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Anti Kickback and Stark Law Enforcement and Compliance Issues [Video]

The Department of Justice and the Health and Human Services-Office of Inspector General have aggressively been enforcing anti-kickback (AKS) and Stark laws. DOJ and HHS-OIG have combined these prohibitions with The False...more

The Intractable Problem of Medicare Fraud

You have to admire the vigilance and dedication of prosecutors and law enforcement investigators who fight Medicare fraud. There is no question that they have ramped up enforcement and promoted a strong message of deterrence....more

Questioning The Caremark Standard

The Justice Department’s aggressive enforcement program has had a profound impact on corporate governance. As a consequence, the last there has been a significant change in emphasis in the C-Suite, among general counsel and...more

Health Law Insights Newsletter - April 2014

In This Issue: - Federal Updates - State Updates - HIPAA Updates - Excerpt from Centers for Medicare & Medicaid Services Issues Guidance for Meaningful Use Hardship Exception: The Centers...more

DOJ OIG Report Critical Of Mortgage Fraud Enforcement Programs

On March 13, the DOJ Office of Inspector General (OIG) issued a report on its audit of the DOJ’s efforts between 2009 and 2011 to pursue alleged mortgage fraud. Of particular note, the report reveals for the first time...more

The Strike Force Approach To Combatting Health Care Fraud

The U.S. Department of Justice (DOJ), Health and Human Services Office of Inspector General (HHS-OIG) and other federal and state agencies are aggressively prosecuting health care fraud and related offenses through a strike...more

Healthcare Enforcement Actions and Trends: 2013 Overview

The Department of Justice (DOJ) and the Office of Inspector General for the U.S. Department of Health and Human Services continued aggressive enforcement of the healthcare industry in 2013. Officials employed a variety of...more

Health Care Enforcement in 2013: A Year in Review

In 2013, the U.S. Department of Justice (“DOJ”), Health and Human Services Office of Inspector General (“HHS-OIG”), and other federal and state agencies continued to aggressively prosecute health care fraud and related...more

Health Update -- Oct 23, 2013

Mapping The New Fraud And Abuse Landscape - In an age of increased government scrutiny and enforcement, providers, payers, pharmaceutical companies and medical device manufacturers, along with their business partners,...more

CMS Issues FAQs Regarding Self-Referral Disclosure Protocol

CMS has released its responses to eight frequently asked questions [PDF] regarding its Self-Referral Disclosure Protocol (SRDP). The questions fall into three categories, listed below, and respond to issues that are often...more

Federal Government Aggressively Pursuing Health Care Fraud

Proactive self-audits help providers identify potential problems - The Federal Government is using every tool available to fight health care fraud and recover overpayments from health care providers. According to the...more

"Health Care Enforcement Update: What Is in Store for the Next Five Years"

While predicting enforcement trends over the next five years is not without uncertainty, the best marker for future activity may be to look to the past. We believe that industry members and counsel can expect the Department...more

Intermountain Healthcare Settlement – Dangers Of Hospital Agreements With Physicians

Hospitals continue to be under the Department of Justice-HHS/Office of Inspector General microscope. DOJ-OIG is a potent combination and carry with them the threat of criminal prosecution, civil false claims enforcement and...more

$25.5 Million Settlement Agreement Reached Between Intermountain Health Care, Inc. and the United States Based on Self Disclosure...

On April 3, 2013, the Department of Justice (DOJ) and Intermountain Health Care, Inc. (Intermountain) entered into a settlement agreement resolving Intermountain’s potential liability under the Stark Law and False Claims Act....more

Infobytes - A Weekly In-depth review of news & developments in the financial services industry - March 22, 2013

In This Issue: - FEDERAL ISSUES - STATE ISSUES - COURTS - MISCELLANY - FIRM NEWS - FIRM PUBLICATIONS - MORTGAGES - BANKING - CONSUMER FINANCE - SECURITIES - E-COMMERCE -...more

State Medicaid Enforcement Efforts Net $2.9 Billion in Recoveries for FY 2012

New state health care fraud recovery statistics reinforce that both the federal and state governments remain committed to health care fraud enforcement and demonstrate that their efforts are paying dividends. Earlier this...more

The Healthcare Industry And The Voluntary Disclosure Process

It is always important to consider how different parts of the government handle voluntary disclosures. The FCPA enforcement initiative has been largely the result of the voluntary disclosure process, and the government...more

OIG Report Calls for More Fraud and Abuse Investigations of Medicare Advantage Plans

The HHS OIG has released a report recommending that CMS grant the Medicare Drug Integrity Contractor (MEDIC) wider latitude in pursuing potential fraud and abuse by Medicare Advantage plans. The report found that the MEDIC,...more

Navigating the Provider Self-Disclosure Protocol

Providers can voluntarily disclose potential fraud with respect to Federal health care programs — Medicare, Medicaid, and potentially private insurers to the extent Federal or state funds are involved — by following the...more

A Message From Donna Clark And Darby Allen On The A To Zs Of Stark Law Compliance

Healthcare providers, particularly physicians and hospitals, regularly engage in business arrangements that may implicate the federal self-referral law, known as the Stark Law. Recent changes to the Stark Law, including...more

Who is Committing Healthcare Fraud?

The financial recoveries for healthcare fraud are staggering. The Justice Department and Health and Human Services (Office of Inspector General (“OIG”) and Centers for Medicare and Medicaid Services (“CMS”)) regularly...more

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