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Investigations Healthcare Fraud

Holland & Hart LLP

Key Compliance Takeaways for Companies from the DOJ's New Corporate Whistleblower Program

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On August 1, 2024, the U.S. Department of Justice (“DOJ”) announced its new “Corporate Whistleblower Awards Pilot Program” (“DOJ Program”), a three-year initiative managed by DOJ’s Money Laundering and Asset Recovery Section....more

Proskauer - Health Care Law Brief

CMS Proposes Additional Modifications to the Overpayment Rule Relating to the Deadline for Reporting and Returning Overpayments

In the context of Medicare Advantage (“MA”) reform initiatives, we previously addressed the Centers for Medicare & Medicaid Services’ (“CMS”) December 27, 2022 proposal to amend its regulations set forth at 42 C.F.R. §...more

Society of Corporate Compliance and Ethics...

[Event] Regional Compliance & Ethics Conference - May 3rd, Lewis Center, OH

Looking for compliance education and networking in your area? SCCE & HCCA’s Regional Compliance & Ethics Conferences bring compliance practitioners from all disciplines together for convenient, local compliance education....more

Health Care Compliance Association (HCCA)

[Event] Regional Compliance & Ethics Conference - May 3rd, Lewis Center, OH

Looking for compliance education and networking in your area? SCCE & HCCA’s Regional Compliance & Ethics Conferences bring compliance practitioners from all disciplines together for convenient, local compliance education....more

Sheppard Mullin Richter & Hampton LLP

Increased Enforcement in Healthcare? DOJ to Add More Prosecutors

An official from the Department of Justice (“DOJ”) recently announced the DOJ’s plans to “substantially” add to its current roster of 75 prosecutors specializing in healthcare fraud. On November 7, John “Fritz” Scanlon,...more

Venable LLP

[Ongoing Program] Life Sciences Series - Current Trends in Life Sciences and Healthcare Enforcement: Understanding and...

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We are excited to announce Venable’s inaugural Life Sciences Webinar Series. This month-long series will explore the intricacies and latest developments that shape the life sciences industry. Join us as we hear from our...more

Health Care Compliance Association (HCCA)

[Webinar] Healthcare Fraud, Waste, & Abuse Investigations - May 2nd, 12:00 pm - 1:30 pm CT

Learning Objectives - The importance of developing investigation standards - How to avoid regency bias when conducting investigations - Presenting your investigation findings to stakeholders (OIG, AG, MFCU, etc.)...more

Oberheiden P.C.

Ten Things You Should Do NOW if Your Medical License is at Risk

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As a doctor or other licensed medical professional, the prospect of losing your license to practice medicine can be overwhelming. But, to protect your license—and your career—to the fullest extent possible, you need to act...more

Oberheiden P.C.

Ten Things You Should Know if Your Clinical Laboratory is Under Investigation

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Similar to other types of healthcare entities, clinical laboratories have been facing enhanced scrutiny from federal authorities over the past couple of years. While this is due in part to fraud concerns related to COVID-19...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

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: Avoiding the Pitfalls in Recent Government Enforcement - December 8th, 12:00 pm - 1:00 pm ET

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Please join us for the December Lunch and Learn with Benjamin Malerba and Benjamin Wisher. The pair will discuss recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG and...more

Bradley Arant Boult Cummings LLP

Medicare Advantage Programs’ Increasing Popularity Invites Heightened FCA and Regulatory Scrutiny

As Medicare Advantage attracts more eligible beneficiaries, it is also drawing attention from False Claims Act (FCA) prosecutors. In 2022, enrollment in Medicare Advantage plans reached 28.7 million Medicare beneficiaries, or...more

Oberheiden P.C.

5 Keys to Effective Texas Medical Board Investigation Defense

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As a licensed physician in Texas, facing a Texas Medical Board (TMB) investigation can entail significant risks. Depending on the allegations underlying the investigation, your medical license could be in jeopardy—and you...more

Oberheiden P.C.

10 Steps to Take When Accused of Healthcare Fraud in Detroit

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Medical professionals, patients, and others can commit healthcare fraud by deceiving the healthcare system, such as providing medically unnecessary services, in order to get unauthorized benefits or payments. Facing...more

K&L Gates LLP

Qui Tam Quarterly - Data on Defense: Invalidating FCA Allegations Based on Statistical Sampling and Extrapolation

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Statistical sampling and extrapolation have become accepted tools for establishing damages in health care administrative proceedings and False Claims Act (FCA) litigation over the past 30 years. Key Takeaways - 1....more

McDermott Will & Emery

DOJ Demonstrates Commitment to COVID-19-Related Healthcare Enforcement with New Criminal Charges

On April 20, 2022, the US Department of Justice (DOJ) announced a nationwide coordinated law enforcement action focused on COVID-19-related healthcare fraud. In total, DOJ brought criminal charges against 21 individuals,...more

Oberheiden P.C.

6 Frequently Asked Questions with Lab Defense Attorney Nick Oberheiden

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Clinical laboratories have come under increased scrutiny in the past few years, especially those that deal with COVID-19 testing or drug testing. These federal investigations can be surprising and confusing for lab...more

Foley & Lardner LLP

What’s New in ’22: More DOJ-Driven False Claims Act Investigations

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On February 1, 2022, the Department of Justice (DOJ) issued its annual release touting its latest accomplishments in the False Claims Act field, advertising another multibillion-dollar year in recoveries; $5.6 billion makes...more

Oberheiden P.C.

5 Tips for Lab Compliance in 2023

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In many ways, the COVID-19 pandemic increased the business opportunities available to clinical labs, including molecular and respiratory labs. As the nation—and the world—struggled to develop adequate testing infrastructure,...more

Health Care Compliance Association (HCCA)

[Event] Nashville Regional Healthcare Compliance Conference - November 5th, Nashville, TN

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Health Care Compliance Association (HCCA)

[Event] Scottsdale Regional Healthcare Compliance Conference - November 5th, Scottsdale, AZ

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Health Care Compliance Association (HCCA)

[Event] Chicago Regional Healthcare Compliance Conference - October 22nd, Chicago, IL

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

ArentFox Schiff

Senator Chuck Grassley Introduces Bipartisan Amendments to False Claims Act Aimed at Clarifying “Confusion” Over Materiality...

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On Monday, Senator Chuck Grassley, R-Iowa, introduced the False Claims Amendments Act of 2021, section 2 of which would provide that defendants “may rebut an argument of materiality” as to an allegedly false claim submitted...more

Oberheiden P.C.

Key Elements of an OIG Compliance Program That Respiratory and Clinical Labs Need to Know

Oberheiden P.C. on

Clinical laboratories such as respiratory and clinical labs that bill Medicare, Department of Health and Human Services (“DHHS”) programs, and other federal programs are subject to oversight by the Office of Inspector General...more

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