Last week, the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) issued Advisory Opinion No. 22-09 (AO 22-09), which addresses a proposed arrangement pursuant to which the operator of a...more
Last week, the Third Circuit joined several other appellate courts in finding that medical opinions related to medical necessity of hospice services can be subject to scrutiny and found to be “false” for purposes of proving a...more
Last week the Department of Justice (DOJ) announced a $57 million settlement with electronic health record (EHR) software vendor Greenway Health LLC (Greenway). According to DOJ, Greenway violated the False Claims Act (FCA)...more
2/14/2019
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
EHR ,
Electronic Health Record Incentives ,
False Claims Act (FCA) ,
Health Care Providers ,
Meaningful Use ,
Medicaid ,
Medicare ,
OIG ,
Settlement Agreements ,
Software ,
Third-Party Service Provider
Overview of Qui Tam Activity -
..We identified 56 health care related qui tam cases that were unsealed in October and November 2017.
..The intervention rate for those unsealed cases was 20%, which is consistent with...more
The U.S. Court of Appeals for the Fifth Circuit recently decided a case that could have a substantial impact on False Claims Act (“FCA”) jurisprudence with respect to the element of “materiality.” In U.S. ex rel. Joshua...more
11/30/2017
/ Attorney's Fees ,
Department of Justice (DOJ) ,
Department of Transportation (DOT) ,
Disclosure Requirements ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Federal Highway Administration ,
Federal Rule 12(b)(6) ,
Material Misstatements ,
Materiality ,
Qui Tam ,
Reimbursements ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Writ of Mandamus
A court in the Southern District of New York (“SDNY” or the “Court”) recently released an important decision applying the Supreme Court’s landmark Escobar ruling to a qui tam action involving percentage fee arrangements for...more
Trends & Analysis -
..This issue looks at 18 health care–related qui tam cases that were unsealed in whole or in part in late October through November 2016.
..The cases identified were filed in federal district courts...more
Featured Unsealed Cases
United States ex rel. Thomas v. Best Choice Home Health Care Agency, Inc., No. 2:13-cv-02209 (D. Kan.) -
Complaint Filed: May 6, 2013 -
Complaint Unsealed: October 24, 2016...more
3/17/2017
/ Anti-Retaliation Provisions ,
Civil Penalty Fund ,
Co-Conspirators ,
Corporate Integrity Agreement ,
Criminal Penalties ,
Dismissals ,
False Billing ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Former Employee ,
Guilty Pleas ,
Home Health Care ,
Intervenors ,
Kickbacks ,
Medicaid ,
Medicare ,
Qui Tam ,
Relators ,
Stark Law ,
State False Claims Acts ,
Whistleblowers