News & Analysis as of

Department of Justice (DOJ) Physicians Medicare Advantage

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - July 21st - 24th, Nashville, TN

Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more

A&O Shearman

DOJ Announces Settlement Where Medical Group And Related Parties Will Pay Over $62M To Resolve False Claims Act Suit

A&O Shearman on

On March 26, the Department of Justice (“DOJ”) announced that a California-headquartered healthcare provider, Seoul Medical Group Inc. (“Seoul Medical”), its former president and majority owner, and a Seoul Medical subsidiary...more

WilmerHale

DOJ Settles False Claims Act Suit Against Medicare Advantage Provider

WilmerHale on

On March 26, 2025, the U.S. Department of Justice (DOJ) announced that it settled a False Claims Act (FCA) action against a California-based healthcare provider and a separate radiology group for allegedly submitting and...more

ArentFox Schiff

Investigations Newsletter: Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses

ArentFox Schiff on

Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses - On March 26, the US Department of Justice (DOJ) announced that a California-based medical group and related parties...more

Bass, Berry & Sims PLC

Seoul Medical Group and Renaissance Imaging Medical Associates Settle Medicare Risk Adjustment Fraud Case for $62 Million

Bass, Berry & Sims PLC on

The Department of Justice announced this week that California-based primary care provider Seoul Medical Group, Inc. (SMG), SMG’s former president and majority owner, and California-based radiology group Renaissance Imaging...more

Bass, Berry & Sims PLC

13th Annual Healthcare Fraud & Abuse Review - 2024

Bass, Berry & Sims is pleased to announce the release of the 13th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2024. Compiled by the firm's Healthcare Fraud & Abuse Task Force,...more

WilmerHale

Lessons from Hospital Criminal Prosecution for Larger Health Systems and Provider Groups

WilmerHale on

On January 8, 2025, the U.S. Department of Justice (DOJ) announced that a federal grand jury indicted the Chesapeake Regional Medical Center (CRMC) in Virginia for conspiracy to defraud the United States and health care...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

Polsinelli on

Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

Bass, Berry & Sims PLC

11th Annual Healthcare Fraud & Abuse Review 2022

Bass, Berry & Sims PLC on

We are pleased to bring you our 11th 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

Epstein Becker & Green

Video: Record-Shattering Year for FCA Recoveries in Health Care - Thought Leaders in Health Law

Epstein Becker & Green on

The U.S. Department of Justice (DOJ) collected $5.6 billion in False Claims Act recoveries in fiscal year (FY) 2021. That is over twice as much as 2020, and a record 90 percent of the total was collected from the health care...more

Steptoe & Johnson PLLC

DOJ Continues to Target Health Care Companies - False Claims Act Settlements and Judgments in Fiscal Year 2021

Steptoe & Johnson PLLC on

The Department of Justice recently reported that in fiscal year 2021, it received more than $5.6 billion in settlements and judgments. Of that total, over $5 billion relates to matters that involved the health care industry....more

Wiley Rein LLP

[Webinar] Adjusting the Risk for Medicare Advantage: Recent Enforcement Trends and Litigation Involving Medicare Advantage Risk...

Wiley Rein LLP on

The Department of Justice (DOJ) continues to concentrate on risk adjustment programs of payers with Medicare Advantage Organizations (MAO) as a prime enforcement target. One particular area of focus, both civilly and...more

King & Spalding

DOJ Settles False Claims Act (FCA) Case Against Medicare Advantage Providers

King & Spalding on

On August 8, 2019, the DOJ announced a $5 million settlement with Beaver Medical Group L.P. (Beaver) and one of its physicians, Dr. Sherif Khalil, to resolve FCA allegations. Dr. David Nutter, a former employee, brought a...more

Shumaker, Loop & Kendrick, LLP

Client Alert: Feds Shine a Light on Medicare Advantage Plans and Physicians Related to Risk Adjustment Practices

Although the sufficiency of medical records documentation supporting beneficiary diagnoses for Medicare Advantage (MA) risk adjustment has been on the OIG’s work plan since 2013, the Department of Justice has upped the ante...more

16 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide