New York Department of Health (DOH) regulations provide that an adult home may not admit additional residents with serious mental illness if it has a capacity of 80 or more beds and its resident population is over 25% persons...more
2/20/2025
/ Americans with Disabilities Act (ADA) ,
Department of Health and Human Services (HHS) ,
Disabilities ,
Disability Discrimination ,
Fair Housing Act (FHA) ,
Healthcare Facilities ,
Hospitals ,
Mental Health ,
New York ,
Public Health ,
Regulatory Authority ,
Regulatory Requirements ,
State and Local Government
At the end of December, the Second Circuit joined several other circuit courts in holding that a plaintiff adequately pleads an Anti-Kickback Statute (“AKS”) violation when she states with the requisite particularity that at...more
The SDNY U.S. Attorney’s Office has targeted several labs and their principals for False Claims Act violations arising out of reimbursements for COVID-19 testing services. In a complaint filed on June 13, the government sued...more
Recently, in United States ex rel. Hart v. McKesson Corp., the Second Circuit clarified the standard for acting “willfully” under the federal anti-kickback statute (AKS).
False Claims Act relator Adam Hart alleged that...more
The recent settlement of a False Claims Act case afforded SDNY Judge Ronnie Abrams the opportunity to address the standard for redacting a qui tam Relator’s FCA complaint. Judge Abrams decided that Relator Devin English had...more
3/22/2023
/ Disclosure ,
False Billing ,
False Claims Act (FCA) ,
Judicial Records ,
Misappropriation ,
National Institute of Health (NIH) ,
Qui Tam ,
Redacted Documents ,
Relators ,
Right of Access ,
Voluntary Dismissals ,
Whistleblowers
The Supreme Court granted certiorari in a case that will decide two important questions under the False Claims Act (FCA). In United States ex rel. Polansky v. Executive Health Resources, Inc., the Relator asks the Court to...more
6/22/2022
/ Certiorari ,
False Billing ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare ,
Medicare ,
Motion to Dismiss ,
Motion To Intervene ,
Regulatory Authority ,
Relators ,
SCOTUS ,
Statutory Violations ,
United States ex rel Polansky v Executive Health Resources Inc
Last week, the EDNY and the DOJ Consumer Protection Branch brought a civil enforcement action against defendants who manufacture and sell an herbal tea product called B4B Earth Tea Extra Strength (“Earth Tea”). Earth Tea...more
3/7/2022
/ Civil Monetary Penalty ,
Consumer Protection Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Advertising ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Fraud ,
FTC Act ,
Infectious Diseases ,
Misrepresentation ,
Permanent Injunctions ,
Plant Based Products ,
Regulatory Violations ,
Social Media ,
Unfair or Deceptive Trade Practices
The Supreme Court will hear argument next week in two consolidated cases that will decide what standard applies when a doctor asserts a good faith defense to a criminal prosecution for unlawful drug distribution. ...more
2/23/2022
/ Certiorari ,
Controlled Substances ,
Criminal Convictions ,
Criminal Prosecution ,
Drug & Alcohol Abuse ,
Drug Distribution ,
Enforcement Actions ,
Food & Drug Regulations ,
Good Faith ,
Opioid ,
Physicians ,
Prescription Drugs ,
SCOTUS
SDNY Judge Jed Rakoff rejected Northwell Health’s bid for insurance coverage for its increased costs and business losses related to the COVID-19 pandemic in a recent decision. ...more
8/9/2021
/ Business Interruption ,
Business Losses ,
Commercial Insurance Policies ,
Coronavirus/COVID-19 ,
Denial of Insurance Coverage ,
Infectious Diseases ,
Ingress/Egress ,
Insurance Claims ,
Insurance Litigation ,
Policy Exclusions ,
Policy Terms
Last week, EDNY Chief Judge Margo Brodie certified a False Claims Act (FCA) appeal to the Second Circuit. In United States ex rel. Quartararo v. Catholic Health System of Long Island Inc., the district court found that...more
Novartis Pharmaceuticals Corp. agreed earlier this month to pay $678 million to settle an SDNY False Claims Act case. The SDNY alleged that Novartis violated the False Claims Act and the Anti-Kickback Statute by giving...more
Compound prescription drugs have increasingly become a target for DOJ health fraud enforcement activities. ...more
The corona virus pandemic has presented new opportunities for fraud, particularly against the elderly and vulnerable, and these fraudulent schemes are often carried out through robocalls....more
Last week, in Washington v. Barr, the Second Circuit addressed a case seeking to strike down the federal government’s classification of marijuana as a Schedule I drug under the Controlled Substances Act (CSA)....more
6/4/2019
/ Abeyance ,
Administrative Remedies ,
Controlled Substances Act ,
DEA ,
Decriminalization of Marijuana ,
Exhaustion Doctrine ,
Healthcare ,
Jurisdiction ,
Marijuana ,
Medical Marijuana ,
Motion to Dismiss ,
PTSD ,
Public Health ,
Veterans
The Supreme Court yesterday unanimously decided that a relator may take advantage of the longer ten-year statute of limitations under the False Claims Act in a case in which the United States has declined to intervene, as...more
5/14/2019
/ Appeals ,
Cochise Consultancy Inc v United States ex rel Hunt ,
False Claims Act (FCA) ,
First-to-File ,
Government Officials ,
Intervenors ,
Oral Argument ,
Qui Tam ,
Relators ,
SCOTUS ,
Split of Authority ,
Statute of Limitations
Earlier this week, the Department of Justice Civil Division announced guidelines for factors to consider and credit to be given in False Claims Act investigations and prosecutions....more
The replacement of stairways at the Middletown Road Subway Station in the Bronx triggered accessibility requirements that may include installing elevators, according to a recent decision from SDNY District Judge Edgardo...more
Home health care aides working twenty-four hour shifts can be paid for as little as thirteen hours under certain conditions, according to a March ruling from the New York Court of Appeals in Andryeyeva v. New York Health...more
4/16/2019
/ Appeals ,
Class Action ,
Class Certification ,
Department of Labor (DOL) ,
Employer Liability Issues ,
Employment Litigation ,
Health Care Providers ,
Home Health Care ,
Home Healthcare Workers ,
Regulatory Requirements ,
Rest and Meal Break ,
State and Local Government ,
State Labor Laws ,
Wage and Hour ,
Work Schedules
The Second Circuit examined the False Claims Act’s “alternate remedy” provision for the first time yesterday, holding that a fugitive who had dismissed his qui tam action was not entitled to a share of a $25.6 million FCA...more
The Eastern District of New York filed a Safe Drinking Water Act complaint this week against the City of New York and the NYC Department of Environmental Protection, seeking to require the City to cover the Hillview Reservoir...more
4/5/2019
/ Consent Decrees ,
Construction Project ,
Contamination ,
Department of Environmental Protection ,
Environmental Policies ,
Environmental Protection Agency (EPA) ,
Property Improvements ,
Public Health ,
Public Projects ,
Real Estate Development ,
Safe Drinking Water Act ,
Water Supplies
Second Circuit Judges recently traded strong language in opinions accompanying the denial of a petition for en banc review in Tanvir v. Tanzin....more
New York City will pay $5.3 million to the United States for fraudulently obtaining FEMA funds related to Superstorm Sandy in a False Claims Act settlement with the Southern District of New York. The City admitted improperly...more
EDNY Judge Nina Gershon analyzed several False Claims Act issues in United States ex rel. Omni Healthcare Inc. v. McKesson Corp., ruling on first-to-file, Rule 9(b), and statute of limitations issues....more
In federal criminal investigations, corporate health care providers have faced a Department of Justice increasingly focused on individuals, one that has limited or foreclosed cooperation credit for corporations not providing...more
12/18/2018
/ Cooperation ,
Corporate Crimes ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Government Investigations ,
Individual Accountability ,
Professional Misconduct ,
White Collar Crimes ,
Yates Memorandum
Last week, in LeadingAge New York, Inc. v. Shah, the New York Court of Appeals addressed Department of Health regulations limiting executive compensation and administrative expenditures by healthcare providers receiving state...more