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The False Claims Act and Health Care: 2023 Recoveries and 2024 Outlook

On 22 February 2024, the US Department of Justice (DOJ) published the statistics for federal civil fraud recoveries in Fiscal Year (FY) 2023. The DOJ announced that the “government and whistleblowers were party to 543...more

US Department of Justice Announces US$2.68 Billion in Fiscal Year 2023 False Claims Act Recoveries

On 22 February 2024, the US Department of Justice (DOJ) published its report (Report) announcing civil recoveries under the False Claims Act (FCA) for Fiscal Year (FY) 2023. The recoveries for FY 2023 exceeded US$2.68...more

Supreme Court Affirms Government's Broad Dismissal Authority in False Claims Act Suits

On 16 June 2023, the United States Supreme Court issued a decision in the case of United States ex rel. Polansky v. Executive Health Resources1, holding that the federal government (Government) maintains the authority to...more

Supreme Court Issues Decision Regarding False Claims Act's Scienter Element

The United States Supreme Court recently held that a defendant’s subjective belief is always relevant to the False Claims Act’s scienter element, regardless of what an objectively reasonable person may have believed. This...more

The False Claims Act and Health Care: 2022 Recoveries and 2023 Outlook

On 7 February 2023, the US Department of Justice (DOJ) publicly reported the statistics for federal civil fraud recoveries in Fiscal Year (FY) 2022. While the DOJ emphasized in its accompanying press release that “the...more

The False Claims Act and Health Care: 2021 Recoveries and 2022 Outlook

In a significant departure from the general downward trend in False Claims Act (FCA) civil fraud recoveries over the past half-decade —and as predicted last year —recoveries in Fiscal Year (FY) 2021 drastically increased...more

Health Care Triage: Cybersecurity Risk in the Health Care Industry

As health care providers are increasingly relying on complex and integrated electronic medical record systems, the health care industry has rapidly become one of the most frequent and often vulnerable targets for...more

The False Claims Act and Health Care: 2020 Recoveries and 2021 Outlook

False Claims Act (FCA) civil fraud recoveries in Fiscal Year (FY) 2020 dropped over US$850 million when compared to those in FY 2019. While the more than US$2.2 billion in recoveries in FY 2020 continued a general downward...more

Qui Tam Quarterly - Risky Business: Health Care Investments Pose Acute False Claims Act Risk for Private Equity

This article analyzes emerging risks to PE firms that invest in the health care sector by examining the current enforcement landscape and significant FCA litigation; identifies key factors that increase FCA risk for PE firms...more

HHS OGC Weighs in on Sub-Regulatory Guidance in Advisory Opinion: What It Might Mean for False Claims Act Cases After Azar v....

The U.S. Supreme Court’s 2019 decision in Azar v. Allina Health Services effectively curtailed the enforceability of certain Medicare policies established without notice-and-comment rulemaking. As a result, health care fraud...more

HHS Creates a Working Group to Increase Collaboration with DOJ

On 4 December 2020, the Department of Health and Human Services (HHS) announced the creation of a False Claims Act Working Group (Working Group), with the goal of enhancing HHS’s partnership with the Department of Justice...more

COVID-19: CARES Act Provider Relief Fund Compliance and Potential FCA Enforcement

On this week’s episode, John Lawrence, Leah Richardson, and John Rothermich discuss compliance requirements associated with federal funding provided to health care providers through the CARES Act Provider Relief Fund, as well...more

Qui Tam Quarterly - Uncertain Relief: Navigating Cares Act Provider Relief Fund Guidance and False Claims Act Risks

This edition of the Qui Tam Quarterly focuses on the potential False Claims Act (FCA) risk areas faced by health care provider recipients of payments from the Provider Relief Fund (PRF) created by the CARES Act, as well as...more

COVID-19: New DOJ Guidance on Inability-to-Pay Claims: What Companies Affected by COVID-19 Need to Know When Seeking Reduced Civil...

As many corporate practitioners know from experience, U.S. Department of Justice (DOJ) lawyers and federal prosecutors often factor a company’s inability to pay into corporate civil and criminal resolutions with the...more

COVID-19: PPP Loan Borrowers - Your Information May Now Be Public

On 19 June 2020, in a major reversal of the U.S. Department of the Treasury’s (Treasury) previous position, the U.S. Small Business Administration (SBA) and Treasury announced that they will publicize additional data...more

COVID-19: K&L Gates Triage: Responding to the Unimaginable: Legal Challenges for Nursing Homes & Long-Term Care Facilities in a...

On this week’s episode, John Lawrence, Myla Reizen and Mark Rush discuss the devastating effects COVID-19 has had on nursing homes and long term care facilities in the United States and potential civil and criminal liability...more

COVID-19: Labs Beware! – EKRA Expands DOJ’s Enforcement Arsenal in the COVID-19 Fraud Battle

I. INTRODUCTION - As discussed in recent alerts, federal and state authorities have focused their enforcement efforts on combatting fraud related to the COVID-19 pandemic....more

COVID-19: Looming False Claims Act Liability for Paycheck Protection Program Loans

In response to the economic crisis caused by the spread of COVID-19, Congress passed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) on March 27, 2020, which President Donald J. Trump subsequently signed...more

COVID-19: CARES Act Overview: Relevant Health Care Provisions

On March 27, 2020, the United States Congress passed the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act, which President Donald J. Trump signed into law on the same day (Public Law No: 116-136). The CARES Act is...more

COVID-19: Government Enforcement in the Time of a Pandemic

In recent days, federal and state authorities have prioritized enforcement related activities aimed at combatting fraud schemes arising out of the public uncertainty and desperation caused by the COVID-19 pandemic. ...more

The False Claims Act & Health Care: 2019 Recoveries and 2020 Outlook

In 2019, the False Claims Act (“FCA”) remained the federal government’s (“Government”) primary method of civil fraud enforcement. While the more than $3 billion in civil fraud recoveries in Fiscal Year (“FY”) 2019 resulted...more

Qui Tam Quarterly - Health Care's New Wilderness: The Intersection of Telehealth & Ancillary Services

New frontiers are emerging in health care as burgeoning technologies merge with health care’s ever-evolving landscape. While these new frontiers provide seemingly endless possibilities and opportunities for improving the...more

The False Claims Act & Health Care: 2018 Recoveries and 2019 Outlook

In 2018, the False Claims Act (“FCA”) continued to be one of the federal government’s (“Government”) preferred civil fraud enforcement tools across a variety of industries. The healthcare industry, however, remained the...more

K&L Gates Triage: Internal & External Health Care Investigations Part 3

In Part 3 of our series on health care investigations, Mark Rush and John Lawrence discuss the process for external investigations conducted by federal and state governmental agencies, including in the context of qui tam...more

K&L Gates Triage: Internal & External Health Care Investigations Part 2

In Part 2 of our series on health care investigations, Mark Rush and John Lawrence continue the discussion on internal investigations. Specifically, the episode walks through how to conduct an internal investigation,...more

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