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
Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more
11/27/2023
/ Anti-Kickback Statute ,
C-Suite Executives ,
Chief Compliance Officers ,
Chief Privacy Officer ,
Continuing Legal Education ,
Criminal Liability ,
Department of Justice (DOJ) ,
Enforcement ,
Ethics ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Hospitals ,
Laboratories ,
Long-Term Care ,
MCOs ,
Mental Health ,
Physicians ,
Self-Disclosure Requirements ,
Substance Abuse ,
Webinars
Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more
11/27/2023
/ Anti-Kickback Statute ,
C-Suite Executives ,
Chief Compliance Officers ,
Chief Privacy Officer ,
Continuing Legal Education ,
Criminal Liability ,
Department of Justice (DOJ) ,
Enforcement ,
Ethics ,
Events ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Hospitals ,
Laboratories ,
Long-Term Care ,
MCOs ,
Mental Health ,
Physicians ,
Self-Disclosure Requirements ,
Substance Abuse
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
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
Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy at the highest levels of...more
1/16/2019
/ Appointments Clause ,
Article II ,
Article III ,
Constitutional Challenges ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Dismissals ,
Drug Distribution ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Materiality ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Relators ,
Standing ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers
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
In the recent past, the government has racked up a number of FCA settlements based on alleged violations of the Anti-Kickback Statute (AKS). This focus undoubtedly will remain a high enforcement priority....more
The government’s FCA enforcement efforts have continued to focus on key areas concerning the pharmaceutical and medical device industries. In fact, drug and device manufacturers accounted for nearly half of the enforcement...more
5/16/2017
/ Anti-Kickback Statute ,
Discount Pricing ,
False Claims Act (FCA) ,
Fraud ,
GlaxoSmithKline ,
Health Insurance ,
Medical Devices ,
Off-Label Promotion ,
Pfizer ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Prescription Drugs ,
RICO
Physician employment arrangements with hospitals have remained a significant area of regulatory scrutiny in recent months with the announcement of several high profile settlements and decisions in key FCA cases involving...more
5/5/2017
/ Anti-Kickback Statute ,
Employment Contract ,
False Claims Act (FCA) ,
Healthcare Facilities ,
Hospitals ,
Medicare ,
Physicians ,
Referral Fees ,
Relators ,
Settlement ,
Stark Law
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