News & Analysis as of

Fraud and Abuse

New FINRA Rules Address Elderly Abuse

by Burr & Forman on

On February 5, 2018, FINRA will enact two rules to assist brokers with addressing financial exploitation of the elderly. Statistically, the elderly have a 1 in 20 chance of being a victim of financial exploitation. ...more

Health Care Fraud Institute Held at Georgia Bar Headquarters

by Arnall Golden Gregory LLP on

On December 7, 2017, the Institute for Continuing Legal Education (ICLE) of the State Bar of Georgia held its annual Health Care Fraud Institute. Topics discussed at the Institute included recent federal and state fraud and...more

OIG Advisory Opinion 17-03 Approves Pharmaceutical Manufacturer's Product Spoilage/Replacement Program

by Baker Ober Health Law on

A pharmaceutical manufacturer proposing to offer customers – at no additional cost – replacements for certain spoiled products that can no longer be administered to patients (Replacement Program) has been granted approval by...more

USCIS to Require Interviews for Employment-Based Adjustment of Status Applications as of October 1

by LeClairRyan on

As of October 1, 2017, United States Citizenship and Immigration Services (USCIS) will mandate an in-person interview for any individual adjusting from an employment-based status to permanent residency (Form I-485 adjustment...more

Expanded Fraud and Abuse Liability under Proposed “Medicare for All” Bill

by Arnall Golden Gregory LLP on

On September 13, 2017, Senator Bernie Sanders (I-VT) introduced his “Medicare for All Act of 2017” which, as the name implies, would expand Medicare to cover nearly every American. Although it is unlikely that the bill will...more

US: Temporary Extension of the NFIP in wake of Hurricane Harvey

by Hogan Lovells on

On September 8th, just days after Hurricane Harvey decimated the Houston metropolitan area, and while many Florida residents were evacuating as Hurricane Irma approached, President Trump signed into law the Continuing...more

OIG Issues Advisory Opinion to Pharmacy

On September 7, 2017, the HHS Office of Inspector General (OIG) issued an Advisory Opinion to the owner of a retail pharmacy chain (Pharmacy) that would allow Federal health care program beneficiaries to participate in a paid...more

USCIS to Mandate In-person Interviews for All Employment-based Permanent Residence Applicants

U.S. Citizenship and Immigration Services (USCIS) has announced that starting Oct. 1, all foreign nationals who have submitted employment-based adjustment of status applications will now be required to undergo a personal...more

OIG Reports That CMS Has Inadequate System for Identifying SNF Abuse

by Holland & Knight LLP on

The U.S. Department of Health & Human Services Office of Inspector General (OIG) has issued an “Early Alert” regarding the preliminary results of an ongoing study of potential abuse or neglect in Medicare-certified skilled...more

Recent Department of Justice Crackdown on Fraud and Abuse

As reported by the New York Times in an article dated July 13, 2017, in an effort to crack down on fraud and abuse, and with a particular focus on opioids, the Department of Justice (“DOJ”) is charging 412 individuals for...more

Supreme Court Limitation on Forfeiture Will Impact Health Care Fraud Prosecutions

by Farrell Fritz, P.C. on

Health care fraud prosecutions in the Second Circuit and throughout the country have typically sought forfeiture money judgments against all defendants for the proceeds of the fraud obtained by all members of a health care...more

Medicaid Fraud Control Units Report Focus on Personal Care Services

by Ruder Ware on

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released a report summarizing activities of State Medicaid Fraud Control Units (MFCUs or Units) for fiscal year 2016. The OIG is the...more

Value-based health care: fraud & abuse laws

by Ropes & Gray LLP on

Michael Lampert, Ropes & Gray health care partner, discusses fraud and abuse law application to value-based health care arrangements. __ Much has been made about how the fraud and abuse laws, which were designed in order...more

Labor Secretary Announces Aggressive Stance on Visa Fraud and Abuse

by Littler on

Secretary of Labor Alexander Acosta has announced that the Department of Labor (DOL) will more aggressively enforce laws governing the administration and enforcement of non-immigrant visa programs. The DOL will continue to...more

Value-based health care: issues for pharmaceutical companies

by Ropes & Gray LLP on

Michael Lampert, Ropes & Gray health care partner, discusses issues facing pharmaceutical companies with the move towards value-based health care models. __ When I think about developing a value-based program for...more

Judge Denies Motion to Dismiss in Case Filed by CFPB Against Debt Relief Attorneys

by Goodwin on

On May 30, 2017, the Honorable Josephine Staton, of the Central District of California, denied? a Motion to Dismiss filed by three law firms, and their principals, in a case filed by the Consumer Financial Protection Bureau...more

Manatt on Health Reform: Weekly Highlights - May 2017 #4

The President's budget proposes over $600 billion in Medicaid cuts on top of major reductions anticipated in repeal and replace legislation; the Trump Administration asks the Court for more time to decide on cost-sharing...more

Tennessee Is Protecting Grandma with New Legislation

Tennessee is protecting Grandma! Two pieces of legislation were approved this year: the Elder and Vulnerable Adult Protection Act, which is on its way to Gov. Haslam to be signed into law, and the Elderly and Vulnerable Adult...more

Why Healthcare and Life Sciences Companies Need to Step Up Their Compliance Efforts in Advance of a U.S. Government Investigation

by Hogan Lovells on

In this hoganlovells.com interview, Hogan Lovells partner Gejaa Gobena discusses how the perception of compliance, remediation, and self-disclosure has evolved in the eyes of government prosecutors from how they factor at...more

USCIS Announces Targeted Use of Site Visits to Certain H-1B Employers to Detect H-1B Visa Fraud and Abuse

by Shipman & Goodwin LLP on

U.S. Citizenship and Immigration Services (USCIS) announced in April multiple measures to deter and detect H-1B visa fraud and abuse. The H-1B visa program is meant to help U.S. companies recruit highly skilled foreign...more

Buy American and Hire American: What it Means for the Construction Industry

On April 18, 2017, President Donald Trump signed into law the “Buy American and Hire American” Executive Order (No. 13788). The Order requires agencies to do a wholesale evaluation of their compliance with “Buy American” laws...more

"Employment Flash – April 2017"

Supreme Court Adopts Deferential Standard of Review for EEOC Cases - On April 3, 2017, in McLane v. EEOC, 137 S.Ct. 30 (2016), the U.S. Supreme Court ruled that appellate courts should review lower court decisions to...more

FINRA's Newest One-Two Punch

by Reminger Co., LPA on

On February 3, 2017, the SEC approved: (1) new FINRA Rule 2165 (Financial Exploitation of Specified Adults[1]) permitting members to place temporary holds on certain customer accounts where there is a reasonable belief of...more

USCIS H-1B Cap Numbers

by Cozen O'Connor on

The U.S. Citizenship and Immigration Services (USCIS) announced on April 7, 2017 that the agency reached the congressionally mandated number of 65,000 visa H-1B Cap petitions for FY2018. USCIS reported on April 17, 2017 that...more

H-1B Cap Reached; President Trump Signs H-1B Executive Order

On April 7, only five business days into the filing season, U.S. Citizenship and Immigration Services (USCIS) announced that it had already received a sufficient number of H-1B petitions to reach the statutory caps for both...more

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