News & Analysis as of

Fraud and Abuse

Morgan Lewis

Philadelphia Enacts Ordinance to Protect Residents From Unfair or Deceptive Trade Practices

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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

Dentons

Ep. 30 – Ensuring Payments to Physicians for Administrative Services Meet a Stark Exception

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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

Rivkin Radler LLP

Radiology Practice to Pay $8.9M to Resolve FCA/AKS Claims

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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

Husch Blackwell LLP

False Claims Act Insights - Are All Healthcare “Kickbacks” Subject to FCA Liability?

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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

Jones Day

Eighth Circuit Holds Penalties in Non-Intervened FCA Case Violate Excessive Fines Clause

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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

Ogletree, Deakins, Nash, Smoak & Stewart,...

IRS Resumes Processing New Claims for Employee Retention Credit

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

Whiteford

Corporate Practice of Medicine, Antikickback and Stark Analysis After the AAEM-PG and Envision Settlement

Whiteford on

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

King & Spalding

OIG Updates Fraud and Abuse Authorities FAQs

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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

The Volkov Law Group

DaVita Pays $34 Million to Settle Kickback Violations

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DaVita is a regular target of government enforcement actions involving fraud and illegal kickbacks.  It has an extensive history of violations and settlements....more

Foley Hoag LLP - White Collar Law &...

Justice Department Highlights Commitment to Successful and Ongoing Health Care Fraud Enforcement Efforts Nationwide

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

The Volkov Law Group

The Continuing Plague of Healthcare Fraud

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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

Bradley Arant Boult Cummings LLP

The Overturn of Chevron: A New Design for Healthcare Law

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

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2024

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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

Amundsen Davis LLC

[Webinar] Health Care Compliance: Developing and Implementing an Effective Program - July 23rd, 12:00 pm CT

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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

Robinson+Cole Health Law Diagnosis

DOJ Charges 36 Defendants in Connection with Telemedicine and Clinical Laboratory Fraud and Abuse Schemes

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

Wiley Rein LLP

Hot Fraud Summer: DOJ’s Latest Criminal Takedown

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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

Farrell Fritz, P.C.

SDNY Sues Labs For Fraudulent COVID-19 Testing Under False Claims Act

Farrell Fritz, P.C. on

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

Bass, Berry & Sims PLC

OIG Advisory Opinion 24-03 Greenlights Travel and Lodging Assistance for Gene Therapy Patients

Bass, Berry & Sims PLC on

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

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | May 2024 Recap

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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

K&L Gates LLP

The False Claims Act and Health Care: 2023 Recoveries and 2024 Outlook

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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

ArentFox Schiff

Investigations Newsletter: District Court Declines to Stay Case Pending Resolution of FCA Causation Standard Issue Before Court of...

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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

Vinson & Elkins LLP

DOJ’s Crackdown on Government Contractors/Defense Contractors: Best Practices for Responding to False Claims Act CIDs

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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

Health Care Compliance Association (HCCA)

The Latest on Healthcare Enforcement

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

Bradley Arant Boult Cummings LLP

Elder Wire Fraud Scams Rising, Produce Huge Losses

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

McDermott Will & Emery

[Event] Physician Practice Management and ASC Symposium 2024 - May 15th - 16th, Nashville, TN

The Physician Practice Management (PPM) and ASC Symposium 2024 is the destination event for PPM and ASC industry leaders and health industry investors. Join us as we deliver actionable insights on the state of the market and...more

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