News & Analysis as of

Kickbacks

Hospital and its Clinic Agree to $34 Million Settlement to False Claims Act Allegation that Compensation to Oncologists Violated...

Last week, the Department of Justice (DOJ) entered into a $34 million settlement with Mercy Hospital Springfield (“Hospital”) of Springfield, Missouri, and its affiliate Mercy Clinic (“Clinic”). The settlement resolves an...more

Operationalizing Compliance: Part III – Human Resources

by Thomas Fox on

This week I am engaging in a week-long series on how a Chief Compliance Officer (CCO) or compliance practitioner might think about operationalizing a compliance program with other corporate functions and disciplines. I am...more

South Korea Fines Prominent Pharmaceutical Manufacturer in Latest Anti-Corruption Enforcement Efforts

by Ropes & Gray LLP on

In a sign that South Korea is ramping up its anti-corruption enforcement efforts, Korean authorities announced on April 27 that they plan to levy a $48 million fine against Swiss pharmaceutical giant Novartis International AG...more

Revenue sharing costs money

by Ary Rosenbaum on

I guess my comments regarding revenue sharing is a bit sarcastic, but I think accurate. While revenue sharing payments from mutual funds to TPA to help defray the costs of administration of a plan sponsor’s plan is legal, it...more

Appellate Court Notes

by Pullman & Comley, LLC on

Supreme Court Advance Release Opinions: SC19734 - Wall Systems, Inc. v. Pompa - Plaintiff - construction company - discovered one of its supervisors who was paid ~$200k/year was working for a competitor at the same...more

The Downside of the Advice-of-Counsel Defense

by Faegre Baker Daniels on

Intent is a necessary element of a False Claims Act (FCA) violation. If a defendant reasonably relied on advice of counsel in performing the actions at issue, the intent element is absent. That’s the upside of the...more

Five Trends in False Claims Act Enforcement: Take Two

In July 2015, we posted about the N.Y. Attorney General’s False Claims Act (FCA) settlements with Trinity HomeCare and its related entities, and how the case provided insight into the future of FCA enforcement. We identified...more

Supreme Court to Resolve Whether Failure to Disclose under Item 303 of SEC Regulation S-K Gives Rise to Securities Fraud Claims

by Carlton Fields on

On March 27, 2017, the Supreme Court granted certiorari in the case of Leidos Inc., f/k/a SAIC Inc. v. Indiana Public Retirement System, a securities fraud class action. The case will resolve a circuit split over whether a...more

U.S. Supreme Court Agrees To Hear Securities Fraud Omissions Case

by Dorsey & Whitney LLP on

The U.S. Supreme Court will resolve a critical question governing the scope of liability in securities fraud cases which has split the circuit courts to date. The case, Leidos Inc. v. Indiana Public Retirement System, No....more

Is Disloyalty Its Own Reward?

May a disloyal employee keep the compensation his employer paid him, even while he was betraying his employer’s trust? In a recent case, the Connecticut Supreme Court said “yes, at least in some circumstances.” Here’s the...more

Mintz Levin Health Care Qui Tam Update: Recently Unsealed Whistleblower Cases

Featured Unsealed Cases United States ex rel. Thomas v. Best Choice Home Health Care Agency, Inc., No. 2:13-cv-02209 (D. Kan.) - Complaint Filed: May 6, 2013 - Complaint Unsealed: October 24, 2016...more

Connecticut Supreme Court Explains Remedies Available to Employers Winning Breach of Duty of Loyalty Claims against Employees

by Robinson & Cole LLP on

In Wall Systems, Inc. v. Pompa, No. SC19734 (Mar. 7, 2017), the Connecticut Supreme Court explained the legal and equitable remedies available to employers that win breach of duty of loyalty claims against their current or...more

SEC Charges Five Senior Executives With Financial Fraud

by Dorsey & Whitney LLP on

Five executives took advantage of their employer’s weak internal controls to repeatedly misappropriate funds, causing a loss of over $11 million over a four year period beginning in 2008. The scheme was discovered when a firm...more

Vavra Decision Highlights Avenues for Potential Anti-Kickback Act Liability

On February 3, 2017, the Fifth Circuit decided US ex rel Vavra v. Kellogg Brown & Root, No. 15-41623, 2017 WL 473873 (5th Cir. 2017), determining that defendant KBR could be held vicariously liable under the enhanced penalty...more

Health Care Fraud and Abuse in the Middle District of Florida in 2016 - a Year in Review

by Carlton Fields on

The United States Attorney’s Office (USAO) for the Middle District of Florida (USAO-MDFL) prosecuted several civil health care fraud matters in 2016 and issued related press releases. A review of the USAO-MDFL’s criminal and...more

Financial Services Weekly News - February 2017 #3

by Goodwin on

Editor's Note - A Not So New Tool for Reigning in Federal Regulations. President Trump has signed a Joint Resolution of Congress which “disapproves the rule submitted by the SEC relating to ‘Disclosure of Payments by...more

Mossack Fonseca Founders Arrested and Detained on Money Laundering Charges

by Ballard Spahr LLP on

The founders of Panamanian law firm Mossack Fonseca were arrested on Saturday, following their indictment on money-laundering charges allegedly tied to the ever-widening Petrobas corruption scandal in Brazil. Kenia...more

CFPB Takes First MSA-Related Action in Nearly Two Years; Orders Mortgage Lender to Pay $3.5M Civil Penalty for Kickbacks

by Goodwin on

On January 31, 2017, the Consumer Financial Protection Bureau (CFPB) announced that it ordered a California-based mortgage lender to pay $3.5 million in civil penalties for an illegal mortgage kickback scheme. According to...more

CFPB Fines Lender and Real Estate Brokers for Improper Kickback Scheme

by BakerHostetler on

On Jan. 31, 2017, the Consumer Financial Protection Bureau (CFPB) filed consent orders against one of the largest independent residential mortgage lenders, two real estate brokers and a mortgage servicer for their roles in an...more

15-Year-Old Whistleblower Lawsuit Survives Statute of Limitations Challenge

by Saul Ewing LLP on

The Eastern District of Pennsylvania recently allowed a fifteen-year old False Claims Act (“FCA”) qui tam action to proceed when it rejected a strict application of the statute of limitations and broadly construed the...more

Feds Two-Step on Texas Sovereignty has Far-Reaching Compliance Implications

by Polsinelli on

The recent federal grand jury indictment of 21 health care executives, investors, and physicians in connection with the now defunct Dallas-based Forest Park Medical Center effectively turned the Texas health care compliance...more

Relax, Sixth Circuit Opinion Indicates Rule 9(b) Pleading Requirement Still Has Bite

by Bass, Berry & Sims PLC on

A recent Sixth Circuit opinion in U.S. ex rel. Hirt v. Walgreen Co. should come as welcome news for FCA defendants concerned about the implications of the Sixth Circuit’s application last year, for the first time, of a...more

France tightens grip on industry payments to HCPs (again)

by Hogan Lovells on

On 19 January 2017, major modifications were adopted in France to the regulations on interactions between the industry and healthcare professionals (and other stakeholders). These new regulations, a.k.a. "anti-benefits...more

A Liar and A Cheat? 3 Ways to Pay...

by Seyfarth Shaw LLP on

Seyfarth Synopsis: Insurer gets to pick its remedy when hospital engages in dishonest billing and illegal kickbacks…to the tune of $41 million. Judge Lynn Hughes of the U.S. District Court for the Southern District of...more

NY Expands Jurisdictional Reach Over Foreign Banks Using Correspondent Accounts

by Bracewell LLP on

The New York Court of Appeals recently gave a leg-up to plaintiffs seeking to hale foreign banks before New York state courts, clarifying that the use of a New York-based correspondent account could, under certain...more

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Cybersecurity

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