False Claims Act (FCA) civil fraud recoveries in Fiscal Year (FY) 2020 dropped over US$850 million when compared to those in FY 2019. While the more than US$2.2 billion in recoveries in FY 2020 continued a general downward...more
In this week’s episode, Richard Church and Mary Beth Johnston discuss a number of critical issues in the health care industry that are likely to be points of focus in the coming year, including the COVID-19 pandemic, False...more
In 2019, the False Claims Act (“FCA”) remained the federal government’s (“Government”) primary method of civil fraud enforcement. While the more than $3 billion in civil fraud recoveries in Fiscal Year (“FY”) 2019 resulted...more
In 2018, the False Claims Act (“FCA”) continued to be one of the federal government’s (“Government”) preferred civil fraud enforcement tools across a variety of industries. The healthcare industry, however, remained the...more
We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more
2/28/2018
/ Bundled Payments ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Cybersecurity ,
Data Privacy ,
Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Exclusions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Fraud and Abuse ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Audits ,
Materiality ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
OCR ,
OIG ,
ONC ,
Opioid ,
Out of Network Provider ,
Overpayment ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Provider Payments ,
Quality Payment Program (QPP) ,
Section 340B ,
Stark Law ,
State Medicaid Programs ,
Telemedicine ,
Underpayment ,
Universal Health Services Inc v United States ex rel Escobar ,
Value-Based Care
Originally published in Haig, Business and Commercial Litigation in Federal Courts, Fourth Edition §§ 87:1 et seq. © 2016 American Bar Association.
This chapter discusses federal court litigation relating to health care...more
12/30/2016
/ Administrative Law Judge (ALJ) ,
Anti-Kickback Statute ,
Breach of Duty ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Data Protection ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
EMTALA ,
False Claims Act (FCA) ,
Fiduciary Duty ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medicare ,
OIG ,
Preemption ,
Price-Fixing ,
Recovery Audit Contractors (RACs) ,
Reimbursements ,
Stark Law
In a pending False Claims Act (“FCA”) case stemming from alleged violations of the physician self-referral law (the “Stark Law”), 42 U.S.C. § 1395nn, and the federal Anti-Kickback Statute (“AKS”), 42 U.S.C. §1320a-7b, the...more