A federal district court recently rejected a health care provider’s claim of attorney-client privilege and ordered the provider to produce written communications with its lawyers regarding the provider’s compliance with the...more
The potential success of a whistleblower lawsuit filed under the False Claims Act (FCA) is significantly reduced when the government fails to intervene because such cases are often assumed to lack merit. However, a plaintiff...more
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
A federal district court recently dismissed a qui tam relator’s complaint in a declined case against the Hospital for Special Surgery (“Hospital”), its former CEO, and an outside billing company alleging that they violated...more
On June 25, the U.S. Department of Justice announced that it had settled with Omnicare Inc. in two matters alleging that kickbacks resulted from below-cost discounts offered to skilled nursing homes as an inducement to select...more
The pharmacy provider agrees to pay US$124 million to resolve allegations of below-cost discounts.
On June 25, the Department of Justice (DOJ) announced that it had settled with Omnicare, Inc. in two matters alleging...more
The advent of federally subsidized private pay health insurance under the Affordable Care Act has the potential to expand the application of the federal anti-kickback statute beyond just Medicare, Medicaid, and Tricare. The...more
Craig Holden co-presented "New Compliance Red Flags Workshop," a workshop hosted by G2 Intelligence.
Over the past five years, the Departments of Justice and Health and Human Services have recovered $19.2 billion from...more
Trends & Analysis:
•We have identified 23 health care–related qui tam cases unsealed since last month’s Qui Tam Update. Only six of those cases were filed in 2013. The majority (13 cases) were filed in 2011 or 2012,...more
Abbott Laboratories has agreed to pay $5.475 million to settle allegations that it paid kickbacks in violation of the Anti-Kickback Act (AKA) to induce doctors to perform surgeries using the company's products. The global...more
Trends and Analysis:
..We have identified 21 health care–related qui tam cases unsealed since last month’s Qui Tam Update. Of those, two were filed in 2013, 15 were filed in 2011 or 2012, and four were filed in 2010 or...more
Trends and Analysis:
..We have identified 20 health care-related qui tam cases unsealed in July 2013. About a quarter of those were filed in 2013.
..Among the cases unsealed in July, the government has declined to...more
The Justice Department recently intervened in a qui tam lawsuit against a home health provider and related individuals, alleging violations of the antikickback statute and the Stark Law, which also constituted alleged...more
In United States v. Kellogg Brown & Root, Inc., No. 12-40447 (5th Cir. July 19, 2013) (“KBR”), the U.S. Court of Appeals for the Fifth Circuit decided questions of first impression concerning the federal Anti-Kickback Act...more
Federal prosecutors recently announced a $12.6 million False Claims Act (FCA) settlement with a major New Jersey health system to resolve allegations that the system paid outside physicians in order to increase referrals....more
From the perspective of False Claims Act (FCA) results, 2012 was a decidedly mixed year for healthcare providers. The bad news was quite bad—increased FCA scrutiny by the Department of Justice (DOJ) led to $3 billion of...more
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