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Healthcare Fraud Healthcare Fraud

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

ArentFox Schiff

Investigations Newsletter: Cooperation Spares Former NBA Shooting Guard From Prison

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Cooperation Spares Former NBA Shooting Guard From Prison - Former National Basketball Association (NBA) shooting guard, Antoine Wright, was sentenced to time served after he pled guilty to conspiracy and aggravated...more

Bradley Arant Boult Cummings LLP

COVID-19 Fraud Enforcement Remains Priority for Federal Law Enforcement

On April 20, 2023, the Department of Justice announced criminal charges against 18 defendants in nine federal districts, alleging over $490 million in alleged theft from federally funded COVID-19 relief programs. This clearly...more

Foley Hoag LLP - White Collar Law &...

Health Care Enforcement: Review of 2022 and A Look Ahead to 2023

This is the third part in our 2023 series examining important trends in white collar law and investigations. Up next: congressional investigations. Health care fraud enforcement remained a top priority at both the national...more

Jenner & Block

Client Alert: Future Implications of Low Dollar False Claims Act Recoveries for FY2022

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The Department of Justice (DOJ) has released its summary of False Claims Act (FCA) recoveries for Fiscal Year 2022. At $2.2 billion, financial recoveries were significantly lower than the $5.7 billion collected the year...more

Cozen O'Connor

Iowa Settles with Centene for $44.4 Million over Medicaid Overbilling Allegations

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Iowa AG Tom Miller announced a settlement with managed care company Centene Corp. in connection with allegations that the company, which operated as Iowa Total Care in the state, overbilled Iowa’s Medicaid program for...more

Mintz - Health Care Viewpoints

DOJ Announces Another Wide-Ranging COVID-19 Fraud Enforcement Action

For the last few years, we have been closely monitoring and reporting on COVID-19 related fraud enforcement efforts by federal agencies. We detailed those findings in our Health Care Enforcement 2020 Year in Review & 2021...more

Arnall Golden Gregory LLP

Government Investigations Team Insights - February 2022

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics.  In this edition, we analyze a recent Eleventh Circuit decision addressing False Claims Act penalties and the...more

Brooks Pierce

Increased DOJ Enforcement in the Health Care Space

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Health care providers and entities take note: The Department of Justice (DOJ) is increasingly focused on enforcement in the health care space. DOJ has long prioritized health care fraud, but under the prior administration...more

Seyfarth Shaw LLP

Insurers, ERISA Plans and Other Payors:  Beware of COVID-19 Fraud Schemes!

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On March 23, 2020, the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) issued an alert to the public about fraud schemes related to the novel coronavirus (COVID-19)....more

The Volkov Law Group

Tenet Healthcare Settles Fraud Case for $514 Million

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If you work in compliance in the healthcare industry, you have a tough job. The number and variety of risks that healthcare providers face is daunting. The False Claims Act is a mighty weapon in the hands of federal...more

Polsinelli

DOJ Hires Compliance Counsel to Aid in Charging Decisions

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In today’s robust enforcement climate, most companies have taken at least the first steps towards establishing a formal corporate compliance program. The mere existence of such a program, however, will not by itself protect a...more

Holland & Knight LLP

DOJ Appoints Compliance Counsel to Provide Advice in FCPA Investigations

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The U.S. Department of Justice (DOJ) is creating a new compliance counsel position in the Criminal Division’s Fraud Section to scrutinize the compliance programs of companies under investigation for possible Foreign Corrupt...more

Cooley LLP

Blog: CMS Announces that Data Analytics has Prevented $820M in Improper Medicare Payments

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The Office of Inspector General (OIG) recently certified the “positive return on investment” from the FPS and recommended its continued operation, although the OIG determined that it was not feasible at this time to expand...more

Cooley LLP

Blog: OIG Reports Targeting Medicare Part D Fraud Issued on the Heels of National Medicare Fraud Sweep

Cooley LLP on

The Health and Human Services (HHS) Office of Inspector General (OIG) released two reports yesterday related to Medicare Part D fraud. The OIG report, Ensuring the Integrity of Medicare Part D, “synthesizes numerous OIG...more

McGuireWoods LLP

Washington Healthcare Update

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This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more

Cooley LLP

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

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Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

Akerman LLP - Health Law Rx

What Is Your Fraud Rank?

On June 2, 2015, Center for Medicare & Medicaid Services (CMS), provided direction to state Medicaid Directors on the implementation of Section 6401 of the Affordable Care Act, Provider Screening and Other Enrollment...more

Williams Mullen

Williams Mullen and Local Counsel, Bryan Davis, Win Declaratory Action Against HSD in New Mexico!!

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For those of you who follow my blog, you know that the single state agency in New Mexico, Human Services Department (HSD), accused 15 behavioral health care providers, which made up 87% of the mental health care in NM, of...more

Faegre Drinker Biddle & Reath LLP

U.S. Accuses NYC of Massive Fraud in Program for Developmentally Challenged Toddlers

It’s the city that never sleeps. So when it does something, it can do it in a big way. That applies to Medicaid fraud, according to a suit filed yesterday by the U.S. Attorney for the Southern District of New York....more

Dickinson Wright

Laboratory Payments to Physicians for Specimen Processing Present Substantial Risk of Fraud and Abuse

Dickinson Wright on

The United States Office of Inspector General (“OIG”) recently issued a “Special Fraud Alert” focusing on two potentially illegal trends that it has detected in arrangements between laboratories and their referring...more

Proskauer - Government Contractor Compliance...

Proskauer Obtains Dismissal of High-Stakes False Claims Act Suit

On August 7, 2014, Judge Castel of the Southern District of New York dismissed a False Claims Act (“FCA”) complaint that was based primarily on allegations that the defendant Hospital improperly focused on referral revenue in...more

Mintz - Health Care Viewpoints

Health Care Update - August 2014 #2

In This Issue: - Brady Unveils Medicare/Medicaid Fraud Bill - Possible Litigation Threat Adds to Considerations in Containing Drug Costs - Implementation of the Affordable Care Act - Other Federal...more

Foley & Lardner LLP

Medicare's Fraud Prevention System: CMS Issues Second-Year Report to Congress

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The Small Business Jobs Act of 2010 (pertinent sections of which are codified at 42 U.S.C. Section 1320a-7m) directed the Centers for Medicare & Medicaid Services (CMS) to use predictive modeling and other analytics...more

Latham & Watkins LLP

Latest Developments in Healthcare Fraud: Companies Facing Increased Scrutiny

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In May 2014 the American Bar Association held its 24th Annual National Institute on Health Care Fraud, focusing on the latest developments in the area of healthcare fraud. Latham & Watkins partner Katherine Lauer served on...more

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