Share on Twitter Share by Email Share Back to top On May 22, 2025, the U.S. Supreme Court issued a significant decision in Kousisis v. United States, affirming a six-year prison sentence for a contractor convicted of federal...more
5/29/2025
/ Compliance ,
Construction Contracts ,
Construction Industry ,
Criminal Liability ,
DBE Program ,
Federal Contractors ,
Federal Funding ,
Fraud ,
Government Agencies ,
SCOTUS ,
Wire Fraud
On August 1, 2024, the Department of Justice’s (DOJ) Criminal Division launched a three-year Corporate Whistleblower Awards Pilot Program (the “Pilot Program”). (See Part 1 and Part 3 of this series for more information.) The...more
Multinational companies should be alert to legal exposure under the False Claims Act (FCA). The FCA is a civil statute that can be quite damaging to a multinational company for several reasons:
The FCA has extremely...more
This year will see a continued proliferation of enforcement against health-care fraud, with old and new theories. Some hot spots for enforcement will involve cases about new technologies; data outliers; entities perceived as...more
1/4/2024
/ Ambiguous ,
Anti-Kickback Statute ,
Biden Administration ,
Compliance ,
Coronavirus/COVID-19 ,
Cyber Crimes ,
Data Mining ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement ,
Executive Orders ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Hospice ,
Kickbacks ,
SCOTUS ,
Telemarketing
Does violating requirements amount to fraud under the False Claims Act (FCA) when the requirements allegedly violated are unclear? There is currently a circuit split and petitions for review pending to the Supreme Court as to...more
1/11/2023
/ Ambiguous ,
Centers for Medicare & Medicaid Services (CMS) ,
Fair Credit Reporting Act (FCRA) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
ICD Codes ,
Medical Reimbursement ,
Medicare Advantage Organizations (MAOs) ,
Motion to Dismiss ,
Regulatory Requirements ,
SCOTUS
Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more
9/23/2022
/ Anti-Kickback Statute ,
Beneficiaries ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Liability ,
Department of Justice (DOJ) ,
Dismissal With Prejudice ,
False Claims Act (FCA) ,
Fee-for-Service ,
Fraud ,
Health Care Providers ,
Managed Care Contracts ,
MCOs ,
Medicare ,
Medicare Advantage ,
Risk Adjustment Formula ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar
The COVID-19 Public Health Emergency (PHE) is expected to prompt unprecedented levels of regulatory enforcement activity that is focused on the use of telemedicine. In fact, fraudulent and abusive telehealth practices was an...more
7/16/2021
/ Audits ,
CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Data Privacy ,
Department of Justice (DOJ) ,
Enforcement Actions ,
FQHC ,
Fraud ,
Health Insurance Portability and Accountability Act (HIPAA) ,
OCR ,
OIG ,
Public Health Emergency ,
Relief Measures ,
Rural Health Care Providers ,
Telehealth
Although a whistleblowing employee typically cannot release fraud claims against her employer brought on behalf of the United States under the False Claims Act (FCA), courts have demonstrated a willingness to enforce properly...more
10/9/2019
/ Anti-Retaliation Provisions ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Qui Tam ,
Release of Claims ,
Retaliation ,
Severance Agreements ,
Waiver of Liability ,
Waivers ,
Whistleblower Protection Policies ,
Whistleblowers