS Moves Forward on Standardized Plan Offerings but Steps Back from Instituting Minimum...

On March 8, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule titled “Patient Protection and Affordable Care Act; CMS Notice of Benefit and Payment Parameters for 2017” (“Final Rule”)[1] setting...more

Hospice Care Eligible Patient Certification is a “Condition of Payment” Under False Claims Act

In order to state a cognizable claim under the False Claims Act (“FCA”) on a false certification theory, a plaintiff must allege that a defendant failed to comply with a federal statute or regulation that was a “condition of...more

Mitigating FCA Whistleblower Risk When Employees Leave

Over the past decade, efforts to enforce health care fraud regulations have been bolstered significantly with increased government funding and a dramatic increase in whistleblower claims filed under the False Claims Act’s qui...more

What is The Status of OFCCP Jurisdiction Over Healthcare Providers?

In recent years, the U.S Department of Labor’s (DOL) Office of Federal Contract Compliance Programs (OFCCP) has aggressively argued that healthcare providers that participate in one of three federal healthcare...more

Services that are Worth Less Aren’t Necessarily Worthless

The Sixth Circuit brought a refreshing sense of reality to the government’s sometimes unreal calculation of damages in False Claims Act (FCA) cases. In this case the government had sought, and won at the trial level, an award...more

Health Care E-Note - February 2016

The U.S. Department of Justice (“DOJ”) has a new view in cases involving corporate wrongdoing (including fraud and abuse, qui tam, and similar matters). And its gaze is focused squarely on rooting out and punishing the...more

Another Day, Another Whistleblower Retaliation Suit

A False Claims Act (“FCA”) retaliation claim, 31 U.S.C. 3730(h), filed January 26, 2016 in federal district court in Oregon, provides a perfect example of the type of challenging cases confronting health care employers today....more

Coming Down Your Chimney: Market Reform Guidance, Information Reporting Penalty Relief and Cadillac Tax Delay

It’s the “silly season” on the Hill and a busy season for ACA regulators. This article gives you brief notes about Notice 2015-87, information reporting relief and the § 4980I delay buried in the omnibus spending bill....more

Labor & Employment E-Note - December 2015

Howard Bogard, Chair of Burr's Health Care Practice Group, outlines his top ten 2015 health care developments for Alabama providers in his annual "Health Care Year In Review” article for the Birmingham Medical News....more

False Claims Act: 2015 Year in Review

This year continued the trend of aggressive False Claims Act (FCA) enforcement by the Department of Justice (DOJ) and high volumes of qui tam lawsuits brought by whistleblowers. In fiscal year 2015, the DOJ marked the fourth...more

More Whistleblowing Means More Worries for Employers

If you are an employer in the health care or defense industry, in addition to compliance with the panoply of employment laws you must adhere to, employers must also be attuned to their exposure to whistleblower claims under...more

OIG Work Plan Series – Installment Four – Oversight of Contracts

The Department of Health & Human Services’ Office of Inspector General (“OIG”) released its 2016 Work Plan, which includes the OIG’s focus on various aspects of federal government contracts. This alert will focus on the new...more

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