News & Analysis as of

Medicare Compliance Fraud

Snell & Wilmer

Scope of FCA Liability Illustrated In Recent Actions Against Higher Education Institutions

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In the past five years, the Federal Government and “Qui Tam” Realtors have ramped up False Claims Act (“FCA”) actions against higher education institutions. These actions highlight the scope and breadth of potential FCA...more

ArentFox Schiff

Investigations Newsletter: Binance to Pay Historic $4 Billion Fine

ArentFox Schiff on

Binance to Pay Historic $4 Billion Fine - Binance Holdings Limited, the operator of the world’s largest cryptocurrency exchange, agreed to pay $4.3 billion to resolve allegations that it violated the Bank Secrecy Act (BSA)...more

WilmerHale

Criminal Indictment for Medicare Advantage Fraud

WilmerHale on

The U.S. Department of Justice (DOJ) recently announced a rare criminal indictment involving the Medicare Advantage program—a contrast from DOJ’s more typical use of its civil enforcement authority to pursue similar issues...more

King & Spalding

OIG Principal Deputy Inspector General Speaks at AHLA Fraud and Compliance Forum

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On September 22, 2021, OIG Principal Deputy Inspector General Christi Grimm delivered a keynote speech to the American Health Law Association (AHLA) Fraud and Compliance Forum. Consistent with her remarks this spring at the...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

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 35. News Briefs: October 2020

Report on Medicare Compliance 29, no. 35 (October 5, 2020) - In a major national enforcement action, the Department of Justice (DOJ) and other federal agencies said Sept. 30 they have charged 345 people, including more...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 25. News Briefs: July 2020

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  -  Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 16. News Briefs: April 2020 #3

Report on Medicare Compliance 29, no. 16 (April 27, 2020) - The HHS Office of Inspector General (OIG) has proposed a rule on civil monetary penalties (CMPs) for information blocking and fraud related to HHS grants, contracts...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 5. News Briefs: February 2020 #2

Report on Medicare Compliance 29, no. 5 (February 10, 2020)  - David Laufer, the former chief of the Prosthetics and Orthotics Department at Walter Reed National Military Medical Center in Bethesda, Maryland, was charged...more

Health Care Compliance Association (HCCA)

Report on Research Compliance, News Briefs: November 2019

Report on Medicare Compliance 28, no. 36 (Oct. 14, 2019). - NIH should “update its guidance on vetting peer reviewer nominees to identify potential foreign threats to research integrity” and “develop a risk-based approach...more

Ruder Ware

ASLMS Annual Meeting Special Coverage: Legal and Compliance Issues Impacting Medical Practices Using Laser Technology

Ruder Ware on

Medical practices that routinely use laser technology are subject to some of the same legal issues as other types of practices. Use of lasers creates additional compliance issues and highlights certain compliance risk areas....more

Ruder Ware

Three Recent Fraud Cases Involving Dermatologists Illustrate Primary Compliance Risks in Dermatology Practices

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Three relatively recent cases involving dermatology billing practices illustrate some of the main compliance risks faced by dermatology practices...more

McDermott Will & Emery

OIG Issues New Exclusion and CIA Guidance

McDermott Will & Emery on

On April 18, 2016, Inspector General Daniel R. Levinson announced the publication of updated guidance on how the Office of Inspector General (OIG) makes decisions about using its permissive exclusion authority and requiring...more

BakerHostetler

Foreign Corrupt Practices Act 2015 Update

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Despite a decline in enforcement actions by the Securities Exchange Commission (“SEC”) and the Department of Justice (“DOJ”), the first half of 2015 has continued to highlight the relevance and ever-evolving effects of the...more

The Volkov Law Group

Defrauding Medicare — A Little Help from the Private Sector?

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The headline on Medicare last week was astounding — $60 billion (not million) was lost each year to Medicare fraud, large numbers of fraudulent providers were providing fake or bad addresses – meaning locations including...more

Foley & Lardner LLP

The Medicaid Fraud Control Units: Fiscal Year 2014 Report

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The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2014 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCUs)...more

Bradley Arant Boult Cummings LLP

False Claim Act: 2013 Year in Review

Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more

Mintz - Health Care Viewpoints

Health Care Enforcement in 2012: A Year in Review

Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more

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