News & Analysis as of

Justice Department Continues to Target Health Care Providers with "Barrier-Free" Initiative

The Department of Justice's recent settlement with a Chicago-based hospital system is the latest reflecting the agency's continuing pursuit of claims against health care providers – small and large -- who fail to provide...more

DOJ Criminal Division Renews Efforts to Investigate Whistleblower Allegations

The Department of Justice (DOJ) has signaled a heightened effort to bring criminal prosecutors into the loop regarding False Claims Act referrals and other whistleblower complaints. In recent remarks at a conference comprised...more

Health Care Companies Beware: Prosecutors Focus on Conduct Alleged in FCA Lawsuits

On September 17, 2014, during a speech at the Taxpayers Against Fraud Education Fund Conference in Washington, D.C., Assistant Attorney General for the Criminal Division of the Department of Justice (DOJ) Leslie Caldwell...more

Department of Justice Files First False Claims Act Lawsuit Against Physician-Owned Distributorship

On Sept. 8, 2014, the United States Department of Justice (DOJ) filed a 98-page civil complaint alleging that investment returns, paid to a Michigan spinal surgeon and other physicians by a spinal implant company partially...more

U.S. Department of Justice Files False Claims Action Against 3 PODs and Physician Investors for Physician and Hospital Claims

On September 8, 2014, the U.S. Department of Justice (DOJ) filed a False Claims Act (FCA) case in the Central District of California against Reliance Medical Systems, two related distributors (Apex Medical Technologies and...more

News from the Health Law Gurus™: July 2014

Survey of ACA Navigators Finds 10.6 Million People Sought Enrollment Help — In a survey released this week, the Kaiser Family Foundation (“Kaiser”) estimates that approximately 10.6 million people received assistance...more

Lawsuit Against Medtronic Alleges Racketeering Over Infuse Bone Graft

When one big industry sues another we learn a lot about how business as usual is conducted. In this case Humana, a giant health insurer, has sued the medical device company Medtronic, maker of the Infuse bone graft. ...more

How Are Your Physicians Compensated? Stark Law + False Claims Act = Halifax Paying $85 Million

On March 10, 2014, just days before trial, Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively “Halifax”) entered into an $85 million settlement with the U.S. Department of Justice resolving allegations...more

Halifax Reportedly Settles Landmark Stark Case

According to minutes filed in the U.S. District Court for the Middle District of Florida, Halifax Hospital Medical Center (Halifax) and the U.S. Department of Justice (DOJ) have reached a settlement in the pending False...more

Health Law Blog: Court's Decision Another Reminder to Hospitals To Use Caution in Calculating Physician Productivity Bonuses

November, a federal district court granted partial summary judgment for the Department of Justice in U.S. ex. Rel. Baklid-Kunz v. Halifax Medical Center, ruling that productivity bonuses paid to employed physicians violated...more

Whistleblowing to the Tune of $6 Million

In early July 2013, Baxano Surgical Inc., formerly known as TranS1 Inc., agreed to pay $6 million to settle charges that it encouraged doctors to overcharge Medicare and other federal health programs and paid kickbacks to...more

Failure To Comply With Physician Supervision Requirements Can Be Costly

The Department of Justice recently announced two large settlement agreements with provider organizations and individual physicians based on failure to provide proper physician supervision for diagnostic imaging and radiation...more

FTC Again Confirms That Antitrust Law Encourages ACO Formation

Once again, the staff of the Federal Trade Commission (FTC) has rebutted calls by physician groups that state legislation is needed to allow independent physicians to collaborate....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

Arrests Made and Investigation Underway at a Chicago Hospital

On April 16, 2013, the United States Department of Justice (DOJ) and U.S. Attorney’s Office in the Northern District of Illinois announced the arrest in Chicago of the owner and senior executive of Sacred Heart Hospital...more

DOJ Ratchets Up ADA Enforcement For Health Care Providers

In 2011, the Department of Justice launched its “Barrier Free Health Care Initiative.” This Initiative utilizes U.S. Attorneys Offices across the Country to act as a “force multiplier” to ensure that individuals with...more

Protecting Your Hospital From Over-Utilization Prosecutions

The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more

When Will They Learn? Doctors Continue to Face Antitrust Charges for Jointly Negotiating Contracts without Clinical or Financial...

Legitimate joint marketing and selling arrangements have the potential to produce efficiencies. This is particularly so, for example, where the arrangement enables the participants to make or market products that they could...more

DOJ Will Not Contest Greater New York Hospital Association Gainsharing Program

On January 16, 2013, the Department of Justice, Antitrust Division (DOJ) announced that it will not challenge a gainsharing program that the Greater New York Hospital Association (GNYHA) proposed in its August 13, 2012...more

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