News & Analysis as of

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

Federal Unemployment Insurance Integrity Act Creates Tough New Standards for Employers Responding to State Unemployment Insurance...

In 2011, Congress passed the Unemployment Insurance Integrity Act (Act) as part of the Trade Adjustment Assistance Extension Act of 2011 (TAAEA). While the TAAEA was primarily concerned with extending retraining assistance...more

PRIME Act: New Legislation to Curb Health Care Fraud

The United States Senate and House of Representatives recently introduced bipartisan legislation designed to reduce fraud, waste, and abuse in the Medicare and Medicaid programs. The legislation, entitled “Preventing and...more

OIG Recommends that CMS Recoup More Than $100 Million in Overpayments for Incarcerated and Unlawfully Present Beneficiaries

CMS made more than $100 million in improper payments to providers for healthcare services on behalf of incarcerated and unlawfully present individuals between 2009 and 2011, according to a pair of reports issued on January...more

Healthcare Prosecutions for Failures to Return Overpayments

Sometimes the deck is stacked against you. No matter what you do and how hard you try, you will lose. In the healthcare area, hospitals, doctors and other service providers have to feel the frustration when it comes...more

Payment Matters: Sovereign Immunity Extended to Medicare Contractors

Win or lose, one out of two clients ask this question after an ALJ hearing: Can we sue the contractors to recoup our legal and other costs? With the recent decision from the United States Court of Appeals for the Third...more

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