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
The Supreme Court today issued its ruling on one of the most significant False Claims Act (FCA) cases it has considered in the last several years. In the consolidated cases of United States ex rel. Schutte et al. v. SuperValu...more
The presence of private equity (PE) investment has exploded in recent years in all areas of the health care sector. PE in health care is a good thing when done right: It can pave the way for much needed innovation,...more
3/30/2023
/ Antitrust Division ,
Biden Administration ,
Department of Justice (DOJ) ,
Due Diligence ,
Enforcement ,
Healthcare ,
Investment ,
Kickbacks ,
Medicaid ,
Private Equity ,
Reimbursements ,
The Clayton Act
On December 6, 2022, the Supreme Court heard argument in United States ex rel. Polansky v. Executive Health Resources, Inc., a case with potential implications on the cost and longevity of certain False Claims Act (FCA)...more
When a company decides to self-disclose misconduct (or conduct that may be construed as such) to the government, that decision triggers a stream of additional questions. In the weighty deliberations about whether and what to...more
12/2/2021
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Disclosure Requirements ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Legal Representatives ,
Liability ,
OIG ,
Self-Disclosure Requirements ,
Suppliers
As most recently spotlighted by the Department of Justice’s intervention in whistleblower claims against ManorCare, DOJ is increasing its enforcement of the False Claims Act (FCA) against therapy providers. In particular, DOJ...more