News & Analysis as of September 23, 2024

Anti-Kickback Statute › Supreme Court of the United States

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The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The... more +

The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -

Federal Agency Deference Eliminated, Now What?

Burr & Forman on 9/19/2024

On June 28, 2024, the U.S. Supreme Court issued a decision that overrules the “Chevron doctrine.” This means that federal agencies are limited in their ability to rely on their own interpretation of the laws they...more

Relator Calls on Supreme Court to Define Standard for a ‘Willful’ Kickback under Federal Anti-Kickback Statute

ArentFox Schiff on 7/19/2024

On June 7, Adam Hart, a former employee of McKesson Corporation, filed a petition for certiorari to the US Supreme Court asking the Court to define the “willfulness” element of the Anti-Kickback Statute (AKS). United States...more

The Supreme Court Made Its Rulings; Corporate Compliance Needs March On

NAVEX on 7/3/2024

At the end of June, the U.S. Supreme Court issued major decisions on the enforcement power of the Securities and Exchange Commission, what does or doesn’t qualify as a bribe of government officials, and on federal judges’...more

Causation Split: First Circuit Pauses Teva Appeal; Regeneron Appeal Going Forward

Bass, Berry & Sims PLC on 6/24/2024

False Claims Act (FCA) practitioners have been closely watching cases in which courts address the causation requirement in FCA actions based on Anti-Kickback Statute (AKS) violations....more

EnforceMintz — Practical Lessons Learned from FCA Litigation in 2023

Mintz on 2/12/2024

In 2023, the Supreme Court and the United States Courts of Appeals published a number of significant decisions with implications for entities in the health care and life science industries facing False Claims Act (FCA)...more

Health-Care Fraud Scrutiny Heats Up For Companies, Providers

Foley & Lardner LLP on 1/4/2024

This year will see a continued proliferation of enforcement against health-care fraud, with old and new theories. Some hot spots for enforcement will involve cases about new technologies; data outliers; entities perceived as...more

District of Massachusetts Split on Causation Standard in Kickback FCA Cases

Bradley Arant Boult Cummings LLP on 10/30/2023

The District of Massachusetts has joined the growing chorus of courts that have applied a heightened causation standard in False Claims Act (FCA) cases predicated on the Anti-Kickback Statute (AKS). U.S. District Judge F....more

True Facts About False Claims: MoFo's FCA Newsletter - October 2023

Morrison & Foerster LLP on 10/11/2023

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

U.S. Supreme Court Declines to Clarify Key Provisions of the False Claims and Anti-kickback Statutes

Stevens & Lee on 10/10/2023

Last week, the U.S. Supreme Court denied the request of qui tam relators that it review the Sixth Circuit’s recent decision in United States of America ex rel. Martin v. Hathaway, No. 22-1463 (6th Cir.). In so doing, the...more

District Courts Wrestle with Causation in Kickback Cases While Circuit Courts Remain Divided

Bass, Berry & Sims PLC on 10/6/2023

Two Massachusetts federal district courts recently addressed—and disagreed about—an important False Claims Act (FCA) issue that has also divided the federal circuit courts: when an alleged FCA violation is based on an...more

Investigations Newsletter: New FCA Filings Point to Future Path Forward For Companies

ArentFox Schiff on 7/17/2023

New FCA Filings Point to Future Path Forward For Companies - The US Supreme Court recently ruled in United States ex rel. Proctor v. Safeway Inc. and United States ex rel. Schutte, et al. v. SuperValu Inc. et al. that...more

False Claims Act Update: A Mid-Year Review (2023)

Husch Blackwell LLP on 7/7/2023

The Supreme Court issued a number of headline-grabbing decisions this term on topics like religious accommodation, LGBTQ protections, and consideration of race in college admissions. These decisions are wide-reaching and...more

Supreme Court Removes Some Defenses to False Claims Act Liability for Government Contractors and Health Care Providers

Warner Norcross + Judd on 6/9/2023

Government contractors, health care providers and many other parties who submit claims for payment to the federal government are subject to liability under the False Claims Act (FCA). This month, the U.S. Supreme Court issued...more

Eighth Circuit Splits with Third: Must Show “But-For” Causation

Zuckerman Spaeder LLP on 12/21/2022

In 2010, Congress amended the Anti-Kickback Statute (the “AKS”) to provide that “a claim that includes items or services resulting from a violation of [the AKS] constitutes a false or fraudulent claim” for purposes of the...more

Managed Care & the FCA: Are Courts Getting It Right?

Foley & Lardner LLP on 9/23/2022

Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more

Investigations Newsletter: HHS Announces Formation of FCA Working Group

ArentFox Schiff on 12/14/2020

HHS Announces Formation of FCA Working Group - On December 4, 2020, the US Department of Health and Human Services (HHS) announced that it is creating a False Claims Act Working Group to enhance the partnership between...more

Escobar’s “Rigorous” Materiality Standard: Recent Developments – Part Two

Bass, Berry & Sims PLC on 4/9/2020

This is the second post of a two-part discussion of recent developments related to the materiality standard set forth by the Supreme Court in Universal Health Services v. U.S. ex rel. Escobar. Read our previous post, which...more

Escobar’s “Rigorous” Materiality Standard: Recent Developments – Part One

Bass, Berry & Sims PLC on 3/23/2020

This is the first post of a two-part discussion of recent developments related to the materiality standard set forth by the Supreme Court in Universal Health Services, Inc. v. U.S. ex rel. Escobar. Our second post will cover...more

Skadden's 2020 Insights

Skadden, Arps, Slate, Meagher & Flom LLP on 1/30/2020

Despite political and economic uncertainties, markets and deal activity were resilient in 2019, and strong fundamentals remain in place heading into 2020. Companies continue to face a challenging litigation and enforcement...more

A Dialogue With Corporate Counsel: Skadden’s Ninth Annual Pharmaceutical and Medical Device Seminar

Skadden, Arps, Slate, Meagher & Flom LLP on 12/2/2019

On October 22, 2019, Skadden hosted our Ninth Annual Pharmaceutical and Medical Device Enforcement and Litigation Seminar in New York, which focused on U.S. enforcement issues companies face throughout the industry. The key...more

False Claims Act: 2016 Year in Review

Bradley Arant Boult Cummings LLP on 1/10/2017

We are pleased to present Bradley’s annual review of significant False Claims Act (FCA) cases, developments, and trends. From a relatively short article several years ago, the Review has grown to a significant publication...more

False Claims Act: 2015 Year in Review

Bradley Arant Boult Cummings LLP on 12/22/2015

This year continued the trend of aggressive False Claims Act (FCA) enforcement by the Department of Justice (DOJ) and high volumes of qui tam lawsuits brought by whistleblowers. In fiscal year 2015, the DOJ marked the fourth...more

OMNICARE and its Implications

CMCP - California Minority Counsel Program on 11/4/2015

In the spring of this year, the Supreme Court issued its long-awaited decision in Omnicare, Inc. v. Laborers District Council Construction Industry Pension Fund, 135 S.Ct. 1318 (2015), resolving a circuit split regarding the...more

Healthcare Legal News: Volume 5, Number 3

Dickinson Wright on 8/24/2015

RESPONDING TO SUBPOENAS AND OTHER REQUESTS FOR PERSONAL HEALTH INFORMATION: TAKE THEM AT FACE VALUE - Healthcare providers and other HIPAA covered entities receive requests for protected health information (“PHI”) from...more

Can an Arbitrator Rule Against a Hospital for Not Violating the Anti-Kickback Statute?

Faegre Drinker Biddle & Reath LLP on 2/17/2015

Here’s a nightmare. An arbitrator rules against your hospital for failing to honor an agreement to refer Medicare patients to a home health agency. Why? Because the home health agency paid your hospital good money for the...more

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