On June 28, 2024, the U.S. Supreme Court issued a decision that overrules the “Chevron doctrine.” This means that federal agencies are limited in their ability to rely on their own interpretation of the laws they...more
9/19/2024
/ Administrative Procedure Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Chevron v NRDC ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Healthcare ,
Loper Bright Enterprises v Raimondo ,
Regulatory Authority ,
SCOTUS ,
Stark Law ,
Statutory Interpretation
Two False Claims Act (“FCA”) cases have recently been decided by the United State Supreme Court, further clarifying one aspect of the FCA. In the recent decisions in U.S. ex rel Proctor v. Safeway, Inc. and U.S. ex rel....more
7/21/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Healthcare ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Reasonable Interpretations ,
Scienter ,
SCOTUS ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al ,
Whistleblowers
AMA Provides a No Surprises Tool-Kit -
As most health care providers know by now, the No Surprises Act (NSA) prohibits out-of-network health care providers from balance billing commercially insured patients, in certain...more
7/25/2022
/ Criminal Convictions ,
Data Management ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
HIPAA Privacy Rule ,
OCR ,
Opioid ,
Patient Privacy Rights ,
PHI ,
Prescription Drugs ,
Reproductive Healthcare Issues ,
Ruan v United States ,
SCOTUS ,
Surprise Medical Bills
The Supreme Court decided Universal Health Services v. U.S. ex rel. Escobar on June 16, 2016 in which it ruled the implied false certification theory, previously recognized in several circuits, can form the basis for False...more
9/7/2016
/ Conditions of Payment ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Implied Certification ,
Material Misrepresentation ,
Materiality ,
Medicaid ,
Mental Health ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar ,
Unlicensed Medical Providers