On June 28, 2024, SCOTUS overturned the long-standing Chevron doctrine in its decision Loper Bright Enterprises v. Raimondo and Relentless v. Department of Commerce. The Court’s ruling will have a significant impact on...more
7/15/2024
/ Administrative Procedure Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Chevron v NRDC ,
Department of Health and Human Services (HHS) ,
Fraud and Abuse ,
Government Agencies ,
Healthcare ,
Hospice ,
Judicial Authority ,
Loper Bright Enterprises v Raimondo ,
MACs ,
Medicaid ,
Medicare ,
Regulatory Authority ,
SCOTUS ,
Statutory Interpretation
The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends.
Although DOJ brought in the second-highest...more
2/17/2023
/ Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Physicians ,
Qui Tam ,
Relators ,
Settlement
This year saw substantial activity in FCA settlements and litigated court cases. Although no single case or development dominated the discourse this year, several important court decisions were issued, including two that may...more
2/1/2021
/ Ambiguous ,
Anti-Kickback Statute ,
Damages ,
Deficit Reduction ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Department of Veterans Affairs ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Aviation Administration (FAA) ,
Fee-Shifting ,
First-to-File ,
Fraud ,
Materiality ,
Medicaid ,
Medicare ,
Qualified Immunity ,
Reasonable Interpretations ,
Retaliation ,
Speaker Programs ,
Statute of Limitations
Companies that work with the federal government (think Medicare and Medicaid reimbursements, government contracts, grant funding) need to stay up to date on the False Claims Act (FCA). The FCA is one of the primary tools used...more
We are pleased to present our annual review of developments in the field of health law. The year was marked by key changes in False Claims Act jurisprudence and Medicare payment policy. 2016 also brought with it focused...more
1/25/2017
/ 60-Day Rule ,
ACOs ,
Centers for Medicare & Medicaid Services (CMS) ,
Corporate Executives ,
Corporate Misconduct ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
ESRD ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Trade Commission (FTC) ,
Final Rules ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Reform ,
Hospital Mergers ,
Long Term Care Facilities ,
Materiality ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Shared Savings Program ,
MIPS ,
OCR ,
Off-Campus Departments ,
OPPS ,
Personal Liability ,
Physician Payments ,
Presidential Elections ,
SCOTUS ,
Stark Law ,
Trump Administration ,
Universal Health Services Inc v United States ex rel Escobar ,
Yates Memorandum
On August 3, 2015, Judge Edgardo Ramos of the United States District Court for the Southern District of New York issued the first judicial opinion addressing when a health care provider has “identified” a Medicare or Medicaid...more
8/14/2015
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
FERA ,
Hospitals ,
Intervenors ,
Medicaid ,
Medicare ,
Motion to Dismiss ,
Overpayment ,
Overpayment Recovery Time Limits ,
Qui Tam
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
1/15/2014
/ Calculation of Damages ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
FERA ,
Fines ,
First-to-File ,
Fraud ,
Halliburton ,
Healthcare ,
Medicare ,
Off-Label Use ,
Overpayment ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Public Disclosure ,
Qui Tam ,
Wells Fargo ,
Whistleblowers ,
WSLA