News & Analysis as of

False Claims Act (FCA) Administrative Procedure Act

Burr & Forman

Federal Agency Deference Eliminated, Now What?

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On June 28, 2024, the U.S. Supreme Court issued a decision that overrules the “Chevron doctrine.”  This means that federal agencies are limited in their ability to rely on their own interpretation of the laws they...more

Stevens & Lee

Welcome to the Post-Chevron World: HHS on the Defensive

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The Supreme Court’s recent ruling in Loper Bright Enterprises v. Raimondo (and its companion case, Relentless v. Department of Commerce), in which it overruled the Chevron doctrine, has received a great deal of attention...more

Foley & Lardner LLP

Chevron’s Demise Creates New False Claims Act Defenses

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The demise of Chevron opens up new potential defenses in False Claims Act (FCA) cases. On June 28, 2024, the Supreme Court, in Loper Bright Enterprises v. Raimondo, put an end to Chevron deference to agency interpretation...more

McDermott Will & Emery

[Hybrid Event] Healthcare Litigation, Compliance and Investigations Forum 2023 - November 1st, Chicago, IL

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McDermott’s Healthcare Litigation, Compliance and Investigations Forum is back when you need it the most. Heightened regulatory scrutiny and enforcement activity pose legal, financial and reputational risks for healthcare...more

Health Care Compliance Association (HCCA)

Hooper, Kearney and Macklin on Cutting Edge Topics in the False Claims Act

While the pandemic put many things on hold, it did not do the same for the False Claims Act (FCA). To find out what is happening in FCA activity we spoke with Patrick Hooper, Jordan Kearney and Alicia Macklin, partners at the...more

WilmerHale

Weekly COVID-19 Oversight & Enforcement Report - April #4

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Pressure is increasing on the Biden Administration to release the delayed Emergency Temporary Standard (ETS) to protect workers from COVID-related risks. On April 26, Representatives Debbie Dingell (D-MI), Rashida Tlaib...more

Cozen O'Connor

Impostor Government Invoices | Car Dealer Employees Working Without Pay? | Democratic AGs v. Trump Administration

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State AGs in the News- Alaska Governor Nominates Acting Attorney General to Be Attorney General- •Alaska Governor Mike Dunleavy nominated acting Alaska AG Clyde “Ed” Sniffen for the AG position. The nomination must be...more

Cozen O'Connor

COVID-19 Fake Cures | Accuracy In Debt Collection Reporting | North Carolina AG Reelected

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2020 AG Elections- Just Called: Incumbent Attorney General Wins Second Term in North Carolina- •North Carolina AG Josh Stein (D) won reelection in a closely watched race over Jim O’Neill (R) by a margin of 51% to 49.9%....more

McDermott Will & Emery

Healthcare Enforcement Quarterly Roundup - Q4 2019

In this installment of the Healthcare Enforcement Quarterly Roundup we cover several topics that have persisted over the past few years and identify new issues that will shape the scope of enforcement efforts in 2020. In this...more

Polsinelli

CMS Outlines New Standard for Challenging Medicare Payment Denials, Echoing Brand Memo on Force of Sub-Regulatory Guidance

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On October 31, 2019, the Office of General Counsel for the U.S. Department of Health and Human Services (HHS) issued an important memo from Kelly M. Cleary, CMS Chief Legal Officer, and Brenna E. Jenny, Deputy General...more

Holland & Knight LLP

Healthcare Law Update: October 2019

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In recent years, the healthcare industry has been turning greater attention to the need to engage or involve patients in developing new technologies and systems to improve healthcare delivery. These patient engagement...more

Bass, Berry & Sims PLC

Medicare Advantage: Recent Developments in FCA Enforcement

The Medicare Advantage program, which allows private insurance companies to offer and administer Medicare benefits, continues to be an area of sharp scrutiny for False Claims Act (FCA) enforcement despite some significant...more

Jones Day

D.C. District Court Vacates 60-Day Medicare Advantage Overpayment Rule

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The Situation: In 2016, several Medicare Advantage ("MA") organizations challenged a 2014 final rule promulgated by the Center for Medicare Services ("CMS") that broadly subjected MA organizations to potential liability under...more

Epstein Becker & Green

Reimbursement Issues Worth Noting: Administrative Law and False Claims Act Implications

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News of two distantly related reimbursement issues with administrative law and False Claims Act (“FCA”) implications is worth noting....more

Sheppard Mullin Richter & Hampton LLP

CMS’ Medicare Advantage Overpayment Rule: Arbitrary, Capricious, and Vacated

In a key case being watched by the industry, Judge Collyer of the United States District Court for the District of Columbia issued an opinion today granting UnitedHealthcare’s Motion for Summary Judgment in UnitedHealthcare...more

Foley & Lardner LLP

DOJ Memoranda Ushering in New Era for Health Care Enforcement

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In January 2018, the Department of Justice (DOJ) issued two memoranda that, taken together, may usher in a new era of False Claims Act (FCA) enforcement in the health care industry. The first memorandum, dated January 10,...more

McDermott Will & Emery

Guidance on Guidance: DOJ Limits Use of Agency Guidance Documents in Civil Enforcement Cases

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In a two-page memorandum, the US Department of Justice (DOJ) announced a broad policy statement prohibiting the use of agency guidance documents as the basis for proving legal violations in civil enforcement actions,...more

Holland & Knight LLP

Contractors Need to Fully Address False Claims Act Allegations During Suspension or Debarment Proceedings

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Companies involved in False Claims Act suits filed by qui tam relators often find themselves facing potential suspension or debarment from federal contracting. A recent decision out of the United States District Court for the...more

Polsinelli

DOJ Doubles FCA Civil Penalties

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As required by last November's Bipartisan Budget Act of 2015, the Department of Justice on June 30 released an interim final rule making inflationary adjustments to civil monetary penalties under its jurisdiction, including...more

Dorsey & Whitney LLP

The Supreme Court - May 2016 #4

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The Supreme Court of the United States issued decisions in three cases on May 31, 2016: Army Corps of Engineers v. Hawkes, No. 15-290: Three mining companies sought a permit under the Clean Water Act seeking to...more

McDermott Will & Emery

Focus on Tax Controversy - December 2013

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In This Issue: A Decade of Lessons Learned from State Tax False Claims Act Cases; Second Circuit Reaffirms Taxpayer’s Use of Protective Refund Claims; and Challenging Regulations After Mayo and Home Concrete. ...more

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