False Claims Act Insights - Are All Healthcare “Kickbacks” Subject to FCA Liability?
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Episode 303 --- Deep Dive into the HHS-OIG Compliance Program Guidance
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Proof in Trial: Appellate Edition: Integra Med Analytics LLC et al. v. Providence Health & Services et al.
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Hooper, Kearney and Macklin on Cutting Edge Topics in the False Claims Act
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Healthcare Headlines Episode 3 - Stay Ready: Trends in Healthcare False Claims Act Investigations
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Will the U.S. Supreme Court Weigh in on Hospice Prognostication? Industry Hopes to Preserve AseraCare Court Decision.
Medical Device Manufacturer THD Pays $700,000 to Resolve FCA Allegations - On September 6, the US Attorney’s Office for the District of Maryland announced that THD America, Inc., and its parent company, THD SpA of Italy,...more
Federal Court Permits Investors to Resume Kickback Suit Against Teva - After a two-year long stay, on August 30, Judge Karen S. Marston of the US District Court for the Eastern District of Pennsylvania ruled that investors...more
Each summer in recent years, the U.S. Department of Justice (DOJ) and associated fraud enforcement partners have indicted many health care defendants, in multiple cases across the country. This summer continued the tradition....more
Background on Indiana’s “Baby HSR” Law - Indiana passed Senate Bill 9 in March 2024, which requires an Indiana healthcare entity involved in a merger or acquisition with another healthcare entity with a value of at least...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
Gentiva, the renamed former Kindred at Home, agreed to pay $19.4 million to resolve claims that its predecessor company, Kindred at Home and related companies, violated the False Claims Act by retaining overpayments for...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
In April of 2024, Centers for Medicare & Medicaid Services (CMS) updated their list of Special Focus Facilities. Special Focus Facilities (SFFs) are “nursing homes that have a history of serious quality issues and are...more
Health Care Fraud and Money Laundering of $18 Million Leads to Prison Sentence for New York Pharmacy Owners - Two pharmacy owners from New York have been sentenced for using their pharmacies to submit fraudulent claims to...more
Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more
Employers must check its employees, contractors and vendors to see if an individual or organization is excluded from participating in federal and/or state programs. While there are a variety of exclusion programs at the...more
Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits - Daniel Hurt, the prior owner and operator of Fountain Health Services LLC, Verify Health, Landmark Diagnostics LLC, First Choice...more
The U.S. Attorney’s Office for the Eastern District of Michigan announced on May 8 that Michigan Ear Care PLLC and James Aronovitz, D.O. agreed to pay over $2 million to resolve allegations that they submitted false claims to...more
On April 11, the medical director and the owner of a pain clinic in Kentucky were sentenced to prison for their roles in a scheme to defraud federal healthcare programs and commercial insurance companies for medically...more
Looking for compliance education and networking in your area? SCCE & HCCA’s Regional Compliance & Ethics Conferences bring compliance practitioners from all disciplines together for convenient, local compliance education....more
Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...more
Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more
The following is a summary of selected 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...more
Effective June 30, 2023, the New Jersey Legislature amended the New Jersey False Claims Act (“NJFCA” or “Act”) to align it more closely with the federal False Claims Act (‘FFCA”) and, thus, make New Jersey eligible for a 10%...more
Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations - On February 28, the US Department of Justice (DOJ) announced the guilty plea of Andrew Maloney, who, along with his clinical laboratory...more
Department of Justice Designates First Chief AI Officer - On February 22, the US Department of Justice (DOJ) designated Jonathan Mayer as the DOJ’s first “Chief Science Technology Advisor and Chief Artificial Intelligence...more
ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more
False Claims Act (FCA) enforcement has routinely targeted false information supplied to Medicare and Medicaid. A new trend in false-reporting cases is emerging under the FCA’s broad authority — cybersecurity enforcement....more
On February 22, 2024, the Department of Justice (DOJ) released its annual statistical report (Annual Report) regarding settlements and judgments obtained in the False Claims Act (FCA) and fraud matters for Fiscal Year (FY)...more