News & Analysis as of

Department of Justice (DOJ) False Billing

Pietragallo Gordon Alfano Bosick & Raspanti,...

Recent False Claims Act Settlement Should Put Treatment Centers on Notice

Late last month, the federal government announced a False Claims Act settlement with Summit BHC New Jersey, LLC, d/b/a Seabrook (“Seabrook”), a prominent New Jersey Drug & Alcohol Rehabilitation facility. The joint settlement...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - January 2025

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

Cozen O'Connor

Whistleblower Watch - A quarterly update on FCA Enforcement and Qui Tam Litigation

Cozen O'Connor on

Whistleblower Watch is a critical resource for in-house counsel and compliance professionals. Each quarter, Cozen O’Connor summarizes the most notable False Claims Act (FCA) enforcement actions, settlements, and legal trends,...more

Lathrop GPM

Fighting the Robots: Texas Attorney General Settles “First-of-its-Kind” Investigation of Healthcare AI Company

Lathrop GPM on

In what it describes as a “First-of-its-Kind Healthcare Generative AI Investigation”, the Texas Attorney General (AGO) recently reached a settlement agreement with an artificial intelligence (AI) healthcare technology...more

Bass, Berry & Sims PLC

HHS-OIG Set To Intensify Scrutiny of Grants and Contract Compliance: How to Prepare

Bass, Berry & Sims PLC on

As we detailed in a previous blog, on October 3, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a strategic plan to “safeguard[] the integrity of HHS grants and contracts.” The...more

ArentFox Schiff

Investigations Newsletter: DOJ Announces Agreement With Rite Aid to Settle Allegations of Violating the FCA and CSA in Relation to...

ArentFox Schiff on

DOJ Announces Agreement With Rite Aid to Settle Allegations of Violating the FCA and CSA in Relation to Opioid Dispensing - On July 10, the US Department of Justice (DOJ) announced that Rite Aid Corporation and 10 of its...more

Husch Blackwell LLP

Arizona Physician Pleads Guilty to Healthcare Fraud over Improper “Incident To” Billings

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“Incident to” billing is widely practiced, and its regulations are generally well-known. But one Arizona physician recently found himself pleading guilty in federal court on April 3, 2024, to a criminal healthcare fraud...more

Harris Beach Murtha PLLC

False Claims Act Enforcement Highlights Need for Robust Compliance Programs

The U.S. Department of Justice (“DOJ”) announced its False Claims Act (“FCA”) enforcement statistics for FY 2023 and identified key priorities for FCA enforcement in 2024 and beyond. The DOJ continues to pursue FCA...more

Cozen O'Connor

Whistleblower Watch - A quarterly update on FCA Enforcement and Qui Tam Litigation - Winter 2024

Cozen O'Connor on

Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

ArentFox Schiff

Investigations Newsletter: Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim

ArentFox Schiff on

Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim - Steven Richardson, the owner of telemedicine companies Expansion Media, LLC and Hybrid Management Group LLC, agreed to settle allegations that...more

Health Care Compliance Association (HCCA)

News Briefs: January 8, 2024

H. Lee Moffitt Cancer Center & Research Institute Hospital Inc. in Tampa, Florida, has agreed to pay $19.564 million to settle false claims allegations over claims submitted to federal health care programs for items and...more

Harris Beach Murtha PLLC

OIG January 2024 Enforcement Summary

The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

DOJ’s Emphasis Of Individual Accountability – Where It Stands, And Where It Could Be Headed

A recent article in Law360 sparked a vigorous conversation among members of Pietragallo’s white collar practice group about the current state of the U.S. Department of Justice’s (DOJ) evolving emphasis on individual...more

Husch Blackwell LLP

Federal Judge Acquits Physician Following Criminal E/M Fraud Conviction at Trial

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As previously reported in this post, criminal trials premised on upcoding evaluation and management (E/M) service codes are extremely rare. The Justice Department took that rare step in Maryland in connection with a practice...more

ArentFox Schiff

Investigations Newsletter: Health Care Network Settles False Claims Act Allegations for $345 Million

ArentFox Schiff on

Health Care Network Settles False Claims Act Allegations for $345 Million - Community Health Network Inc. (CHN) has agreed to pay $345,000,000 to settle allegations that it violated the False Claims Act (FCA) for knowingly...more

Maynard Nexsen

Recent FCA Settlement Highlights Small Business Certification Issues in Private Equity Transactions

Maynard Nexsen on

The Department of Justice ("DOJ") recently announced a $1.75 million false claims settlement with a contractor that "improperly obtained government contracts that were set-aside for small businesses." The DOJ settlement...more

Morrison & Foerster LLP

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

Morrison & Foerster LLP on

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

Husch Blackwell LLP

Physician Loses Rare Criminal E/M Fraud Trial

Husch Blackwell LLP on

Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...more

Health Care Compliance Association (HCCA)

News Briefs: August 14, 2023

Report on Medicare Compliance Volume 32, no 29 (August 2023) In a new Medicare transmittal (12,202), CMS introduced a new place of service (POS) code (27) for “Outreach Site/Street.” POS 27 is defined as “a non-permanent...more

Bradley Arant Boult Cummings LLP

Government Contractor Booz Allen Hamilton Enters One of the Largest Procurement Fraud Settlements with DOJ over FCA Allegations

On Friday, July 21, 2023, DOJ announced it has reached a $377,453,150 settlement with Booz Allen Hamilton Holding Corporation (Booz Allen), the parent company of Booz Allen Hamilton, Inc., the large government and military...more

Morrison & Foerster LLP

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

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2023

Bass, Berry & Sims PLC on

There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023.  Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more

Husch Blackwell LLP

Justice Department Sues Iowa Surgeon Under False Claims Act for Masking Non-Covered Cosmetic Procedures as Covered Surgeries

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Cosmetic surgeries are on the rise. One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. Facelifts were up 54...more

Rivkin Radler LLP

Fraud Week: Focus on Florida Fraud

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To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence...more

Rivkin Radler LLP

Fraud Week: DOJ Announces COVID-Related Fraud Sweep

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The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16...more

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