We are pleased to bring you our 12th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more
2/27/2024
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medical Devices ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Settlement ,
Stark Law ,
Telemedicine
The False Claims Act encourages whistleblowers to come forward when they suspect their employer is committing fraud. This post provides a general overview of the False Claims Act’s anti-retaliation provision, which protects...more
5/5/2022
/ Anti-Retaliation Provisions ,
Attorney's Fees ,
Damages ,
Employer Liability Issues ,
Employment Litigation ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Fraud ,
Investigations ,
Litigation Fees & Costs ,
Pleading Standards ,
Qui Tam ,
Remedies ,
Retaliation ,
Whistleblower Protection Policies ,
Whistleblowers
On November 4, 2021, the federal Occupational Safety and Health Administration (OSHA) issued its long-awaited emergency standards to implement President Biden’s Vaccine/Testing Mandate for businesses with 100 or more...more
Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more
2/4/2021
/ Annual Reports ,
Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Criminal Investigations ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Long Term Care Facilities ,
Medical Devices ,
Medicare ,
Medicare Advantage Organizations (MAOs) ,
Nurses ,
Nursing Homes ,
OIG ,
Opioid ,
Pharmaceutical Industry ,
Pharmacist ,
Physicians ,
Qui Tam ,
Settlement Agreements ,
Stark Law ,
Telemedicine
The Department of Justice (DOJ) recently released its report detailing the settlements and judgments obtained in 2019 from civil cases involving fraud and abuse claims. As in years past, the substantial majority of these...more
1/28/2020
/ Appeals ,
Department of Justice (DOJ) ,
Dismissals ,
Durable Medical Equipment ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Final Judgment ,
Health Care Providers ,
Kickbacks ,
Medicaid ,
Medicare ,
Pleading Standards ,
Qui Tam ,
Relators ,
Reversal ,
Rule 9(b) ,
Settlement
Enforcement activity by the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) showed no signs of slowing throughout 2018 and has already picked up speed in 2019. More recent and significant actions...more
4/25/2019
/ Administrative Law Judge (ALJ) ,
California Consumer Privacy Act (CCPA) ,
Civil Monetary Penalty ,
Compliance ,
Cybersecurity ,
Electronic Medical Records ,
Electronic Protected Health Information (ePHI) ,
Enforcement Actions ,
General Data Protection Regulation (GDPR) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Breach ,
Medical Records ,
OCR ,
Patient Privacy Rights ,
Personally Identifiable Information ,
PHI
In recent years, healthcare providers have increasingly faced civil and criminal enforcement actions premised on the allegation that services billed to government healthcare programs were not medically necessary. As a result,...more
10/9/2018
/ Appeals ,
Civil Liability ,
Criminal Prosecution ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
False Statements ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Jury Verdicts ,
Medical Necessity ,
Medical Reimbursement ,
Physicians ,
Reversal