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Investigations Medicare

Gardner Law

Kickbacks and Consequences: Lessons from the Innovasis Settlement

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On May 29, 2024, the U.S. Department of Health and Human Services’ Office of Inspector General (HHS OIG) announced a $12 million settlement with Innovasis Inc., a medical device manufacturer, and two of its senior executives...more

Davis Wright Tremaine LLP

21st Century Cures Act Information Blocking Rule Finally Has Teeth With Respect to Providers

On July 1, 2024, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) published a final rule...more

Mintz - Health Care Viewpoints

DOJ Releases COVID-19 Fraud Enforcement Task Force Report Touting Its Successes and Urging Lawmakers to Enact New Legislation

The government’s continued dedication of resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs appears to have borne fruit according to the results of the COVID-19 Fraud Enforcement Task...more

Society of Corporate Compliance and Ethics...

[Event] Regional Compliance & Ethics Conference - May 3rd, Lewis Center, OH

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

Health Care Compliance Association (HCCA)

[Event] Regional Compliance & Ethics Conference - May 3rd, Lewis Center, OH

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

Foley & Lardner LLP

Health Care Private Equity: Senate Budget Committee Investigates Hospital Ownership 

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On December 7, 2023, the Senate Budget Committee (the “Committee”) launched a bipartisan investigation into the reality of private equity ownership of hospitals in the United States. This investigation stems from concerns...more

Sheppard Mullin Richter & Hampton LLP

EMTALA and Pregnancy Care Remains a Federal Enforcement Priority

On May 1, 2023, the Centers for Medicare and Medicaid Services (“CMS”) announced two investigations of hospitals that failed to offer necessary stabilizing care to a pregnant individual experiencing an emergency medical...more

White & Case LLP

Five Drug Pricing Issues to Watch in 2023

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Despite a busy 2022, drug pricing remains a hot topic at the federal and state levels, with a number of recent developments and trends worth monitoring heading into 2023. In the past year, the FTC increasingly focused on the...more

Verrill

Maine, New Hampshire, & Vermont Remain DOJ Health Care Enforcement Priorities: Targeted Federal Enforcement Presents Serious Risk

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The United States Department of Justice (DOJ) has recently emphasized that Maine, New Hampshire, and Vermont are priorities for health care investigations and anticipated significant enforcement. Even well-managed (and...more

Health Care Compliance Association (HCCA)

[Event] Research Compliance Conference - June 8th - 10th, Anaheim, CA

Hear about the latest in research compliance - Do you want to learn… - How to prepare for upcoming changes in Medicaid? - Ways to build and maintain a better research compliance work plan for your program? - How...more

Foley & Lardner LLP

What’s New in ’22: More DOJ-Driven False Claims Act Investigations

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On February 1, 2022, the Department of Justice (DOJ) issued its annual release touting its latest accomplishments in the False Claims Act field, advertising another multibillion-dollar year in recoveries; $5.6 billion makes...more

Oberheiden P.C.

What You Need to Know About Continuous Glucose Monitoring Compliance

Oberheiden P.C. on

For diabetic patients and the doctors who treat them, blood sugar levels are crucially important. However, the traditional method of testing one’s blood sugar with a pin-prick is undesirable for many patients, which leads to...more

Health Care Compliance Association (HCCA)

[Event] Scottsdale Regional Healthcare Compliance Conference - November 5th, Scottsdale, AZ

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Oberheiden P.C.

Federal Authorities Place Cardiovascular Stress Testing Under the Microscope

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Cardiovascular stress testing to diagnose patients with coronary artery disease (CAD) and other related types of conditions can be a highly-effective tool in many cases. In fact, many cardiologists routinely recommend stress...more

King & Spalding

Seventh Circuit Upholds Dismissal of Medicare Overpayment Lawsuit Brought by Home Health Agency for Failing to Complete...

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On June 3, 2021, the Seventh Circuit upheld a decision by the U.S. District Court of the Northern District of Illinois to dismiss a home health agency’s lawsuit against a Medicare integrity contractor for temporarily...more

BakerHostetler

Biden's New HHS Secretary Promises "Robust Enforcement"

BakerHostetler on

Introduction - On March 18, 2021, the Senate narrowly confirmed Xavier Becerra, the former attorney general of California, as U.S. Department of Health and Human Services (“HHS”) Secretary....more

ArentFox Schiff

Investigations Newsletter: Despite Decrease in 2020 False Claims Act Recoveries, Investigations and Litigation Expected to Rise...

ArentFox Schiff on

Despite Decrease in 2020 False Claims Act Recoveries, Investigations and Litigation Expected to Rise Under the Biden Administration - As previously detailed by Arent Fox, total False Claims Act (FCA) recoveries for the...more

K&L Gates LLP

Qui Tam Quarterly - COVID-19 and the Big-Data Revolution of Health Care False Claims Act Litigation

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This edition of Qui Tam Quarterly focuses on: - the history of big data in health care FCA investigations and litigation; - how the government has increased its ability to gather health care claims data and use it to...more

Sheppard Mullin Richter & Hampton LLP

Nursing Home Liability Waivers and Nursing Home Investigations and Enforcement: A Delicate Balance During the COVID-19 Pandemic

As we discussed in our April 27, 2020 blog post, nursing homes have become the focus of significant attention during the COVID-19 crisis. In many respects, the attention is well deserved: 1. Nursing homes traditionally...more

Health Care Compliance Association (HCCA)

[Event] 2020 Clinical Practice Compliance Conference - October 26th - 28th, Atlanta, GA

Our annual Clinical Practice Compliance Conference provides information about the latest government initiatives related to physicians and clinics, and physician integrity trends. Unite with your colleagues to discuss...more

Cooley LLP

Blog: HHS OIG Hands Out 2015 Work Plan For Halloween

Cooley LLP on

On Friday October 31, 2014, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) released its annual “Work Plan” for fiscal year 2015. The Work Plan is a compilation of the OIG’s plans for...more

King & Spalding

CMS Announces New Unified Program Integrity Contractors

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CMS recently announced plans to implement a new Medicare and Medicaid program integrity contractor, Unified Program Integrity Contractors (UPICs). ...more

King & Spalding

OIG Reports on Observation Stays and Short Inpatient Stays for Medicare Beneficiaries

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The Office of Inspector General (OIG) recently published the results of a study regarding hospitals’ use of observation stays and short inpatient stays for Medicare beneficiaries, citing CMS concerns as one of the reasons for...more

Baker Donelson

Deferred Prosecution Agreements: How an Effective Compliance Program Can Help You Plan for the Unpredictable

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During the past several years, prosecutors have increasingly used Deferred Prosecution Agreements (DPAs) against corporations in enforcing white collar criminal statutes. DPAs have enabled companies to avoid the costs and...more

King & Spalding

Healthcare Sector Under Scrutiny: Congressional Oversight of the Affordable Care Act by Daniel F. Donovan and William Clarkson

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"I've long maintained that there are three possible routes to repeal of ObamaCare: the courts, the presidential election, and our constitutional responsibility for oversight. With two of them having come up short, the third...more

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