AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more
7/23/2024
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Artificial Intelligence ,
Drug Trafficking ,
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Whistleblowers
In the realm of False Claims Act (“FCA”) litigation, the emergence of artificial intelligence (“AI”) and data mining technologies has introduced both opportunities and complexities for defense strategies. Historically, qui...more
On August 6, 2020, the United States Court of Appeals for the Sixth Circuit upheld the conviction of a patient recruiter in a Medicare kickback case, finding insufficient evidence to demonstrate that the recruiter was a “bona...more
On March 15, 2020, the Fifth Circuit issued an unpublished decision holding that a provider facing recoupment during the course of a Medicare claims appeal could not obtain federal question jurisdiction under 28 U.S.C. § 1331...more
On April 10, 2020, the Department of Health and Human Services (DHHS) released the first $30 billion portion of the $100 billion stimulus fund intended to provide financial relief to healthcare providers during the COVID-19...more
With the introduction of RACs, ZPICs, and UPICs, the administrative process for Medicare payment disputes has resulted in three to five year delays in adjudicating claims while providers are faced with almost certain...more
On Friday, September 14, 2018, U.S. District Judge Steven Merryday for the Middle District of Florida sentenced Dr. John Janick of Port Charlotte to five months in prison and three years of supervised release, plus...more
On January 11, 2018, the United States District Court for the Middle District of Florida set aside a nearly $350 million False Claims Act (FCA) jury verdict rendered in February 2017 against a group of fifty-three skilled...more
On October 5, 2017, in United States of America ex rel. Swoben v. Scan Health Plan, et al. (“Swoben”), Judge John F. Walter of the United States District Court for the Central District of California granted United Health...more
On July 13, 2017, the Department of Justice, in conjunction with the Department of Health and Human Services, announced the largest series of health care charges in American history. The government charged 412 individuals,...more
On January 17, 2017, the Department of Health and Human Services (HHS) released a Final Rule announcing a three-prong appellate process change in an effort to decrease the growing Medicare appeals backlog at the...more