News & Analysis as of

Fraud and Abuse

Morgan Lewis

Ninth Circuit’s Refusal to Consider Government Appeal of FCA Dismissal Authority Portends Trouble

Morgan Lewis on

Just as the government’s exercise of its statutory authority to dismiss non-intervened False Claims Act (FCA) qui tam cases was beginning to pick up steam, the US Court of Appeals for the Ninth Circuit has issued a new...more

Epstein Becker & Green

Fraud and Abuse Enforcement Priorities in the Wake of COVID-19 - Diagnosing Health Care Podcast

In this Diagnosing Health Care episode, hear how the government’s fraud and abuse enforcement priorities have shifted as a result of the COVID-19 pandemic and how compliance programs must also pivot to mitigate new risks. The...more

Michael Volkov

Oklahoma City Hospital, Management Company, And Physician Group To Pay $72.3 Million To Settle Federal And State False Claims Act

Michael Volkov on

The Justice Department’s enforcement programs are resuming – False Claims Act, FCPA and other programs will continue.  The rate of enforcement, however, is subject to change once again from the impact of the pandemic....more

Baker Ober Health Law

OIG Approves Discount Medical Plan Arrangement with Chiropractors in Advisory Opinion 20-03

Baker Ober Health Law on

In Advisory Opinion 20-03, published July 1, 2020, the Office of Inspector General (OIG) approved an arrangement in which a discount medical plan organization (DMPO) that receives annual membership fees from its members also...more

Bradley Arant Boult Cummings LLP

The Clock is Ticking: The Countdown to Final Compounding Pharmacy Prosecutions

Many compound pharmacists who participated in the TRICARE program learned, in the most painful of ways, that the Department of Justice (DOJ) casts a very long shadow when large amounts of money pour out of a government...more

Bricker & Eckler LLP

Anticipating COVID-19 enforcement action: Risks for providers

Bricker & Eckler LLP on

Federal and local governments have issued numerous waivers and provided significant funding in order to enable health care providers to combat the COVID-19 pandemic. These waivers and additional funding have given providers...more

Michael Volkov

Drug and Medical Device Fraud Risks Increase in Pandemic Era

Michael Volkov on

The drug and medical device/testing industry is under significant pressure to develop new products to address the COVID-19 pandemic.  The federal government is increasing spending and support of drug and device companies in...more

Seyfarth Shaw LLP

OIG Announces Strategic Plan for Oversight of COVID-19 Response and Recovery Efforts

Seyfarth Shaw LLP on

The US Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) recently announced its “Strategic Plan: Oversight of COVID-19 Response and Recovery,” a document that sets forth OIG top goals and...more

Pierce Atwood LLP

COVID-19: Rash of Fraudulent Unemployment Claims Blanketing New England

Pierce Atwood LLP on

Over the past two weeks, companies in Maine, Massachusetts and Rhode Island, have been receiving notices of unemployment benefits claims filed on behalf of employees who are still working and who did not file for...more

Robinson+Cole Health Law Diagnosis

CMS Issues Explanatory Guidance of Blanket Physician Self-Referral (Stark) Law Waivers for COVID-19 in Response to Industry...

Amidst the cavalcade of regulatory and policy changes from federal and state governments intended to help health care providers confront the COVID-19 pandemic, on April 21, 2020 the Centers for Medicare & Medicaid Services...more

Lathrop GPM

Minimizing Risk of Liability Under the False Claims Act in the COVID-19 World

Lathrop GPM on

Long-term care providers face multiple challenges that have put them at the epicenter of the COVID-19 public health crisis. Not only is COVID-19 exacting an extraordinary and tragic human toll on nursing homes, it is creating...more

Bricker & Eckler LLP

COVID-19 Update: CMS issues explanatory guidance on Stark Law blanket waivers

Bricker & Eckler LLP on

On April 21, 2020, the Centers for Medicare & Medicaid Services (CMS) issued additional guidance explaining the scope and application of the Stark Law blanket waivers to certain financial relationships. CMS issued the Stark...more

Akerman LLP - Health Law Rx

Buyer Beware – FBI Warns of Fraud Involving Procurement of PPE and Other COVID-19 Supplies

Many employers are now making plans to have their employees return to the workplace. Based on recent alerts from the FBI, part of preparing to protect workers from COVID-19 at work should include protecting the company from...more

Arent Fox

Investigations Newsletter: SDNY Files Civil Fraud Lawsuit Against Anthem

Arent Fox on

SDNY Files Civil Fraud Lawsuit Against Anthem - On March 27, 2020, the Manhattan U.S Attorney announced the filing of a civil fraud lawsuit against Anthem Inc. for allegedly falsely certifying the accuracy of diagnosis...more

Foley & Lardner LLP

Charitable Giving, Government Support and Concession Requests, and Anti-Corruption Compliance in the Time of the Coronavirus...

Foley & Lardner LLP on

The COVID-19 pandemic has created hardships across the globe at unprecedented levels – with practically no region or industry unaffected. Governments at all levels across the globe, along with non-governmental and...more

Cadwalader, Wickersham & Taft LLP

COVID-19 Update: Are You For Real? Due Diligence in the Age of Coronavirus

In the context of COVID-19, there are significant challenges involved in conducting due diligence: hard-copy documents are inaccessible, in-person meetings have moved online, and on-site visits may be impossible....more

Arent Fox

Department of Justice Directed to Prioritize Investigation and Prosecution of COVID-19-Related Fraud

Arent Fox on

On March 16, 2020, United States Attorney General William Barr issued a memo directing all U.S. Attorneys to prioritize the detection, investigation, and prosecution of COVID-19-related fraud, amid reports of scams, malware,...more

Arnall Golden Gregory LLP

Mitigating Fraud and Corruption Risks During the COVID-19 Crisis

Fraud and corruption thrive in chaos. The COVID-19 pandemic and its economic destabilization create the conditions in which misconduct can thrive....more

Morgan Lewis - Health Law Scan

Mere Differences of Judicial Opinion Emerge to Muddle Healthcare Providers False Claims Act Exposure for Mere Differences of...

In the Care Alternatives False Claims Act (FCA) appeal, a panel of the US Court of Appeals for the Third Circuit on March 4 reversed the summary judgment granted to hospice provider Care Alternatives at the district court,...more

Polsinelli

FCA Targets Areas For 2020 and Increased Use Of The Voluntary Disclosures

Polsinelli on

Jody Hunt, Assistant Attorney General for DOJ’s Civil Division, and Michael Granston, Deputy Assistant Attorney General, Commercial Litigation Branch, spoke recently about False Claims Act (“FCA”) enforcement at the Federal...more

Polsinelli

DOJ Cuts Bait in High-Profile Statistical Sampling FCA Case

Polsinelli on

On Thursday, AseraCare, a national hospice care provider, announced that it had settled a long-standing Medicare billing dispute with the DOJ, a case that has garnered nationwide attention in healthcare since 2008. At issue...more

Robinson+Cole Data Privacy + Security Insider

OIG Audit Finds that Majority of Part D Providers Surveyed used E1 Transactions for Potentially Inappropriate Purposes

The Centers for Medicare and Medicaid Services (CMS) requested an audit by the Office of Inspector General of Medicare Part D eligibility transactions (E1) transactions....more

Holland & Hart - Health Law Blog

Patient Inducements: Gifts, Discounts, Waiving Co-Pays, Free Screening Exams, Etc.

Although often well-intentioned, offering free or discounted items or services to patients (e.g., gifts, rewards, writing off copays, free screening exams, free supplies, etc.) may violate federal and state laws governing...more

Morgan Lewis - Health Law Scan

$1 Million Settlement Reached in AseraCare FCA Case

In an action especially significant to hospice providers but also other healthcare providers regarding the determinations of medical necessity for Medicare billing purposes, the US Department of Justice (DOJ) and AseraCare...more

K&L Gates LLP

The False Claims Act & Health Care: 2019 Recoveries and 2020 Outlook

K&L Gates LLP on

In 2019, the False Claims Act (“FCA”) remained the federal government’s (“Government”) primary method of civil fraud enforcement. While the more than $3 billion in civil fraud recoveries in Fiscal Year (“FY”) 2019 resulted...more

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Updates to This Policy

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Contacting JD Supra

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