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
There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023.
Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more
7/18/2023
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Hospitals ,
Kickbacks ,
Medical Devices ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Popular ,
Settlement ,
Stark Law
On February 7, the Department of Justice (DOJ) issued a press release indicating that settlements and judgments under the False Claims Act (FCA) exceeded $2.2 billion in the fiscal year ending September 30, 2022. Of this...more
4/5/2023
/ Corporate Counsel ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Long Term Care Facilities ,
Manufacturers ,
Medical Devices ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Skilled Nursing Facility ,
Suppliers
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 roller coaster ride of U.S. ex rel. Ruckh v. Genoa Healthcare, LLC continues. In a previous post, we wrote about the staggering $348 judgment entered following a jury verdict against a management company and skilled...more
In two prior posts [Government Files Amended FCA Complaint Against Private Equity Firm and its Portfolio Company and DOJ Intervention in Healthcare Fraud Case Highlights Potential Risks for Private Equity Firms], we wrote...more
11/22/2019
/ Amended Complaints ,
Department of Justice (DOJ) ,
Drug Compounding ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Investors ,
Kickbacks ,
Military Service Members ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Portfolio Companies ,
Prescription Drugs ,
Private Equity Firms ,
Settlement ,
Telemedicine ,
Veterans
This is the second post of a two-part discussion of FCA pleading standards and discusses the pleading requirements for connecting a fraudulent scheme to the submission of false claims. Read our previous post on the...more
The False Claims Act (FCA) continues to be the federal government’s primary civil enforcement tool for imposing liability on healthcare providers who defraud federal healthcare programs. A significant portion of FCA...more
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
A recent jury verdict in an FCA lawsuit pending in the United States District Court for the Middle District of Florida resulted in a not-so-subtle reminder of just how high the stakes can be in such litigation....more
3/15/2017
/ Civil Monetary Penalty ,
Discovery Disputes ,
False Billing ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Jury Verdicts ,
Medicaid ,
Medicare ,
Skilled Nursing Facility ,
Statistical Sampling ,
Treble Damages