Host Jonathan Porter welcomes Husch Blackwell’s Lorinda Holloway to explore settlements in the context of False Claims Act (FCA) litigation. Jonathan and Lorinda discuss the differences between FCA settlements and those...more
Host Gregg N. Sofer welcomes Husch Blackwell’s Jonathan Porter back to the podcast to discuss the sentencing of Sam Bankman-Fried, the founder and former CEO of the bankrupt cryptocurrency exchange FTX, who was convicted in...more
Host Jonathan Porter welcomes Husch Blackwell’s Catherine Hanaway to explore the government’s use of civil investigation demands (CIDs) within the context of False Claims Act investigations. The CID is a powerful and broad...more
“Incident to” billing is widely practiced, and its regulations are generally well-known. But one Arizona physician recently found himself pleading guilty in federal court on April 3, 2024, to a criminal healthcare fraud...more
Host Jonathan Porter welcomes Husch Blackwell’s Jody Rudman to this inaugural podcast episode to discuss the changing profile of whistleblowers in False Claims Act (FCA) litigation.
Traditionally, relators, or...more
Most experienced False Claims Act (FCA) practitioners are all too familiar with the statutory provision requiring defendants to pay whistleblowers’ attorneys’ fees at the end of FCA cases. What is less commonly known is the...more
The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this episode of Hospice Insights: The Law and Beyond, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about...more
Husch Blackwell’s False Claims Act team previously covered the results of a rare False Claims Act (FCA) trial in which a federal jury found that a surgical product distributor was liable for paying kickbacks to physicians....more
As previously reported in this post, criminal trials premised on upcoding evaluation and management (E/M) service codes are extremely rare. The Justice Department took that rare step in Maryland in connection with a practice...more
For years, law enforcement has bypassed traditional means of securing evidence by informal requests for documents from witnesses of crimes. At some point, that practice bled over into informal requests for healthcare...more
Host Gregg N. Sofer welcomes Husch Blackwell partner Jonathan Porter to the podcast to discuss the conclusion of one of the most closely watched jury trials in recent memory: the guilty verdict on all counts against Sam...more
Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...more
Large managed care plans have been squarely in DOJ’s crosshairs for years, but a late July 2023 Justice Department settlement agreement with one regional healthcare provider’s Medicare Advantage Plan offers a glimpse into an...more
On June 14, 2023, a federal jury found that a Georgia physician knowingly violated the False Claims Act following a two-week trial on allegations that he made false claims to the Medicare Program. Now, despite just $1.1...more
The False Claims Act imposes liability for false and fraudulent claims a defendant submitted with the requisite state of mind, or scienter. Before the Supreme Court handed down its June 1, 2023, decision in the combined...more
6/8/2023
/ 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
In this episode, Husch Blackwell’s Meg Pekarske and Jonathan Porter, a former federal prosecutor, discuss takeaways from the recent American Bar Association’s Annual National Institute on Health Care Fraud. Most importantly,...more
Hospice professionals are often left wondering how the Centers for Medicare and Medicaid Services (CMS) and other government entities identify enforcement priorities. They also seek understanding about the subsequent steps...more
Cosmetic surgeries are on the rise. One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. Facelifts were up 54...more
On April 18, 2023, the United States Supreme Court heard oral argument in two consolidated cases that have the potential to upend False Claims Act (FCA) litigation. Oral argument on both sides and questioning from the...more
4/24/2023
/ Case Consolidation ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Intent ,
Reasonable Interpretations ,
Scienter ,
SCOTUS ,
Subjective Standard ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
Last month, The Economist published a call to action titled, “There is a worrying amount of fraud in medical research: And a worrying unwillingness to do anything about it.” The article is the latest in a sequence of alarms...more
3/23/2023
/ Clinical Laboratory Testing ,
Clinical Trials ,
Department of Justice (DOJ) ,
False Statements ,
Foreign Governments ,
Fraud ,
Grants ,
Hospitals ,
Medical Research ,
Misleading Statements ,
Universities
On February 27, 2023, a jury in Minnesota federal court rendered a verdict in favor of the United States and against a surgical product distributor following a False Claims Act jury trial that lasted six weeks. The jury...more
In the world of qui tams, it is usually the whistleblower pushing cases to trial. But on February 23, 2023, a federal judge in West Virginia set down for trial a hospital’s case against a whistleblower. Now, in a trial set...more
The United States Supreme Court started the long weekend on Friday evening by announcing it would hear a consolidated pair of cases that should clarify a critical aspect of the False Claims Act (FCA). These cases are worth...more