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Seventh Circuit Allows Percentage-Based Marketing Relationship

On April 14th, 2025, the U.S. Court of Appeals for the Seventh Circuit reversed the Anti-Kickback Statute (AKS) conviction of Mark Sorensen, the owner and operator of a Medicare-registered durable medical equipment...more

Marketing, Misconduct and Healthcare: Ninth Circuit Issues First EKRA Appellate Ruling

On July 11, 2025, in United States v. Schena, the U.S. Court of Appeals for the Ninth Circuit issued the first appellate decision interpreting the Eliminating Kickbacks in Recovery Act (“EKRA”). The decision marks a...more

DOJ and HHS Reestablish False Claims Act Working Group, Delineate Healthcare Enforcement Priorities

On July 2, 2025, the U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services (HHS) announced the reestablishment of the DOJ-HHS False Claims Act Working Group. Originally formed in December 2020 at...more

New Administration Antitrust Push: DOJ, FTC to Identify Anticompetitive Government Regulations and Labor-Related Practices

In recent weeks, the Department of Justice (DOJ) Antitrust Division and Federal Trade Commission (FTC) launched task forces that target potential barriers to competition created by government regulators and private-sector...more

First Circuit Adopts “But For” AKS Standard, Leaving Third Circuit Alone in Causal-Link Standard

On Feb. 18, 2025, the U.S. Court of Appeals for the First Circuit adopted the “but for” causality standard for violations of the federal Anti-Kickback Statute (AKS) that give rise to violations of the federal False Claims Act...more

Ten Action Items for Healthcare Portfolio Companies in 2024

The investor-backed provider community may be feeling pressure and facing scrutiny from various angles in 2024, as federal and state agencies implement complex pre-closing review processes for healthcare transactions from an...more

DOJ Settles Self-Reported Referral Incentives With Dermatology Practice Manager

On Sept. 13, 2023, the U.S. Attorney’s Office for the Northern District of Texas announced a settlement with Oliver Street Dermatology Management LLC. Oliver Street agreed to pay the United States $8.892 million to resolve...more

California Court: Fair Market Value Payments May Not Avert Anti-Kickback Liability

In February 2022, the U.S. District Court for the Central District of California denied a defendant’s motion to dismiss a qui tam action alleging that the defendant had violated the federal Anti-Kickback Statute (AKS). In its...more

Eye Care Practice Settles with Government for Employing Excluded Individual

On March 18, the Department of Justice (“DOJ”) and the Connecticut Attorney General announced that a Connecticut eye care practice and its owners had agreed to pay $192,699 to resolve allegations that the practice improperly...more

2021’s First-Half Notable Themes on The FCA Insider

As vaccination rates rise, the COVID-19 pandemic continues to reverberate through 2021. These reverberations also impacted the healthcare fraud and abuse landscape that is the basis of The FCA Insider’s coverage. To-date,...more

First Provider Relief Fund Indictment

The U.S. Department of Justice (DOJ) announced charges this month against a Michigan woman, Amina Abbas, for embezzling government property. This indictment is the first in the nation related to the CARES Act public health...more

Recent Physical Therapy Enforcement Actions Highlight Compliance Concerns

The government has stepped up efforts to monitor physical therapy billing fraud and recoup overpayments. While the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) have long policed fraudulent...more

Federal Authorities Crack Down on Fraudulent COVID-19 Schemes

As the public faces the crisis related to the 2019 novel coronavirus (COVID-19), federal authorities announced initial actions against individuals and companies promoting fraudulent schemes and products to the public. Federal...more

DOJ Announces $26.67 Million False Claims Settlement with Massachusetts-Based Laboratory

The DOJ recently announced that Boston Heart Diagnostics Corporation (Boston Heart) has agreed to pay a $26.67 million settlement related to alleged violations of the Federal Anti-Kickback Statute and the Stark Law. This...more

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