News & Analysis as of

Fraud Office of the Inspector General False Claims Act (FCA)

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Health Care Compliance Association (HCCA)

Missing COI Program, Fabricated Outreach, Job, Health Records: The Many Types of Falsehoods

Report on Research Compliance 21, no. 9 (September, 2024) - How many types of falsehoods might sully applications for research funds and the studies they support? Unfortunately, the most recent semiannual report to...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - July 2024

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

American Conference Institute (ACI)

[Event] FCPA & Anti-Corruption for the Life Sciences Industry - May 9th - 10th, New York, NY

Hosted by the American Conference Institute, the 19th Annual FCPA & Anti-Corruption Conference for the Life Sciences Industry returns for another exciting year with carefully researched programming based on critical findings...more

Venable LLP

Federal Efforts to Incentivize States to Promulgate False Claims Statutes

Venable LLP on

The federal False Claims Act (FCA) is widely regarded as a powerful tool to punish fraud against the federal government. Since 1986, the federal government has recovered more than $75 billion from FCA settlements and...more

Hendershot Cowart P.C.

Doctors: Don’t Fall Victim To Telemedicine Fraud Schemes

Hendershot Cowart P.C. on

Telemedicine companies are supposed to facilitate medically necessary services to beneficiaries over the telephone via licensed medical professionals. In reality, however, many of these “telemedicine companies” are...more

Mintz

EnforceMintz — COVID-19 Fraud Enforcement Unlikely to Slow Down in 2024

Mintz on

The government continued to dedicate enormous resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs in 2023. While we observed some civil False Claims Act settlements, criminal enforcement...more

Mintz

EnforceMintz — Tele-Fraud Enforcement in 2023 Remained Focused on Same Schemes as Years Past

Mintz on

Government enforcement activities focused on tele-fraudsters remained active in 2023, but did not break substantial new ground. Several significant criminal resolutions last year involved allegations that were similar to each...more

Foley & Lardner LLP

Remote Patient Monitoring: OIG Issues Consumer Alert

Foley & Lardner LLP on

On November 22, 2023, while many were preparing for the Thanksgiving holiday, the Office of Inspector General (OIG) posted a consumer alert (Alert) warning the public about a fraud scheme involving monthly billing for remote...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | April 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for April 2023. We discuss several criminal and civil enforcement actions related to the Anti-Kickback Statute (AKS) and the...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

Mintz - Health Care Viewpoints

EnforceMintz — With Telemedicine Here to Stay, Enforcement Agencies Continued their Scrutiny

The Department of Justice and other federal enforcement agencies continued to hotly pursue individuals and entities involved in criminal telefraud schemes in 2022, as evidenced by the national coordinated law enforcement...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Self-Disclosures

Bass, Berry & Sims PLC on

When healthcare providers and other government contractors are subject to scrutiny for bills submitted to the government, it is often the result of a whistleblower complaint filed under the qui tam provisions of the False...more

Cozen O'Connor

Sham Transactions in Digital Health Industry

Cozen O'Connor on

In its recently published Special Fraud Alert, the Office of Inspector General (“OIG”) presented a list of suspect characteristics related to arrangements with telehealth and telemedicine companies, which may help determine...more

Mintz - Health Care Viewpoints

The Government's Long Game for Investigating COVID-era Relief Fraud

n a recent article in the New York Times, David Fahrenthold outlined the big issue facing prosecutors investigating COVID-era fraud: the sheer magnitude of it. The title of the article, “Prosecutors Struggle to Catch Up to a...more

Harris Beach PLLC

OIG Enforcement Summary: August 1, 2022 – August 15, 2022

Harris Beach PLLC on

The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more

Harris Beach PLLC

OIG Enforcement Summary: July 16, 2022 – July 31, 2022

Harris Beach PLLC on

The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more

Wilson Sonsini Goodrich & Rosati

OIG Special Fraud Alert Lists Suspect Characteristics in Telemedicine and Telehealth Arrangements

Based on recent enforcement actions and increased scrutiny in telemedicine, the Office of Inspector General (OIG) recently published a Special Fraud Alert regarding fraud concerns in arrangements between healthcare...more

ArentFox Schiff

OIG Warns Health Care Practitioners About Fraud Schemes With Telemedicine Companies in Special Fraud Alert

ArentFox Schiff on

On July 20, 2022, the HHS Office of Inspector General (OIG) issued a Special Fraud Alert cautioning physicians and other health care practitioners to use “heightened scrutiny” when entering into telemedicine arrangements that...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Medical Practitioners Beware: Telemedicine Schemes May Result In Unexpected Liability

Takeaway: Medical practitioners should exercise extreme caution when entering into telemedicine agreements, in order to avoid unintended civil and criminal consequences. It is advisable to consult with an attorney before...more

Foley & Lardner LLP

OIG Special Fraud Alert on Arrangements with Telemedicine Companies

Foley & Lardner LLP on

On July 20, 2022, HHS-OIG published a new Special Fraud Alert on arrangements with telemedicine companies, setting forth seven characteristics OIG believes could suggest a given arrangement poses a heighted risk of fraud and...more

Rivkin Radler LLP

NY Pharmacy Owner Sentenced for Healthcare Fraud

Rivkin Radler LLP on

A New York woman was sentenced last month to 78 months in prison for defrauding healthcare programs, including obtaining more than $6.5 million from Medicare Part D plans and Medicaid drug plans....more

Mintz - Health Care Viewpoints

OIG Expresses Concern about Laboratory Specimen Collection Payments to Hospitals in AO 22-09

Last week, the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) issued Advisory Opinion No. 22-09 (AO 22-09), which addresses a proposed arrangement pursuant to which the operator of a...more

ArentFox Schiff

Investigations Newsletter: Physician Partners of America Agrees To Pay $24.5 Million To Resolve False Claims Act Allegations

ArentFox Schiff on

Physician Partners of America Agrees To Pay $24.5 Million To Resolve False Claims Act Allegations - Physician Partners of America LLC (PPOA), its founder, and its former chief medical officer agreed to pay $24.5 million to...more

Arnall Golden Gregory LLP

Government Investigations Team Insights - February 2022

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics.  In this edition, we analyze a recent Eleventh Circuit decision addressing False Claims Act penalties and the...more

Health Care Compliance Association (HCCA)

Two Washington Universities Ink Settlements For Exceeding Salaries, Falsified Application

Report on Research Compliance 18, no. 12 (December, 2021) - Washington State University’s (WSU) recent settlement with the HHS Office of Inspector General (OIG) for more than $800,000 followed a university-wide audit that...more

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