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Anti-Kickback Statute › False Billing › Health Care Providers

The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The... more +
The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -
Troutman Pepper Locke

State AGs Join $202M Settlement Over HIV Drug Kickback

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On July 16, 49 attorneys general (AGs) announced that they joined a $202 million settlement with Gilead Sciences, Inc. (Gilead). Previously announced by the Department of Justice in April, the settlement resolved allegations...more

Harris Beach Murtha PLLC

HHS Office of Inspector General November 2023 Enforcement Activity

Harris Beach Murtha PLLC on

The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2023

Bass, Berry & Sims PLC on

There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023.  Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more

Bass, Berry & Sims PLC

Recap of Webinar: Billing, Coding, and Collecting for Infusion Services

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Bass, Berry & Sims attorney Shannon Wiley, with Carine Leslie and Katie Garmon of PYA, P.C., recently discussed the complexities associated with billing, coding, and collecting for infusion services as part of the Infusion...more

Oberheiden P.C.

Ten Things You Should Know if Your Clinical Laboratory is Under Investigation

Oberheiden P.C. on

Similar to other types of healthcare entities, clinical laboratories have been facing enhanced scrutiny from federal authorities over the past couple of years. While this is due in part to fraud concerns related to COVID-19...more

The Volkov Law Group

DOJ Announces Two Significant Indictments Charging Individuals with Healthcare Fraud

The Volkov Law Group on

The Justice Department is continuing to use criminal enforcement as an important tool in the fight against healthcare fraud.  While the False Claims Act continues its important place in the fight against healthcare fraud, DOJ...more

Robinson+Cole Health Law Diagnosis

DOJ Focused on Toxicology Testing – EKRA and Anti-Kickback Statute Violations Abound

Robinson+Cole Health Law Diagnosis on

On November 4, 2021, the Department of Justice (DOJ) announced the conviction of several South Florida addiction treatment facility operators following a seven-week trial. ...more

Freeman Law

DOJ hands down fines for FCA, kickbacks, and failure to stop kickbacks.

Freeman Law on

In July of 2021, the Department of Justice announced that it entered into a settlement agreement with two Texas companies, Alliance Parent, Inc. (“Alliance”) and Anchor Holdings LP d/b/a Anchor Capital Partners (“Anchor”),...more

Jones Day

Federal Enforcement Keeps Pace with the Expansion of Telemedicine Services

Jones Day on

Federal government enforcement in the telemedicine space continues to escalate, with three separate announcements in just the last three weeks regarding criminal and civil telemedicine-related actions. These enforcement...more

ArentFox Schiff

Investigations Newsletter: Health Information Technology Developer to Pay $145 Million to Resolve Kickback Allegations

ArentFox Schiff on

In the DOJ’s first-ever criminal action against an electronic health records vendor, San Francisco-based Practice Fusion Inc. agreed to pay $145 million to resolve allegations that it received kickbacks from pharmaceutical...more

Robinson+Cole Health Law Diagnosis

DOJ Announces $26.67 Million Settlement with Laboratory to Resolve FCA Allegations

Robinson+Cole Health Law Diagnosis on

On November 26, 2019, the Department of Justice (DOJ) announced a $26.67 million settlement with a laboratory testing corporation, Boston Heart Diagnostics Corporation (Boston Heart). The settlement resolves allegations of...more

Holland & Knight LLP

Hospitals, Doctors (and Others) Beware: DOJ May Apply Travel Act to Healthcare Prosecutions - Arrangements Viewed Under the...

Holland & Knight LLP on

• A recent federal jury verdict in Dallas affirms the U.S. Department of Justice's determination to extend federal prosecutions to healthcare arrangements involving commercial payers by utilizing the federal Travel Act, which...more

Jackson Lewis P.C.

Healthcare Whistleblowers Collecting Under The FCA Even Where There Are No Fraudulent Billings: What Is An Employer To Do?

Jackson Lewis P.C. on

The Department of Justice recently reported that the healthcare industry accounted for $2.5 billion of the $2.8 billion dollars it recovered in False Claims Act (FCA) cases in Fiscal Year 2018. Qui tam actions (FCA claims...more

The Volkov Law Group

Focusing on “Payments” to Healthcare Professionals (Part I of III)

The Volkov Law Group on

The United States healthcare industry poses an infinite number of risks when it comes to interactions with healthcare professionals. Given the aggressive regulation and enforcement of prohibitions against kickbacks and...more

The Volkov Law Group

Health Management Associates Pays Over $260 Million in Criminal and Civil Penalties for Pervasive False Billing and Kickback...

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Healthcare Management Associates (HMA) settled criminal and civil charges with the Justice Department for illegal fraud and kickback schemes. HMA billed federal government healthcare programs for inpatient services that...more

The Volkov Law Group

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

The Volkov Law Group on

Despite the controversial impact of the Supreme Court’s Escobar decision, the Justice Department’s False Claims Act prosecutions and settlements are continuing at a consistent rate – heading towards another multi-billion...more

Robinson+Cole Health Law Diagnosis

One-Two Punch: On Consecutive Days, DOJ Announces High Dollar Fraud and Abuse Settlements with Hospitals

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The Department of Justice (DOJ) announced two significant False Claims Act (FCA) settlements in recent days that signal continued close government scrutiny of billing, coding and referral practices at hospitals....more

K&L Gates LLP

K&L Gates Triage: 2018 Health Care Fraud Takedown

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Recently, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced its largest ever national health care fraud takedown, resulting in charges against 601 diverse defendants including...more

Cadwalader, Wickersham & Taft LLP

OIG Delivers Home Care a One – Two Punch: Release of Report and Alert on Home Health Fraud Highlights Increased OIG Scrutiny of...

Cadwalader, Wickersham & Taft LLP on

On June 22, 2016, the Office of Inspector General (“OIG”) issued two communications that underscore its continued focus on fraud in home health care, along with the role of physicians as “gate keepers” in authorizing...more

The Volkov Law Group

Compliance Reminder — DOJ Announces Largest Healthcare Fraud Takedown

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On Wednesday, June 22, 2016, the DOJ announced the largest nationwide heath care fraud takedown in history, which resulted in criminal and civil charges against 301 individuals for alleged participation in health care fraud...more

Mintz - Health Care Viewpoints

Mintz Levin Health Care Qui Tam Update: Recent Developments & Unsealed Cases - September 2015

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Trends & Analysis - Since our last Qui Tam Update, we have identified 39 health-related False Claims Act (“FCA”) qui tam cases that have been unsealed. Of those cases...more

The Volkov Law Group

Prosecuting Doctors for Medicare Fraud

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Federal prosecutors have turned their attention to physicians for Medicare fraud prosecution. Physicians who participate in the Medicare program have to be aware of the significant risks of Medicare fraud....more

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