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Materiality Health Care Providers

Dorsey & Whitney LLP

The False Claims Act and the Anti-Kickback Statute: Causation, Materiality, and the Connection Between the Two

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Violations of the federal Anti-Kickback Statute (the “AKS”) have long served as a basis for liability under the federal False Claims Act (the “FCA”). Recently, however, there has been increasing uncertainty regarding how far...more

Stevens & Lee

False Claims Act’s Materiality Requirement Spotlighted Again in Recently-Decided Third Circuit Case

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The False Claims Act’s (FCA) materiality requirement as articulated by the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel. Escobar, 579 U.S. 176 (2016) was again front and center, this time in a...more

Manatt, Phelps & Phillips, LLP

New York’s Disclosure of Material Transactions Law Takes Effect

As part of the Fiscal Year (FY) 2024 New York State Budget, New York adopted legislation that granted the Department of Health (DOH or Department) oversight of certain health care transactions involving physician practices...more

Bass, Berry & Sims PLC

Recent False Claims Act Decisions to Know

In this post, we summarize noteworthy False Claims Act (FCA) decisions so far from 2023. Each of the three circuit court opinions discussed here ruled in favor of the defendants on different aspects of the FCA: the Sixth...more

Bradley Arant Boult Cummings LLP

2021 AHLA Year in Review: False Claims Act and Government Enforcement

E. False Claims Act: Materiality - 1. False Claims Amendments Act of 2021 (S.2428) - • The Senate Committee on the Judiciary has approved for the Senate’s full consideration an amendment to the FCA that would...more

Goodwin

Senate Judiciary Committee Advances False Claims Act Amendment to Full Senate

Goodwin on

On October 28, a majority of members on the Senate Judiciary Committee voted 15-7 to advance to the full Senate a bipartisan bill that would make a number of amendments to the False Claims Act (“FCA”), including one that...more

Proskauer - Health Care Law Brief

False Claims Act Spotlight (2 of 3): Recent Proposed Amendments to the FCA Fall Short of Cohesive and Substantive Change

In July 2021, Senator Chuck Grassley led a bipartisan group of senators in introducing S.B. 2428, the “False Claims Amendments Act of 2021,” which aims to address legal developments in FCA doctrine that, according to the...more

McDermott Will & Emery

[Webinar] Providers and Healthcare Enforcement in 2021: Biden, COVID-19 and FCA Updates Impacting Your Business - April 12th, 1:00...

The large volume of relief funding distributed by the government in connection with the COVID-19 pandemic will be the source of enforcement and regulatory scrutiny for years to come. During this webinar – the first in a...more

American Conference Institute (ACI)

[Virtual Event] 8th Annual Advanced Forum on False Claims and Qui Tam Enforcement - March 24th - 25th, 8:15 am - 4:45 pm...

THE ONLY EVENT WHERE YOU'LL HEAR FROM Government, In-house Counsel, The Judiciary, the Defense & Relator’s Bar - ACI’s 8th Annual Advanced Forum on False Claims and Qui Tam Enforcement will address the underlying...more

Bradley Arant Boult Cummings LLP

False Claims Act: 2019 Year in Review

The year 2019 was another active year in False Claims Act (FCA) investigations and litigation. Although the year lacked a singular blockbuster case, there were decisions of particular note. The Supreme Court clarified the...more

Foley Hoag LLP - White Collar Law &...

White Collar Year in Preview: False Claims Act Trends in 2020

Editors’ Note: This is the fourth in our start-of-year series examining important trends in white collar law and investigations in the coming year. Our previous entry discussed anti-corruption trends in 2020. Up next: a look...more

Dorsey & Whitney LLP

Escobar in Action: Physician-owners’ fraud claims against hospital defeated in Fifth Circuit appeal for lack of materiality

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Following the passage of the Affordable Care Act (“ACA”), which placed new limits on physician-owned hospitals, St. Luke’s Health System (“System”) took action to change one of its hospital’s ownership structures through a...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

Mintz - Health Care Viewpoints

Third Time’s Not the Charm: Supreme Court Again Declines to Weigh in on Escobar’s “Materiality” Standard

The Supreme Court denied a petition for certiorari last Monday in U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc., No. 17-5826 (6th Cir. June 11, 2018), again declining to revisit or clarify the False Claims...more

K&L Gates LLP

K&L Gates Triage: Triage in 2019: Health Care Topics to Watch in the New Year

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As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more

McDermott Will & Emery

Health Care Enforcement Quarterly Roundup - Q4 | January 2019

McDermott Will & Emery on

This latest installment of the Health Care Enforcement Quarterly Roundup reflects on trends that persisted in 2018 and those emerging trends that will carry us into 2019 and beyond. Leading off with the US Department of...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Year End Review: A Look Back…A Look Ahead

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Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy at the highest levels of...more

Skadden, Arps, Slate, Meagher & Flom LLP

A Dialogue With Corporate Counsel: Skadden’s Eighth Annual Pharmaceutical and Medical Device Seminar

On October 30, 2018, Skadden hosted its Eighth Annual Pharmaceutical and Medical Device Enforcement and Litigation Seminar in New York City, which focused on U.S. enforcement issues faced by companies throughout the industry....more

Bass, Berry & Sims PLC

No Consensus on Materiality: Courts Continue to Grapple with Escobar’s Key Holdings

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Since the 2016 Supreme Court decision in Universal Services Inc. v. United States ex rel. Escobar, courts have wrestled with exactly how to apply the unanimous decision. This post highlights developments across the country in...more

The Volkov Law Group

The Supreme Court’s Escobar Decision and the Impact on False Claims Act Cases (Part I of IV)

The Volkov Law Group on

This week I am running a series of posts on healthcare fraud enforcement and the False Claims Act. With all the controversy swirling around the Mueller investigation and prosecutions, the Justice Department continues its...more

Cadwalader, Wickersham & Taft LLP

Untimely Physician Certifications for Medicare Home Care Claims—Arguably a Technicality—Vulnerable to False Claims Act...

On June 11, 2018, the United States Court of Appeals for the Sixth Circuit sustained a complaint against a home health care agency alleging that the agency had violated the False Claims Act (the “FCA”) by submitting numerous...more

Sheppard Mullin Richter & Hampton LLP

What Have We Learned About False Claims Act Litigation in the Two Years Since Universal Health Services, Inc. v. United States ex...

Summer is almost here. For some, that means planning vacations to the beach, hitting the gym to shed that winter weight, or perhaps hitting the golf course—but for us at the Sheppard Mullin Healthcare Law Blog and the False...more

Skadden, Arps, Slate, Meagher & Flom LLP

Enforcement and Litigation Strategies: Skadden’s Eighth Annual Pharmaceutical, Biotechnology and Medical Device Seminar

On March 15, 2018, Skadden hosted its Eighth Annual Pharmaceutical, Biotechnology and Medical Device Seminar in Palo Alto, California, which focused on U.S. enforcement issues faced by companies throughout the industry. The...more

Foley & Lardner LLP

DOJ Memoranda Ushering in New Era for Health Care Enforcement

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In January 2018, the Department of Justice (DOJ) issued two memoranda that, taken together, may usher in a new era of False Claims Act (FCA) enforcement in the health care industry. The first memorandum, dated January 10,...more

K&L Gates LLP

K&L Gates Triage: Triage in 2018: Health Care Topics to Watch in the New Year

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We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more

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