News & Analysis as of

Department of Justice (DOJ) Long Term Care Facilities

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

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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

Troutman Pepper

Lessons for Skilled Nursing and Assisted Living Facilities From the ‘Largest Health Care Fraud Case’

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Phillip Esformes, the alleged mastermind of one of “the largest single criminal health care fraud cases ever brought against individuals by the Department of Justice,”has finally reached a plea deal with the Department of...more

McGuireWoods LLP

Senior Living Alert – Antitrust Developments Related to Transactions Involving Private Equity Investment in Senior Living...

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White House and Agency Initiatives - On Dec. 13, 2023, the White House announced new efforts to lower healthcare and prescription drug costs, issuing a detailed Fact Sheet. Two of the initiatives focus on private equity...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q1 2023

On February 7, the Department of Justice (DOJ) issued a press release indicating that settlements and judgments under the False Claims Act (FCA) exceeded $2.2 billion in the fiscal year ending September 30, 2022. Of this...more

Baker Donelson

Tips for Long Term Care Providers' Prevention of and Defending Against Quality of Care Allegations

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Quality of care allegations against long term care providers are a focus for the Biden administration, the Department of Justice (DOJ), and the HHS-OIG – all of whom are targeting providers whom they deem to be providing...more

Verrill

The PHE is Ending: Do You Know Where Your Waivers Are?

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While the pandemic is not over, the COVID-19 public health emergency (PHE) is expected to expire soon, which means that a number of operational, safety, and billing standards that were waived at the beginning of the pandemic...more

Dentons

Department of Justice Files False Claims Act Charges Against Nursing Home Chain

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The United States Department of Justice (DOJ) has filed another False Claims Act case against a long-term care provider premised on the quality of care provided to its residents. The DOJ is increasingly utilizing substandard...more

Bradley Arant Boult Cummings LLP

DOJ Brings False Claims Act Suit Against Serial LTC Whistleblower

Thomas Prose is the founder and owner of a Michigan-based “post-hospitalist” company named General Medicine P.C. (GM), which purports to specialize in the care of post-acute patients in long-term care facilities by providing...more

Bradley Arant Boult Cummings LLP

Skyline Fraud Charges Serve as a Warning to Inexperienced Operators

In the past month, state and federal prosecutors have separately charged the former CEO of Skyline Healthcare, Joseph Schwartz, with Medicaid and tax fraud. The criminal actions, which represent the latest legal action...more

Bradley Arant Boult Cummings LLP

Private Equity in the Crosshairs

Private equity investors in nursing homes should brace and prepare for an active near-term enforcement environment. Congressional skepticism of private equity involvement in healthcare, developments in False Claims Act cases...more

Bradley Arant Boult Cummings LLP

Heightened Scrutiny of Nursing Homes (and Private Equity) in Post-COVID-19 Enforcement

On March 3, 2020, then-Attorney General William Barr announced the Department of Justice’s National Nursing Home Initiative, which aimed to “bring justice to those owners and operators who have profited at the expense of...more

McGuireWoods LLP

DOJ Announces Plan for Coordinated Civil Rights Response to COVID-19

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On April 2, 2021, Pamela S. Karlan, the Principal Deputy Assistant Attorney General for Civil Rights at the U.S. Department of Justice Civil Rights Division (DOJ), issued a public statement regarding the Division’s intent to...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2020

Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more

Troutman Pepper

Trying Times For Nursing Homes: How Increased Compliance Practices Can Stem The Next Wave Of DOJ Enforcement

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As the world’s health care facilities grapple with the devastating and unexpected operational struggles brought by COVID-19, nursing homes and long-term care facilities face the added challenge of protecting their residents...more

Manatt, Phelps & Phillips, LLP

Heightened Risk of Criminal and Civil Liability for Nursing Homes in the Time of COVID-19

Nursing homes and other post-acute healthcare providers have long been the focus of both government investigations and private plaintiffs focusing on quality of care, staffing and billing issues. Now that such facilities have...more

UB Greensfelder LLP

Guidance for Long-Term Care Facilities Facing Increased Scrutiny in the Wake of Coronavirus

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In recent weeks, the U.S. Department of Justice has sharply increased scrutiny of owners and operators of long-term care facilities and nursing homes. On March 3, 2020, Attorney General William Barr announced the “DOJ’s...more

McGuireWoods LLP

New DOJ Task Force to Target Substandard Nursing Home Care

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In a March 3, 2020, speech by Attorney General Bill Barr, the Department of Justice (DOJ) announced a new nursing home enforcement initiative targeting “grossly-substandard” care of Medicare and Medicaid beneficiaries in...more

Baker Donelson

Evaluating the Effectiveness of Corporate Compliance Programs – What the Government is Looking For

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The U.S. Justice Department has updated its "Evaluation of Corporate Compliance Programs," a guidance document detailing topics and questions prosecutors should weigh when determining whether a company has demonstrated...more

Bass, Berry & Sims PLC

Tennessee Nursing Home Chain Reaches “Largest Worthless Services Resolution in Tennessee’s History”

Government Settles with Several Entities, Individuals - Last week, Vanguard Healthcare and related entities reached a settlement with the Department of Justice (DOJ) for the stated amount of more than $18 million to settle...more

Baker Donelson

A Year Into the Elder Justice Task Force: Is Your Community a Target?

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On March 30, 2016, the Department of Justice issued a press release announcing its launch of ten Elder Justice Task Forces in the Northern District of California, Northern District of Georgia, District of Kansas, Western...more

Bradley Arant Boult Cummings LLP

2016 – Health Law Year in Review

We are pleased to present our annual review of developments in the field of health law. The year was marked by key changes in False Claims Act jurisprudence and Medicare payment policy. 2016 also brought with it focused...more

Farella Braun + Martel LLP

Kickback Prosecutions Expanding Beyond Drugs and Devices to Care Networks

The DOJ has recently showed some new muscle by applying anti-kickback laws to care facility owners rather than drug manufacturers. The uptick in federal healthcare fraud prosecutions in 2016 has been well-documented, but...more

Polsinelli

DOJ Targets Nursing Fraud with New Task Forces

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On March 30, 2016, the U.S. Department of Justice launched 10 regional task forces targeting “grossly substandard care” in nursing homes and other long-term care facilities across the country. The task forces combine federal,...more

King & Spalding

DOJ Announces Regional Elder Justice Task Forces

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On March 30, 2016, the United States Department of Justice (DOJ) issued a press release announcing the launch of ten regional Elder Justice Task Forces. The release describes these Task Forces as part of DOJ’s efforts to...more

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