When I litigated False Claims Act (FCA) cases at the U.S. Department of Justice (DOJ), it was common practice for settlements to require Corporate Integrity Agreements (CIAs) setting forth ongoing duties and responsibilities...more
2/20/2025
/ Compliance ,
Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Liability ,
Reverse False Claims ,
Settlement ,
Whistleblowers
In a significant ruling, the Second Circuit Court of Appeals recently expanded the scope of the Anti-Kickback Statute (AKS).The Court joined other circuit courts across the country in adopting, for the first time, the...more
1/8/2025
/ Anti-Kickback Statute ,
Compliance ,
Enforcement ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Pleading Requirements ,
Fraud ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Litigation Strategies ,
Medicare ,
Novartis ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Quid Pro Quo ,
Relators ,
Whistleblowers
When I investigated and litigated False Claims Act (FCA) cases at the U.S. Department of Justice (DOJ) over the last 10 years, I was often surprised by just how little I knew about the broad array of government agencies and...more
12/26/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Federal Funding ,
Fraud ,
Government Agencies ,
Insurance Industry ,
Medicare ,
Medicare Advantage ,
OIG ,
Privatization ,
Reimbursements ,
Risk Adjustment Formula