Any suggestion that the Trump Administration might not be committed to healthcare fraud enforcement was definitively quashed by two recent developments. First, on July 2, 2025, the U.S. Department of Justice (DOJ) and the...more
On February 18, 2025, the U.S. Court of Appeals for the 1st Circuit issued a highly anticipated ruling interpreting the relationship between the False Claims Act ("FCA") and the federal Anti-Kickback Statute ("AKS"), holding...more
2/26/2025
/ Anti-Kickback Statute ,
Appellate Courts ,
But For Causation ,
Causation ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Pharmaceutical Industry
The Coronavirus Aid, Relief, and Economic Security (CARES) Act will make available an initial $2.2 trillion in government funds to mitigate the economic effects of COVID-19. Government agencies have been immediately tasked...more
In a unanimous decision issued on June 16, 2016, in Universal Health Inc. v. U.S. et al. ex rel. Escobar et al. the United States Supreme Court resolved a circuit split and held that an “implied certification” theory can...more
On Feb. 12, 2016, CMS published the much anticipated final regulations implementing the so-called “60-Day Rule.” Congress adopted the 60-Day Rule as part of the Affordable Care Act (ACA). The Rule requires health care...more
The federal physician self-referral ban or Stark law has been a part of the legal landscape for almost 25 years. The breadth of the law’s prohibitions, its strict liability formulation and draconian remedies have made it the...more
7/28/2015
/ BPCI ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Shared Savings Program ,
Physician Fee Schedule ,
Physicians ,
Qui Tam ,
Relators ,
Stark Law ,
Tuomey
The U.S. Department of Justice and New York State Attorney General’s Office recently intervened in a federal False Claims Act case in federal District Court based on allegations that a provider failed to report and refund an...more
Health care organizations should take careful note of a recent decision from a Florida federal district court that sharply limited the defendant hospital’s ability to shield what it considered to be attorney-client...more