I. Introduction -
While 2020 was a year like no other in many ways, the challenges posed by the global COVID-19 pandemic do not appear to have stalled the Department of Justice’s (DOJ) health care fraud enforcement...more
2/3/2021
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
OIG ,
Telemedicine
Telemedicine providers – whether they are established or new to the space – should examine the type of conduct DOJ has recently focused on and adapt their compliance systems accordingly. Providers should also consider the...more
As scientists around the globe team up to discover and develop treatments and vaccine candidates for COVID-19, we are also seeing unprecedented speed and coordination in the effort to quell a different kind of virus — the...more
8/4/2020
/ CARES Act ,
Coronavirus/COVID-19 ,
Criminal Investigations ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Federal Trade Commission (FTC) ,
Healthcare Fraud ,
Memorandum of Understanding ,
Securities Fraud ,
SIGPR ,
White Collar Crimes
On June 18, the Third Circuit affirmed a District of Delaware decision dismissing a False Claims Act (FCA) case against Medco Health Solutions, Inc. because the relator was not an original source of the information underlying...more
On April 9, after four days of deliberations, a jury returned guilty verdicts for seven defendants in United States v. Beauchamp, No. 16-cr-00516-D (N.D. Tex. 2016). ...more
The Northern District of Illinois is the latest court to grant a defendant’s motion to dismiss in a False Claims Act (FCA) case, after the relator failed to meet the substantial pleading burden established in the U.S. Supreme...more
3/22/2019
/ False Billing ,
False Claims Act (FCA) ,
FRCP 9(b) ,
Healthcare Fraud ,
Hospira ,
Materiality ,
Medical Devices ,
Medicare ,
Motion to Dismiss ,
Pfizer ,
Relators ,
Universal Health Services Inc v United States ex rel Escobar
It has been one year since the U.S. Supreme Court’s landmark ruling in Universal Health Services v. United States ex rel. Escobar, which resolved a circuit split as to the validity of the implied false certification theory...more
9/21/2017
/ Conditions of Payment ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Implied Certification ,
Materiality ,
Medicaid ,
Motion to Dismiss ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar ,
Unlicensed Medical Providers