False Claims Act Insights - Are All Healthcare “Kickbacks” Subject to FCA Liability?
The Latest on Healthcare Enforcement
Episode 303 --- Deep Dive into the HHS-OIG Compliance Program Guidance
Litigating Elder Financial Exploitation Cases: Defending Banks in a Tough Spot — The Consumer Finance Podcast
UPIC Report Card: The OIG’s Evaluation of the UPICs Provides Insight Into the Future of Hospice Audits
Health Care Fraud and Abuse Control Program FY 2021 Report
Forecast for Telehealth Fraud and Abuse Risk in 2021 - Diagnosing Health Care Podcast
Fraud and Abuse Enforcement Priorities in the Wake of COVID-19 - Diagnosing Health Care Podcast
Nota Bene Episode 37: How to Prevent or Defend Against Business Crimes with Chuck Kreindler
Value-based health care: fraud & abuse laws
Value-based health care: issues for pharmaceutical companies
Federal whistleblowers have been exposing health care fraud for years. The False Claims Act (“FCA”) contains robust whistleblower provisions and protections that reward whistleblowers with financial payouts. The process for...more
Philadelphia joins other major US cities in passing a local law to address consumer fraud and abuse. With its newfound enforcement authority, the Philadelphia Law Department can investigate and initiate legal action against...more
Providers will often pay physicians for serving in important administrative roles within the organization. Compensation for administrative services can create risk to the organization under multiple laws, including the...more
The U.S. Attorney’s Office for the Southern District of Texas announced on August 20 that National Interventional Radiology Partners PLLC (NIRP) and its founder and CEO will pay $8,884,091 to the United States to resolve...more
Host Jonathan Porter welcomes Georgia Deputy Attorney General Jim Mooney to the show to explore the intersection of the False Claims Act (FCA) and the federal Anti-Kickback Statute (AKS). Our discussion begins with an...more
The Situation: The False Claims Act ("FCA") imposes treble damages on defendants, as well as mandatory penalties per false claim. Because alleged false claims often involve much smaller amounts—for example, in cases with a...more
After lifting the moratorium on processing tax refund claims, the Internal Revenue Service (IRS) has begun processing a large backlog of claims for the employee retention tax credit (ERC), aimed at businesses impacted by...more
The American Academy of Emergency Medicine Physician Group (AAEM-PG) recently settled a lawsuit in United States District Court for the Northern District of California against Envision Healthcare and Envision Physician...more
On July 8, 2024, OIG updated the Frequently Asked Questions on its website, adding four new questions and answers to its General Questions Regarding Certain Fraud and Abuse Authorities...more
DaVita is a regular target of government enforcement actions involving fraud and illegal kickbacks. It has an extensive history of violations and settlements....more
On the heels of a nationwide sweep in June 2024, in which almost 200 defendants who allegedly committed over $2.7 billion in health care fraud were charged by the U.S. Department of Justice (“DOJ”) Health Care Fraud Unit...more
Healthcare fraud is an ever-growing constant in our economy. It is a battle that presents new and exponential challenges. The U.S. Department of Justice, the HHS-Office of Inspector general and State Attorneys’ General all...more
On June 28, 2024, SCOTUS overturned the long-standing Chevron doctrine in its decision Loper Bright Enterprises v. Raimondo and Relentless v. Department of Commerce. The Court’s ruling will have a significant impact on...more
Halfway through 2024, the government’s False Claims Act (FCA) enforcement efforts show few signs of letting up. Last month alone, the Department of Justice (DOJ) announced at least five eight-figure FCA settlements,...more
Join Suzannah Wilson Overholt and Moses Suarez for a discussion of federal guidance impacting compliance programs in the health care setting and critical steps in implementing those programs, including the roles of risk...more
On June 27, 2024, the Department of Justice (DOJ) announced its 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants for alleged participation in various health care...more
The U.S. Department of Justice (DOJ) Criminal Division’s Health Care Fraud Strike Force announced the results of its latest nationwide enforcement action on June 27, 2024, one year (almost to the day) since its last major...more
The SDNY U.S. Attorney’s Office has targeted several labs and their principals for False Claims Act violations arising out of reimbursements for COVID-19 testing services. In a complaint filed on June 13, the government sued...more
On June 17, the U.S. Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion 24-03, approving an arrangement under which a pharmaceutical manufacturer provides travel, lodging, and...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for May 2024. We discuss several notable cases and enforcement resolutions, including the US Court of Appeals for the District of...more
On 22 February 2024, the US Department of Justice (DOJ) published the statistics for federal civil fraud recoveries in Fiscal Year (FY) 2023. The DOJ announced that the “government and whistleblowers were party to 543...more
District Court Declines to Stay Case Pending Resolution of FCA Causation Standard Issue Before Court of Appeals - Earlier this week, a Massachusetts federal judge denied a motion to stay proceedings filed by Medtronic,...more
In 2023, the Department of Justice (DOJ) achieved a record-breaking number of recoveries under the False Claims Act (“FCA”), underscoring its ongoing commitment to combating fraud against the federal government. Government...more
Healthcare enforcement is never quiet. There’s always something, or many things, going on, and compliance teams need to stay on top of the trends to ensure that their programs are staying ahead of the risks. To find out...more
As part of implementing a robust cybersecurity standard, we must understand how bad actors are intentionally targeting our older colleagues and loved ones. On April 30, 2024, the U.S. Department of Justice (DOJ) announced...more