News & Analysis as of September 19, 2024

Medicaid › Financial Conduct Authority (FCA)

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Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +

Judge Endorses Extrapolation Techniques for False Claims Act Whistleblowers

Polsinelli on 5/7/2015

In a lawsuit brought under the False Claims Act ("FCA") a federal district judge in Florida recently rejected a defendant's challenge to a statistical sampling and extrapolation methodology advanced by a qui tam plaintiff's...more

CMS Delays 60-Day Rule, But Overpayment Case Law Emerging

Mintz - Health Care Viewpoints on 2/24/2015

The Centers for Medicare & Medicaid Services (CMS) recently announced a one-year delay in finalizing the long-awaited and closely watched rule addressing the 60-day deadline to return Medicare and Medicaid overpayments (the...more

False Claims Act – 2014 Year in Review

Parker Poe Adams & Bernstein LLP on 2/23/2015

The False Claims Act (FCA) imposes liability on individuals and companies who defraud or submit false claims to the federal government. The FCA allows the federal government to seek treble damages, civil penalties and...more

2014—A Record-Setting Year for Whistleblowers

Ogletree, Deakins, Nash, Smoak & Stewart,... on 2/23/2015

2014 was a record-breaking year for whistleblowers, including both the U.S. Department of Justice’s prosecution of cases under the False Claims Act (FCA) and the U.S. Securities and Exchange Commission’s prosecution of cases...more

Commission-Based Sales Agreements for Medical Supplies and Equipment: More Whistleblower Activity on the Horizon? - A Wide Range...

Holland & Knight LLP on 7/1/2014

The common industry practice of compensating independent contractor sales representatives on a "percentage of sales" commission basis may be creating an enhanced risk of False Claims Act liability for illegal kickbacks in...more

Second Circuit Dismisses $50 Million FCA Suit

Proskauer - Government Contractor Compliance... on 5/28/2014

Last week, the United States Court of Appeals for the Second Circuit affirmed the dismissal of a False Claims Act (“FCA”) whistleblower suit seeking $50 million in damages from Huron Consulting Group Inc. (“Huron”) for...more

Long Island Radiology Group Settles FCA Allegations That It Billed Medicaid And Medicare For Unnecessary Tests For $15.5M

Benesch on 3/7/2014

A company operating diagnostic testing facilities in New York has agreed to pay $13.65 million to the federal government and $1.85 million to New York and New Jersey for a total of $15.5 million in penalties to settle claims...more

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