Yesterday, a federal district court in the Middle District of Florida issued a decision that threatens the federal government’s continued reliance on the False Claims Act (“FCA”) as the most powerful weapon in the Department...more
Most Medicare Advantage (“MA”) beneficiaries rely on agents and brokers to help them navigate the complex process of selecting a health plan that will meet their needs. In exchange, brokers and agents received certain fixed...more
4/16/2024
/ Agents ,
Beneficiaries ,
Brokers ,
Centers for Medicare & Medicaid Services (CMS) ,
Compensation ,
Competition ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement ,
Fair Market Value ,
Final Rules ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Mental Health ,
OIG
For a brief moment in time last April, the U.S. Food and Drug Administration’s (“FDA”) approval of the commonly-used abortion medication, Mifepristone, was curtailed. Just days after a Texas federal judge’s ruling suspended...more
6/16/2023
/ Abortion ,
Class Action ,
Department of Justice (DOJ) ,
Dobbs v. Jackson Women’s Health Organization ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Healthcare ,
Pharmaceutical Industry ,
Planned Parenthood of Southeastern Pennsylvania v Casey ,
Prescription Drugs ,
Roe v Wade ,
SCOTUS ,
Texas
The U.S. Food and Drug Administration’s (“FDA”) approval of the commonly-used abortion medication, Mifepristone, has been curtailed following dueling federal court decisions in Texas and Washington. Just days after a Texas...more
4/17/2023
/ Abortion ,
Department of Justice (DOJ) ,
Dobbs v. Jackson Women’s Health Organization ,
Executive Branch ,
FDA Approval ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Patient Access ,
Pregnancy ,
Prescription Drugs ,
Reproductive Healthcare Issues ,
State and Local Government
Following remarks made on March 2 and March 3, 2023 at the American Bar Association’s 38th Annual National Institute on White Collar Crime, the U.S. Department of Justice (“DOJ”) issued revisions to its Evaluation of...more
3/21/2023
/ Clawbacks ,
Compliance ,
Compliance Manuals ,
Compliance Monitoring ,
Corporate Governance ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Executive Compensation ,
Incentives ,
Instant Messaging Apps ,
Mobile Devices ,
Pilot Programs ,
Shareholders ,
White Collar Crimes
The COVID-19 Public Health Emergency (“PHE”) led to a rapid expansion in the utilization of telehealth. Now, almost three years later, governmental entities have focused their attention on telehealth services and the...more
12/13/2022
/ Controlled Substances ,
Coronavirus/COVID-19 ,
DEA ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Health Care Providers ,
Healthcare Fraud ,
OIG ,
Prescription Drugs ,
Public Health Emergency ,
Ryan Haight Act ,
Telehealth
A major California-based health care system, Sutter Health, and several of its medical practice foundation affiliates have agreed to pay a total of $90 million to settle allegations that they violated the False Claims Act...more
9/14/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare ,
Medicare Advantage ,
Risk Adjustment Formula ,
Settlement ,
Whistleblowers
It has been a little over a year since the leaking of the infamous Granston memo, an internal U.S. Department of Justice memorandum that provides guidance to government attorneys on when to exercise their authority to invoke...more
U.S. Attorney’s Offices (“USAOs”) across the country are issuing warning letters to physicians and other prescribers (collectively, “Prescribers”) cautioning them about their opioid prescribing practices (the “Warning...more
2/7/2019
/ Criminal Investigations ,
DEA ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Federal Trade Commission (FTC) ,
Food and Drug Administration (FDA) ,
Opioid ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Prescription Drugs ,
Regulatory Oversight ,
Risk Mitigation ,
U.S. Attorney ,
Warning Letters