Key Points -
Courts have routinely observed that Medicare and Medicaid texts are among the most completely impenetrable texts within human experience.
In recent developing case law, more than a half dozen appellate...more
Key Points:
- False Claims Act plaintiff cannot use discovery to satisfy Fed. R. Civ. P. 9(b).
- Payment of fair market value is a dispositive defense in FCA actions alleging a violation of the Anti-Kickback...more
1/28/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Discovery ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
FRCP 9(b) ,
Health Care Providers ,
Medicaid ,
Medicare ,
Qui Tam ,
Relators ,
Rulemaking Process ,
Stark Law ,
Whistleblowers
• Reasonable disagreement among clinicians, by itself, does not result in a false claim.
• Clinical judgment must be objectively false to constitute an FCA violation.
• A clinical judgment may only be objectively false...more
10/11/2019
/ Billing ,
False Billing ,
False Claims Act (FCA) ,
Federal Contractors ,
Guilty Pleas ,
Health Care Providers ,
Healthcare Fraud ,
Hospice ,
Jury Instructions ,
Medicare ,
Overpayment ,
Physicians ,
Qui Tam ,
Relators ,
Scienter
If you read one thing…
- The False Claims Act’s (FCA) language, structure, court precedent and purpose limit its application to only regulatory breaches that are conditions of payment and not conditions of...more
On October 3, 2014, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a long-awaited proposed rule for implementing amendments to safe harbors under the Anti-kickback Statute and...more