News & Analysis as of September 21, 2024

Whistleblowers

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The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -

Whistleblower Watch - Summer 2024

Cozen O'Connor on 8/2/2024

Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Health Care Compliance Association (HCCA) on 2/20/2024

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Health Care Compliance Association (HCCA) on 8/8/2023

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

[Virtual Conference] Nashville Healthcare Fraud Conference - December 15th - 16th, 8:00 am - 1:00 pm CST

Bass, Berry & Sims PLC on 11/15/2022

Please join us for the 8th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Health Care Compliance Association (HCCA) on 9/1/2022

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

False Claims Act Settlements to Know from Q2 2022

Bass, Berry & Sims PLC on 7/21/2022

The second quarter of 2022 brought a number of noteworthy False Claims Act (FCA) settlements, including several of $20 million or more. This post summarizes key settlements of interest to healthcare providers....more

DOJ Intervenes in FCA Case Over Hospital Alliance With Doctors; 340B Drugs Are an Issue

Health Care Compliance Association (HCCA) on 4/19/2022

Report on Medicare Compliance 31, no. 14 (April 18, 2022) - The Department of Justice (DOJ) said April 11 it has intervened in a whistleblower lawsuit against Methodist Le Bonheur Healthcare (MLH) in Memphis, Tennessee,...more

Whistleblower Lawsuit Against Fresenius Alleges Unlawful Arrangements with Hospitals and Nephrologists Intended to Induce Dialysis...

Benesch on 2/16/2021

On February 5, 2021 a long-time former Fresenius Medical Care North America (“Fresenius”) employee, Martin Flanagan, filed a qui tam relator amended complaint (“Complaint”) against Fresenius alleging that the company had...more

Recent Stark Act decision could have significant impact for employed physicians compensated based on personal productivity

Bricker Graydon LLP on 10/7/2019

On September 17, 2019, the Third Circuit Court of Appeals issued a decision with potentially far-reaching consequences involving the Stark Act. The case, United States ex rel. Bookwalter v. UPMC, involves allegations that a...more

Hospitals raise legal concerns by lavishing pay and perks on staff doctors

Patrick Malone & Associates P.C. | DC Injury... on 6/6/2019

As hospitals boost their size and power to push their profits even higher, they’re also raising alarms with federal regulators over their too cozy relationships with doctors who are pulling down big pay from them now as part...more

Top 10 Regulatory Challenges in the Healthcare Environment?

NAVEX on 10/30/2018

Regulatory frameworks are essential for ensuring compliance with basic standards, but in some instances, the impact of regulatory as well as legal and ethical issues can be significant. Originally published on...more

Health Management Associates Pays Over $260 Million in Criminal and Civil Penalties for Pervasive False Billing and Kickback...

The Volkov Law Group on 10/25/2018

Healthcare Management Associates (HMA) settled criminal and civil charges with the Justice Department for illegal fraud and kickback schemes. HMA billed federal government healthcare programs for inpatient services that...more

Healthcare Law Update: September 2018

Holland & Knight LLP on 9/7/2018

Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

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

Mintz on 8/7/2017

In this issue we report on recent qui tam activity and look at three unsealed cases. One case involves allegations of “up coding” by a hospital that allegedly billed routine transport as emergency transport, reimbursed at...more

Free Parking, Yes, But No Stark Law Claim

Ruder Ware on 6/23/2017

A federal court recently dealt a victory to a health care provider over whistleblower allegations that free parking and valet service at a medical office building violated the Stark Law and the Anti-Kickback Statute....more

Court Puts the Brakes on Whistleblower's FCA Parking Claims

Baker Donelson on 6/19/2017

The Department of Justice (DOJ) reports that, in fiscal year 2016 ending September 30, it obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims. More than half of this...more

Tenet Healthcare Settles Fraud Case for $514 Million

The Volkov Law Group on 10/25/2016

If you work in compliance in the healthcare industry, you have a tough job. The number and variety of risks that healthcare providers face is daunting. The False Claims Act is a mighty weapon in the hands of federal...more

Healthcare Compliance: Juggling Risk Mitigation Strategies

The Volkov Law Group on 8/31/2016

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk...more

Suing the Hand that Feeds You

Faegre Drinker Biddle & Reath LLP on 10/7/2015

Jeffrey Jacobs alleges that Idaho’s Pocatello Hospital violated the False Claims Act because of physician recruitment contracts that were overly generous to his practice group. Jeff should know because he was recruited under...more

Healthcare Legal News: Volume 5, Number 3

Dickinson Wright on 8/24/2015

RESPONDING TO SUBPOENAS AND OTHER REQUESTS FOR PERSONAL HEALTH INFORMATION: TAKE THEM AT FACE VALUE - Healthcare providers and other HIPAA covered entities receive requests for protected health information (“PHI”) from...more

Free Patient Parking May Trigger False Claims Act Violation

Faegre Drinker Biddle & Reath LLP on 8/21/2015

Who knew? When you park for free at your doctor’s office, you may be a pawn in a scheme to violate the Anti-Kickback Statute, the Stark Law, and the False Claims Act. It’s enough to make you sick....more

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: June 2015

Mintz on 6/8/2015

Trends & Analysis: ..We have identified 33 health care–related qui tam cases that have been unsealed in whole or in part since the cases covered in our last Qui Tam Update. In addition, we have also identified one case...more

What’s Scarier than a Compliance Officer Turned Whistleblower? A Whole Association of Them

Faegre Drinker Biddle & Reath LLP on 8/14/2014

In U.S. ex rel. Corporate Compliance Assocs. v. N.Y. Society for the Relief of the Ruptured & Crippled the court ruled that the whistleblower failed to meet the False Claims Act’s requirement that allegations be described...more

Mintz Levin Health Care Qui Tam Update - Recent Developments and Unsealed Cases

Mintz - Health Care Viewpoints on 8/20/2013

Trends and Analysis: ..We have identified 20 health care-related qui tam cases unsealed in July 2013. About a quarter of those were filed in 2013. ..Among the cases unsealed in July, the government has declined to...more

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Anti-Kickback Statute › Hospitals › Whistleblowers

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