News & Analysis as of

Health Care Providers Statistical Sampling

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

American Conference Institute (ACI)

[Event] False Claims and Qui Tam Enforcement Forum – Strategies to Respond to the Rapidly Changing Landscape of False Claims Act...

With more than 34.8 billion recovered by the government since 2010 under the federal False Claims Act, it has never been more crucial for private practitioners and corporate in-house counsel to keep abreast of the changes and...more

Morgan Lewis

CMS Makes Significant Changes in Statistical Sampling Methodology for Overpayment Estimation

Morgan Lewis on

A new update to the Medicare Program Integrity Manual offers healthcare providers and suppliers more details on how Medicare contractors should perform statistical sampling and when extrapolation of overpayment determinations...more

Sheppard Mullin Richter & Hampton LLP

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

Arnall Golden Gregory LLP

Health Care Fraud Institute Held at Georgia Bar Headquarters

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

Latham & Watkins LLP

Fourth Circuit Declines to Address Use of Statistical Sampling in False Claims Act Cases

Latham & Watkins LLP on

Court of Appeals panel rules use of statistical sampling is inappropriate for interlocutory appeal, leaving FCA litigants without any direct appellate court guidance. In the closely watched case United States ex rel....more

Saul Ewing LLP

Fourth Circuit Sidesteps Statistical Sampling Issue

Saul Ewing LLP on

In a decision issued yesterday, the United States Court of Appeals for the Fourth Circuit dismissed an appeal that would have addressed one of the most pressing unresolved issues in False Claims Act jurisprudence: whether...more

Arnall Golden Gregory LLP

Another Court Rejects Statistical Sampling and Rules That Difference of Opinion About Hospice Eligibility Is Insufficient for...

Back in March of this year, in U.S. ex rel. Paradies v. AseraCare, Inc., a district court in Alabama granted summary judgment to a defendant hospice finding that an expert physician’s disagreement with a certifying...more

BakerHostetler

Differences in Medical Opinions: Not Enough to Prove FCA Liability

BakerHostetler on

In a $200 million False Claims Act (FCA) litigation with certain twists and turns, the U.S. District Court for the Northern District of Alabama recently found that the federal government failed to show that claims submitted...more

Skadden, Arps, Slate, Meagher & Flom LLP

"Supreme Court Permits Use of Statistical 'Representational Evidence': Implications for the FCA"

On March 22, 2016, the U.S. Supreme Court issued a decision in the Fair Labor Standards Act (FLSA) class action Tyson Foods, Inc. v. Bouaphakeo. In an opinion authored by Justice Anthony Kennedy, the majority held that class...more

Baker Donelson

Senate Considering Bill to Speed Medicare Claims Appeals

Baker Donelson on

In early December of last year, Orrin Hatch (Senate Finance Committee Chairman, R-UT) and Ron Wyden (D-OR) introduced the Audit and Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (AFFIRM Act). The purpose of...more

Robinson & Cole LLP

JAMA Releases Study Analyzing Scope and Characteristics of Recent Data Breaches

Robinson & Cole LLP on

Reports of security breaches involving health care information have become increasingly prevalent in recent years, and such breaches seem to be continually growing in scope and magnitude. In the April 14, 2015, issue of JAMA,...more

12 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide