There are still several unsettled legal issues regarding the standards applicable to a False Claims Act (FCA) claim, such as the standard to prove causation when an FCA claim is based on a violation of the Anti-Kickback...more
A recent federal court decision has the potential to significantly impact the future of False Claims Act (FCA) lawsuits initiated by whistleblowers and to upend the FCA. In United States of America ex rel. Clarissa Zafirov v....more
The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule, 89 FR 61596, that revives portions of a 2022 proposal to amend the Medicare Overpayment Rule. The 2024 proposed rule comes after...more
Every year, the New Jersey legislature passes statutes that impact healthcare beyond rate increases under the Medicaid program. Last year was no different, and the discussion below highlights some of those statutes, such as...more
6/6/2024
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Centers for Medicare & Medicaid Services (CMS) ,
Cost-Sharing ,
Drug Pricing ,
False Claims Act (FCA) ,
Healthcare ,
Hospitals ,
Licensees ,
Medical License ,
Mental Health ,
New Jersey ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Supply Chain ,
Telehealth