News & Analysis as of

False Claims Act (FCA) UnitedHealth

King & Spalding

U.S. Supreme Court Will Not Review D.C. Circuit Court’s Revival of False Claims Act Liability for Medicare Advantage Plans Failing...

King & Spalding on

On June 21, 2022, the Supreme Court denied certiorari in the case of UnitedHealthcare Co., et al v. Becerra et al., Case No. 21-1140, wherein UnitedHealthcare attempted to overturn the D.C. Circuit Court’s revival of CMS’s...more

Foley & Lardner LLP

Provider Relief Fund: Protecting Your Institution from False Claims Act Allegations after Receipt of CARES Act Funding

Foley & Lardner LLP on

In April 2020, the Department of Health and Human Services (HHS) revealed a plan to disperse $175 billion in funding for health care providers allocated by the Coronavirus Aid, Relief, and Economic Security (CARES) Act and...more

Bass, Berry & Sims PLC

Medicare Advantage: Recent Developments in FCA Enforcement

The Medicare Advantage program, which allows private insurance companies to offer and administer Medicare benefits, continues to be an area of sharp scrutiny for False Claims Act (FCA) enforcement despite some significant...more

Troutman Pepper

Federal Court Strikes DOJ's Risk Adjustment False Claims Act Case - For Now

Troutman Pepper on

On October 5, a federal district court in California dealt a significant setback to the government’s efforts to extend False Claims Act (FCA) liability to Medicare risk adjustment submissions....more

Sheppard Mullin Richter & Hampton LLP

Alert: In a Surprise Decision Issued on October 5, 2017, Honorable John Walter, United States District Judge, Dismissed a Medicare...

On October 5, 2017, the Honorable Judge John Walter of the United States District Court, Central District of California, granted the Defendants’ Motion to Dismiss the Medicare Advantage (“MA”) Federal False Claims Act (“FCA”)...more

Sheppard Mullin Richter & Hampton LLP

Medicare Advantage Plans Under Fire: The Department of Justice Files Complaints-in-Intervention

As reported in earlier blogs, the federal Department of Justice (DOJ) has been actively looking into potential abuses by Medicare Advantage (MA) Organizations as to allegedly improper risk adjustment claims submissions and...more

Bass, Berry & Sims PLC

DOJ Intervenes in Risk Adjustment FCA Case

Recently, the DOJ intervened in one of several currently pending qui tam cases involving Medicare Advantage (MA) and the Risk Adjustment process used to determine the amount of payments to Medicare Advantage Organizations...more

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