This Tuesday, April 18, 2023, the U.S. Supreme Court heard argument in U.S. v. SuperValu. SuperValu is the second – and more consequential – False Claims Act (FCA) case of the term....more
We previously discussed how recipients of payments from the Provider Relief Fund (PRF) are at risk for allegations of fraud and specifically addressed how these recipients may become targets of False Claims Act (FCA)...more
7/6/2020
/ CARES Act ,
Compliance ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Federal Grants ,
Health Care Providers ,
Healthcare Facilities ,
Hospitals ,
Provider Relief Fund ,
Public Health Emergency ,
Relief Measures ,
Risk Management ,
Whistleblowers
In our last article, we discussed how recipients of payments from the Provider Relief Fund are at risk for allegations of fraud and specifically addressed how these recipients may become targets of False Claims Act (FCA)...more
While the Provider Relief Fund payments sent to health care providers under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) have provided a lifeline to compensate for increased expenses and lost revenues...more
False Claims Act (“FCA”) cases involving medical necessity continue to receive great attention. A March 7, 2017 opinion that overruled a jury’s criminal fraud conviction of a cardiologist demonstrates the broader implications...more
The Seventh Circuit recently added an arrow to a False Claims Act (FCA) defendant's quiver by requiring relators to plead fraud allegations based on objective criteria pursuant to Fed. R. Civ. P. 9(b). This ruling will...more
Since the late 1990s, the False Claims Act (“FCA”) has heavily affected the healthcare industry. In 2015, two-thirds of FCA lawsuits targeted healthcare entities, which paid out $1.9 billion. However, it is likely that this...more
On Feb. 11, the Centers for Medicare & Medicaid Services (CMS) published a final rule relating to the overpayment providers receive from federally funded health care programs. While the rule eases some of the burden for...more