Dept. of Justice Healthcare

The United States Department of Justice is a federal executive department established in 1870 by federal statute. The Department is headed by the Attorney General and is responsible for administering and... more +
The United States Department of Justice is a federal executive department established in 1870 by federal statute. The Department is headed by the Attorney General and is responsible for administering and enforcing federal law. The Department is compromised of many different divisions which handle a wide variety of civil and criminal issues.    less -
News & Analysis as of

Trial Challenging Proposed Anthem, Cigna Merger Is Underway

On November 21, 2016, the U.S. District Court for the District of Columbia heard opening arguments in the Department of Justice’s lawsuit challenging the proposed merger between Anthem, Inc. and Cigna Corporation. This is...more

White Collar Crime Law Enforcement in a Trump Justice Department - 8 Predictions

After a conventional presidential campaign, determining the policy priorities and direction of the incoming administration with respect to the Justice Department’s white collar law enforcement responsibilities can be a...more

Health Care E-Note - November 2016

You just formed your medical practice inAlabama, and you either chose a professional corporation (a “PC”) or an LLC. If you went with a PC, you got to choose between an “S” corporation (“S corp”) or a “C” corporation (“C...more

Corporate Investigations and White Collar Defense - October 2016

Supreme Court: What Constitutes an Insider Trading “Personal Benefit” - Why it matters: On October 5, 2016, the Supreme Court heard oral argument in Salman v. United States, where the central issue was what the...more

DOJ/FTC Joint Guidance for Human Resources Professionals Suggests Broad Antitrust Risks

Provisions restricting the hiring of another company’s employees are often included in vendor agreements and a variety of corporate transactions and licenses. And it’s not unusual to see similar constraints adopted in...more

Monster Movie Month: Episode III – Son of Frankenstein and Evolution From Yates Memo and FCPA Pilot Program

Welcome to my third installment in this month’s classic monster movie festival. This year I am revisiting the Frankenstein series. Today I want to explore the final movie where Boris Karloff starred as Frankenstein’s Monster;...more

DOJ-AmEx Case Could Have Ramifications for Health Care Providers

The U.S. Department of Justice's loss to American Express sends a message to health care providers: Steering, tiering, exclusive dealing and other contractual arrangements that appear to suppress competition in one part of...more

DOJ Announces Settlement with Tuomey CEO Following Yates Memo Directive to Hold Individuals Accountable

The Department of Justice’s recent settlement with a healthcare system executive indicates a continued focus on pursuing individuals in enforcement actions. On September 27, 2016, the DOJ announced it reached a $1 million...more

One Year Later: The Yates Memo, False Claims Act and Director & Executive Liability

On September 19 and 27, 2016, the US Department of Justice announced two False Claims Act settlements that required corporate executives to make substantial monetary payments to resolve their liability. How will director and...more

Former Home Health Agency Owner Sentenced to 20 Years for $57MM Medicare Fraud

The US Department of Justice announced that Khaled Elbeblaswy, the former owner and manager three Miami-area home health agencies, was sentenced to 20 years in prison and ordered to pay $36.4 million in restitution for his...more

The Department of Justice Ups the Ante: Per Claim Penalties for False Claims Act and Anti-Kickback Statute Violations Nearly...

On June 30, 2016, the Department of Justice (“DOJ”) published an interim file rule that dramatically increases the per claim penalties for violations of the False Claims Act (“FCA”) and the Anti-Kickback Statute (“AKS”) among...more

Headlines from Mid-Year FCPA Enforcement Review

Just to add my voice to the cottage industry surrounding FCPA enforcement and compliance, I wanted to take a deep breath and offer some observations on FCPA enforcement in 2016. There are a few significant headlines...more

Mega-Mergers Highlight Risk to Health Care Providers

Consolidation in health insurance markets can injure hospitals and doctors by creating buyer-side market power that can force providers to accept below-market prices, limit patients’ access to care, and reduce innovation in...more

Prevailing in an Era of Regulatory Enforcement – Balancing Risk and Compliance [Expect Focus – Vol. II, July 2016]

IN THE SPOTLIGHT - - SEC Sanctions Unregistered EB-5 Investments Broker SECURITIES - - FINRA to Assess Member Firms’ Culture - SEC Seeks Fund Responses to Distribution-In-Guise Guidance...more

Caution: False Claims Act Penalties Poised to Double

A preview of the effects that a provision in the Bipartisan Budget Act of 2015 will have on healthcare providers came to light this week when the Railroad Retirement Board (Board) published an interim final rule implementing...more

DOJ Antitrust Head Remains Focused on Health Care in Era of Consolidation

Speaking at an industry conference on November 13, U.S. Assistant Attorney General Bill Baer reiterated the government’s focus on competition concerns in the health care industry. According to Baer, head of the Department of...more

Health Care Update - November 2015

Ways & Means Leadership Changes – Health Policy Implications Looming: As Congress pushes forward with a two-year budget deal, and new Speaker Paul Ryan begins his tenure as the top Republican in the House of...more

Tuomey Settles, Post-Judgment, Alleged Violations of FCA and Stark Law

The Department of Justice and Tuomey Healthcare have announced a $72.4 million settlement in a lawsuit that the DOJ touts as “another achievement for the [DOJ and DHS] Health Care Fraud Prevention and Enforcement Action Team...more

Justice Department Charges Pharma President with Kickback Conspiracy

In the public relations battle following the issuance of the Yates Memo, the Justice Department can now cite one example for the new policy – the recent arrest and charging of Carl Reichel, former President of Warner...more

Record-breaking FCA settlements underscore importance of Stark Law compliance

In September and October, the Department of Justice (DOJ) announced four record-breaking False Claims Act settlements – ranging from $25 million to $115 million – involving health care systems that allegedly made improper...more

Congress Takes Long Look at Proposed Health Insurance Mergers

While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

Skeletons in the Closet? Beware of Potential Enforcement Actions

With Halloween looming, a discussion of skeletons that may be lurking in a health care provider’s closet is timely. Many of our previous posts, as well as the monthly Qui Tam Updates published by our Health Care Enforcement...more

FTC-DOJ Join Forces: Encourage Repeal/Retrenchment of Virginia CON Laws

The Federal Trade Commission (“FTC”) and Department of Justice Antitrust Division (“DOJ”) (collectively, “agencies”) issued a joint statement to Virginia’s Certificate of Public Need (“COPN”) Work Group, which was recently...more

OMB Receives Final Medicare Parts A and B 60-Day Overpayment Rule from CMS

On October 21, 2015, the Office of Management and Budget (OMB) received the Medicare Parts A and B overpayment final rule from CMS which is the last phase before the rule is issued in the Federal Register. While the text of...more

Tuomey Resolves Stark Law and False Claims Act Judgment for $72.4 Million

The Department of Justice announced on October 16, 2015 a settlement agreement with Tuomey Healthcare System that resolves a $237 million judgment against the system involving claims submitted to the Medicare program in...more

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