News & Analysis as of

False Claims Act (FCA)

United States Intervenes in Suit Against Private Equity Firm Based on Health Care Portfolio Company's Alleged False Claims Act...

• In an unusual move, the government has decided to pursue a False Claims Act (FCA) suit against a private equity firm based on an alleged commission scheme at its pharmacy portfolio company to promote sales of products...more

Civil and criminal penalties increased for fraud and abuse

by Bricker & Eckler LLP on

The Bipartisan Budget Act of 2018 (BBA 2018) significantly increased civil and criminal penalties for federal health care program fraud and abuse. Below is a summary of some of the BBA 2018 changes to the maximum penalty...more

Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies

by Polsinelli on

The Bipartisan Budget Act of 2018, commonly referred to as the “Continuing Resolution,” was recently signed into law, creating a short-term fix to funding the federal government for six weeks while also raising the debt...more

Health Care Investors Beware: U.S. Attorney Sues Private Equity Firm For Portfolio Company’s Alleged Billing Fraud

The U.S. Attorney for the Southern District of Florida has recently decided to intervene in a lawsuit brought under the Federal False Claims Act and initiated by a whistleblower. The U.S. Attorney has filed his own...more

Monitoring Company to Pay $550,000 to Settle False Claims Act Allegations

by King & Spalding on

Marshfield Medical, Inc., formerly Bromedicon, Inc. (“Bromedicon”), has agreed to pay $550,000 to settle allegations under the False Claims Act (FCA)....more

Weekly Update Newsletter - March 2018 #2

by PilieroMazza PLLC on

GOVERNMENT CONTRACTING - San Diego Communications Company Pays More Than $12 Million to Settle False Claim Act Allegations Regarding Eligibility for Small Business Innovation and Research Contracts - According to a news...more

Changes in Federal Enforcement Cases and the Stark Law May Benefit Health Care Providers

by Ruder Ware on

Some recent changes in federal law and in federal agency interpretation of federal law may both clarify and relieve some regulatory obligations of health care providers. Lessening Dependence on Federal Agency...more

Government Contracts Legislative and Regulatory Updates - March 2018

by Dentons on

Our March edition of “Government Contracts Legislative and Regulatory Update” offers a summary of the relevant changes that took place during the month of February....more

Recent Healthcare Fraud Suit Puts Private Equity Industry on Notice as to Potential Liability for Portfolio Company Conduct

by White and Williams LLP on

In February, the Department of Justice (DOJ) intervened in a False Claims Act case alleging healthcare fraud, a common enough event. The case in question, originally began in 2015 as a whistleblower case brought by two...more

Recent Anti-Kickback Cases Emphasize Government Scrutiny of Speaker’s Bureaus and Lavish Meals Funded by Pharmaceutical and Device...

The Department of Justice (DOJ) recently resolved two health care fraud cases – one criminal and one civil – that demonstrate the government’s continued scrutiny of lavish meals and “speaker’s bureaus” sponsored by...more

Bipartisan Budget Act Revises Stark Law, Increases Penalties for AKS and CMP Law Violations, and Expands Telehealth Coverage

On February 9, 2018, Congress passed the Bipartisan Budget Act of 2018 (the Act), which included a number of important health law provisions.. ...more

The State AG Report Weekly Update

by Cozen O'Connor on

Consumer Protection- Arizona Attorney General Announces Settlement with Auto Manufacturer Over Alleged Ignition Switch Defects- Arizona AG Mark Brnovich reached a settlement with auto manufacturer General Motors LLC...more

Healthcare Industry Beware: The Use of Statistical Sampling to Establish Damages and Liability Under the False Claims Act Remains...

The False Claims Act contains numerous requirements that are designed to prevent meritless cases from proceeding to discovery and trial. Among these provisions is the rule that, to establish liability, the government or a...more

Compliance and the Attorney-Client Privilege

by Michael Volkov on

Chief compliance officers have to work closely with the chief legal officer or general counsel on a number of important issues. ...more

FCA Materiality May Return to High Court

by Morrison & Foerster LLP on

In Escobar, the U.S. Supreme Court held that a defendant could be found liable under the False Claims Act for submitting impliedly false claims for payment. Under the implied certification theory of liability, a claim for...more

Recent FCA Settlement Shows That What’s Old Is New in Health Care Fraud Enforcement

Last week, the U.S. Attorney’s Office for the District of Massachusetts announced that it had entered into an agreement with a Massachusetts-based medical device manufacturer to settle allegations that the Company had...more

Your Daily Dose of Financial News

by Robins Kaplan LLP on

Breakingviews on what the White House’s intervention into Broadcom’s [dropped] bid for Qualcomm could mean for the US-based chip maker. [Hint, it involves China, and it’s not great for the big Q]....more

Red Notice Newsletter - Russian

ANTICORRUPTION DEVELOPMENTS – U.S. Agencies Decline to Prosecute Teradata for Alleged FCPA Violations – On February 26, 2018, Teradata Corporation, an Ohio-based enterprise software database management company,...more

Red Notice Newsletter - Chinese

ANTICORRUPTION DEVELOPMENTS – U.S. Agencies Decline to Prosecute Teradata for Alleged FCPA Violations – On February 26, 2018, Teradata Corporation, an Ohio-based enterprise software database management company,...more

Healthcare Fraud & Abuse Review 2017

by Bass, Berry & Sims PLC on

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Brand’s Memo and Dan’s Desk

Last month, then-Associate Attorney General Rachel Brand issued a memorandum to Department of Justice civil lawyers concerning the circumstances under which they may and may not use federal agencies’ “guidance documents” in...more

Defending False Claims Act Cases: Two New Tools Under the Trump Administration

by Foley Hoag LLP on

Earlier this year, the Department of Justice, Civil Division, issued two policy memos that will directly affect its civil enforcement priorities, particularly with regard to healthcare and life sciences companies. The first...more

Hospital, Cardiology Group Settle False Claims Act Allegations for $20.75 Million

by King & Spalding on

As reported previously, Hamot Medical Center (“Hamot”) and Medicor Associates, Inc. (“Medicor”) entered into a preliminary settlement agreement under which they agreed to pay $20.75 million to resolve kickback allegations...more

DOJ Memoranda Ushering in New Era for Health Care Enforcement

by Foley & Lardner LLP on

In January 2018, the Department of Justice (DOJ) issued two memoranda that, taken together, may usher in a new era of False Claims Act (FCA) enforcement in the health care industry. The first memorandum, dated January 10,...more

False Claims Act Alert - An Escobar Roundup: Falsity, Materiality, and Scienter

by WilmerHale on

In its June 2016 decision in Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016), the Supreme Court held that implied certification claims are viable under the False Claims Act (FCA), but...more

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