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
Seyfarth Synopsis: In a major victory for ERISA plans and other payors, the Fifth Circuit recently overturned a district court’s notorious decision in favor of a healthcare provider and reinstated a plan administrator’s...more
2/13/2018
/ Appeals ,
Breach of Duty ,
CIGNA ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Health and Welfare Plans ,
Healthcare Facilities ,
Healthcare Fraud ,
Medical Reimbursement ,
Plan Administrators ,
Reversal ,
Underpayment
Seyfarth Synopsis: The Fourth Circuit found that the medical necessity of a given service constitutes a material element of representations regarding submissions for payment, potentially providing payors with another legal...more
11/16/2017
/ Clinical Laboratories ,
Criminal Convictions ,
Drug & Alcohol Abuse ,
Drug Testing ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
False Billing ,
Health Clinics ,
Health Insurance ,
Healthcare Fraud ,
Material Misrepresentation ,
Medical Necessity