For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA)...more
2/24/2021
/ Appellate Courts ,
Certifications ,
False Claims Act (FCA) ,
Health Care Providers ,
Hospice ,
Medicare ,
Objective Falsity ,
Physician Medicare Reimbursements ,
Physicians ,
Rule 9(b) ,
SCOTUS ,
Summary Judgment
A LOOK BACK... A LOOK AHEAD -
While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more
3/13/2018
/ Affordable Care Act ,
Anti-Kickback Statute ,
Attorney's Fees ,
Attorney-Client Privilege ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Damages ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Discovery ,
Enforcement Actions ,
False Claims Act (FCA) ,
First-to-File ,
Food and Drug Administration (FDA) ,
Fraud and Abuse ,
Health Care Providers ,
Health Insurance ,
Healthcare Fraud ,
Home Health Care ,
Hospice ,
Hospitals ,
Individual Accountability ,
Laboratories ,
Long-Term Care ,
Managed Care Contracts ,
Manufacturers ,
Medicaid ,
Medical Devices ,
Medical Necessity ,
Medical Records ,
Medicare ,
Nursing Homes ,
OIG ,
Pharmaceutical Industry ,
Physicians ,
Pleading Standards ,
Protected Activity ,
Public Disclosure ,
Qui Tam ,
Relators ,
Retaliation ,
Reverse False Claims ,
Settlement Agreements ,
SNF ,
Specialty Healthcare ,
Stark Law ,
Universal Health Services Inc v United States ex rel Escobar
The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we will...more
Bass, Berry & Sims is pleased to announce the release of its fifth annual Healthcare Fraud and Abuse Review 2016. The Review, compiled by the firm’s Healthcare Fraud Task Force, is an industry-leading guide to healthcare...more
4/13/2017
/ 60-Day Rule ,
Anti-Kickback Statute ,
Damages ,
Enforcement Actions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Fraud and Abuse ,
Healthcare Fraud ,
HITECH Act ,
Hospice ,
Hospitals ,
Individual Accountability ,
Long Term Care Facilities ,
Managed Care Contracts ,
Materiality ,
Medical Devices ,
Off-Label Promotion ,
Overpayment Recovery Time Limits ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Pleading Standards ,
Public Disclosure ,
Qui Tam ,
Relators ,
Retaliation ,
Reverse False Claims ,
Scienter ,
Settlement Agreements ,
Skilled Nursing Facility ,
Stark Law ,
Universal Health Services Inc v United States ex rel Escobar ,
Yates Memorandum
After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more
2/22/2017
/ Administrative Authority ,
Attorney General ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Hospice ,
Interlocutory Appeals ,
Qui Tam ,
Relators ,
Settlement ,
Statistical Sampling ,
Veto Rights