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Department of Justice (DOJ) Civil Monetary Penalty False Claims Act (FCA)

DLA Piper

False Claims Act Year in Review: 2024

DLA Piper on

The US government and private plaintiffs use the False Claims Act (FCA) – a federal statute originally enacted in 1863 in response to defense contractor fraud during the American Civil War – to combat various forms of fraud...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Private Equity Throws FCA Enforcement Off-Kilter

Over the last 15 years, private equity (“PE”) firms have invested hundreds of billions of dollars in the healthcare sector, infiltrating every corner of the industry from emergency rooms and labs to billing providers and...more

Mintz - Health Care Viewpoints

EnforceMintz — Telemedicine Enforcement: Trends in 2024 Suggest More Sophisticated Enforcement to Come in 2025

The Department of Justice (DOJ) and the Office of the Inspector General for the Department of Health and Human Services (OIG) have historically focused their virtual health care enforcement efforts on “traditional”...more

Proskauer Rose LLP

Top 10 Whistleblowing and Retaliation Events of 2024

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Following our annual tradition — which started over a decade ago — we are analyzing the year's 10 most significant whistleblower and retaliation events. As you'll see, in 2024, actions taken by a range of courts and...more

Mintz

The New Private Equity Post-Acquisition Paradigm

Mintz on

With private equity deals under harsh scrutiny from the Department of Justice, it is critical that sponsors follow appropriately structured pre and post-acquisition best practices to avoid enforcement exposure and best...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Whistleblower Update: SEC, DOJ Still Focusing on Employment Agreements and Written Policies, Off-Channel Communications

The U.S. Securities and Exchange Commission (SEC) brought more actions targeting regulated entities for recordkeeping violations related to employees using noncompany communications platforms, and both the SEC and the U.S....more

Hendershot Cowart P.C.

Doctors: Don’t Fall Victim To Telemedicine Fraud Schemes

Hendershot Cowart P.C. on

Telemedicine companies are supposed to facilitate medically necessary services to beneficiaries over the telephone via licensed medical professionals. In reality, however, many of these “telemedicine companies” are...more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

Mintz

EnforceMintz — COVID-19 Fraud Enforcement Unlikely to Slow Down in 2024

Mintz on

The government continued to dedicate enormous resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs in 2023. While we observed some civil False Claims Act settlements, criminal enforcement...more

ArentFox Schiff

Texas Lab Settles Unnecessary Drug Testing Allegations for $6 Million

ArentFox Schiff on

A laboratory company based in Texas, Genotox Laboratories Ltd., recently reached an agreement with the federal government to resolve False Claims Act and Anti-Kickback Statute violations, stemming from allegations related to...more

Mintz - Health Care Viewpoints

CMS Proposed Rule for Refunding Overpayments Would Align With False Claims Act “Knowledge” Standard

The Centers for Medicare & Medicaid Services (CMS) proposed a rule late last year to harmonize the standard it would apply for providers to identify and refund overpayments with the “knowledge” standard under the False Claims...more

Foley & Lardner LLP

Will CMS’s Proposed Rule on “Identified Overpayments” Increase Reverse FCA Cases?

Foley & Lardner LLP on

On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule which, in part, seeks to amend the existing regulations for Medicare Parts A, B, C, and D regarding the standard for when an...more

Bass, Berry & Sims PLC

Government Announces First FCA Settlement with PPP Lender

Bass, Berry & Sims PLC on

The Department of Justice (DOJ) announced on September 12, the first-ever False Claims Act (FCA) settlement with a Paycheck Protection Program (PPP) lender. Prosperity Bank, a Texas-based regional bank, agreed to pay...more

ArentFox Schiff

Investigations Newsletter: DC Circuit Adopts Pro Tanto Approach to False Claims Act Settlement Offsets

ArentFox Schiff on

DC Circuit Adopts Pro Tanto Approach to False Claims Act Settlement Offsets - In an opinion issued on August 30, 2022, the US Court of Appeals for the DC Circuit held in United States v. Honeywell International, Inc., ---...more

Harris Beach Murtha PLLC

OIG Enforcement Summary: July 16, 2022 – July 31, 2022

The following is a summary of the 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 are...more

Foley & Lardner LLP

OIG Special Fraud Alert on Arrangements with Telemedicine Companies

Foley & Lardner LLP on

On July 20, 2022, HHS-OIG published a new Special Fraud Alert on arrangements with telemedicine companies, setting forth seven characteristics OIG believes could suggest a given arrangement poses a heighted risk of fraud and...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Damages

Bass, Berry & Sims PLC on

Having previously examined the falsity, materiality, and scienter elements of the False Claims Act (FCA) in our FCA Fundamentals series, we now turn to what damages can arise from violations of the False Claims Act...more

Dorsey & Whitney LLP

Latest PPP Fraud Settlement Showcases Civil and Criminal Penalties for Knowingly Submitting False Claims

Dorsey & Whitney LLP on

The Department of Justice (“DOJ”) continues racking up more settlement agreements under the False Claims Act, 31 U.S.C. § 3729 et seq (“FCA”) with companies and individuals alleged to have improperly used funds received...more

Baker Donelson

Cybersecurity: A Whistleblower's Paradise

Baker Donelson on

Cyber whistleblowing is the newest and hottest area of exposure for organizations. All government contractors and grant recipients must develop an understanding of the use of the False Claims Act (FCA) to address...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: What Is a Relator?  

A relator is a private person or entity who files a False Claims Act (FCA) lawsuit on behalf of the United States in exchange for receiving a portion any recovery from the defendant. The FCA was enacted in 1863 in response to...more

Perkins Coie

DOJ’s False Claims Act Recoveries Jump to $5.6 Billion in FY 2021

Perkins Coie on

The U.S. Department of Justice (DOJ) recovered more than $5.6 billion in civil False Claims Act (FCA) judgments and settlements in fiscal year (FY) 2021, the second largest ever annual total in FCA recoveries and the largest...more

Bass, Berry & Sims PLC

DOJ Releases 2021 FCA Civil Monetary Penalties Inflation Adjustment

Bass, Berry & Sims PLC on

On December 13, the Department of Justice (DOJ) published its Final Rule on the Civil Monetary Penalties Inflation Adjustment for 2021.  Under the Bipartisan Budget Act of 2015, the DOJ annually adjusts for inflation civil...more

Health Care Compliance Association (HCCA)

Two Washington Universities Ink Settlements For Exceeding Salaries, Falsified Application

Report on Research Compliance 18, no. 12 (December, 2021) - Washington State University’s (WSU) recent settlement with the HHS Office of Inspector General (OIG) for more than $800,000 followed a university-wide audit that...more

Dorsey & Whitney LLP

HHS OIG Releases an Updated Health Care Fraud Self-Disclosure Protocol

Dorsey & Whitney LLP on

On November 8, 2021, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) released a revised Provider Self-Disclosure Protocol, renamed Health Care Fraud Self-Disclosure Protocol (“SDP”). Prior...more

Mintz - Health Care Viewpoints

OIG Revises and Renames the Provider Self-Disclosure Protocol

For the first time since April 2013, the Department of Health and Human Services’ Office of Inspector General (OIG) revised the Provider Self-Disclosure Protocol (SDP) on November 8, 2021. The SDP allows providers and other...more

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