News & Analysis as of

Department of Justice (DOJ) False Billing Healthcare Fraud

Troutman Pepper Locke

State AGs Join $202M Settlement Over HIV Drug Kickback

Troutman Pepper Locke on

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

Pietragallo Gordon Alfano Bosick & Raspanti,...

Recent False Claims Act Settlement Should Put Treatment Centers on Notice

Late last month, the federal government announced a False Claims Act settlement with Summit BHC New Jersey, LLC, d/b/a Seabrook (“Seabrook”), a prominent New Jersey Drug & Alcohol Rehabilitation facility. The joint settlement...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - January 2025

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Husch Blackwell LLP

Arizona Physician Pleads Guilty to Healthcare Fraud over Improper “Incident To” Billings

Husch Blackwell LLP on

“Incident to” billing is widely practiced, and its regulations are generally well-known. But one Arizona physician recently found himself pleading guilty in federal court on April 3, 2024, to a criminal healthcare fraud...more

Harris Beach Murtha PLLC

False Claims Act Enforcement Highlights Need for Robust Compliance Programs

The U.S. Department of Justice (“DOJ”) announced its False Claims Act (“FCA”) enforcement statistics for FY 2023 and identified key priorities for FCA enforcement in 2024 and beyond. The DOJ continues to pursue FCA...more

Cozen O'Connor

Whistleblower Watch - A quarterly update on FCA Enforcement and Qui Tam Litigation - Winter 2024

Cozen O'Connor on

Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

ArentFox Schiff

Investigations Newsletter: Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim

ArentFox Schiff on

Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim - Steven Richardson, the owner of telemedicine companies Expansion Media, LLC and Hybrid Management Group LLC, agreed to settle allegations that...more

Health Care Compliance Association (HCCA)

News Briefs: January 8, 2024

H. Lee Moffitt Cancer Center & Research Institute Hospital Inc. in Tampa, Florida, has agreed to pay $19.564 million to settle false claims allegations over claims submitted to federal health care programs for items and...more

Harris Beach Murtha PLLC

OIG January 2024 Enforcement Summary

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

Pietragallo Gordon Alfano Bosick & Raspanti,...

DOJ’s Emphasis Of Individual Accountability – Where It Stands, And Where It Could Be Headed

A recent article in Law360 sparked a vigorous conversation among members of Pietragallo’s white collar practice group about the current state of the U.S. Department of Justice’s (DOJ) evolving emphasis on individual...more

Husch Blackwell LLP

Federal Judge Acquits Physician Following Criminal E/M Fraud Conviction at Trial

Husch Blackwell LLP on

As previously reported in this post, criminal trials premised on upcoding evaluation and management (E/M) service codes are extremely rare. The Justice Department took that rare step in Maryland in connection with a practice...more

ArentFox Schiff

Investigations Newsletter: Health Care Network Settles False Claims Act Allegations for $345 Million

ArentFox Schiff on

Health Care Network Settles False Claims Act Allegations for $345 Million - Community Health Network Inc. (CHN) has agreed to pay $345,000,000 to settle allegations that it violated the False Claims Act (FCA) for knowingly...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - October 2023

Morrison & Foerster LLP on

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Husch Blackwell LLP

Physician Loses Rare Criminal E/M Fraud Trial

Husch Blackwell LLP on

Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...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

Husch Blackwell LLP

Justice Department Sues Iowa Surgeon Under False Claims Act for Masking Non-Covered Cosmetic Procedures as Covered Surgeries

Husch Blackwell LLP on

Cosmetic surgeries are on the rise. One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. Facelifts were up 54...more

Rivkin Radler LLP

Fraud Week: Focus on Florida Fraud

Rivkin Radler LLP on

To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence...more

Rivkin Radler LLP

Fraud Week: DOJ Announces COVID-Related Fraud Sweep

Rivkin Radler LLP on

The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16...more

Health Care Compliance Association (HCCA)

Enforcement actions relating to a lack of medical necessity

In a climate of shrinking margins, diminishing reimbursement, and frequent denials, healthcare organizations may make efforts to increase the volume of services they provide, especially those that are more profitable. Of...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

Rivkin Radler LLP

Be careful about upcoding; DOJ may come after it as a false claim

Rivkin Radler LLP on

A recent article in Part B News, “Be careful about upcoding; DOJ may come after it as a false claim,” discussed how the U.S. Department of Justice frequently prosecutes improper billing of CPT codes for Medicare patients. ...more

Epstein Becker & Green

Telemental Health Laws: Overview - 2022

Epstein Becker & Green on

Since 2016, Epstein Becker Green (EBG) has researched, compiled, and analyzed state-specific content relating to the regulatory requirements for professional mental/behavioral health practitioners and stakeholders seeking to...more

Akerman LLP - Health Law Rx

Recent FCA Settlements Warn Providers of Improper Billing Practices

Two recent multi-million dollar False Claims Act (“FCA”) settlements demonstrate the vigor with which the Department of Justice (“DOJ”) is investigating and prosecuting allegedly fraudulent health care billing practices....more

Robinson+Cole Health Law Diagnosis

DOJ Announces $13 Million Settlement Related to Improper Billing for Lab Tests

On October 17, 2022, the United States Department of Justice (DOJ) announced a $13 million settlement with health care services provider Sutter Health, which arose from alleged violations of the federal False Claims Act...more

Cozen O'Connor

Physicians Group Services Fined by DOJ, Florida AG and HHS for Alleged False Urine Test Claims

Cozen O'Connor on

Physicians Group Services, P.A. (PGS) has reached a settlement with the U.S. and Florida to resolve allegations that it submitted false or fraudulent claims to the Florida Medicaid Program....more

78 Results
 / 
View per page
Page: of 4

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide