On September 30, 2024, a federal district court in Florida held the qui tam enforcement provision of the False Claims Act (“FCA”), which permits private citizens to pursue actions in the name of and on behalf of the...more
10/11/2024
/ Appointments Clause ,
Article II ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Florida ,
Medicare ,
Officers of the United States ,
Qui Tam ,
Relators ,
SCOTUS ,
Take Care Clause ,
United States ex rel Polansky v Executive Health Resources Inc
On April 20, 2022, the Department of Justice (“DOJ”) announced twenty-one (21) defendants were charged in nine (9) different districts related to $149 million in COVID-19-related false billing issues. $8 million in cash and...more
4/26/2022
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Confidential Information ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement ,
False Billing ,
Fraud ,
Healthcare Fraud ,
Personal Protective Equipment ,
Provider Relief Fund
CMS and OIG released highly anticipated final changes to the rules implementing the Stark Law, the safe harbors issued under the Anti-Kickback Statute (AKS) and the beneficiary inducements provision in the civil monetary...more
12/1/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Cybersecurity ,
Digital Health ,
DMEPOS ,
Electronic Health Record Incentives ,
Fair Market Value ,
Final Rules ,
OIG ,
Proposed Rules ,
Remuneration ,
Risk Assessment ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Healthcare systems, hospital networks, and other healthcare providers regularly face challenges that may require an internal investigation to determine the root cause of an issue in order to evaluate how best to remediate and...more
11/12/2019
/ Auditors ,
Audits ,
Best Practices ,
Data Preservation ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Internal Investigations ,
Medicare ,
Overpayment ,
Publicly-Traded Companies ,
Risk Management ,
Witnesses
On September 9, 2019, the Eleventh Circuit issued a highly anticipated opinion addressing the critical question of when Medicare claims for reimbursement (in this case, claims for hospice care) can be considered “false” under...more