News & Analysis as of

Department of Justice (DOJ) Skilled Nursing Facility Healthcare Fraud

Baker Donelson

Looking Back at 2024: Key Health Care Regulatory Legal Developments in Fraud and Abuse, Compliance, and Enforcement

Baker Donelson on

The health care regulatory space realized significant regulatory and enforcement developments in 2024 that are influencing how providers and industry stakeholders approach various compliance measures and enforcement...more

ArentFox Schiff

Investigations Newsletter: Home Health Care Company to Pay $3 Million to Resolve FCA Allegations

ArentFox Schiff on

Home Health Care Company to Pay $3 Million to Resolve FCA Allegations - The US Department of Justice (DOJ) announced that Saad Enterprises Incorporated, operating as Saad Healthcare, agreed to pay $3 million to resolve...more

ArentFox Schiff

Investigations Newsletter: Massachusetts District Court Judge Applies Heightened Causation Standard in FCA Case

ArentFox Schiff on

Massachusetts District Court Judge Applies Heightened Causation Standard in FCA Case - On January 6, a District Court of Massachusetts judge granted summary judgment for defendants on allegations of violating the...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

Polsinelli on

Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Troutman Pepper Locke

Lessons for Skilled Nursing and Assisted Living Facilities From the ‘Largest Health Care Fraud Case’

Troutman Pepper Locke on

Phillip Esformes, the alleged mastermind of one of “the largest single criminal health care fraud cases ever brought against individuals by the Department of Justice,”has finally reached a plea deal with the Department of...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | November 2023 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for November 2023. We discuss several US Department of Health and Human Services (HHS) agency actions, including the new General...more

Robinson+Cole Health Law Diagnosis

DOJ Settlement Targets Owner and Management Company in Addition to Post-Acute Care Facilities

On November 15, 2023, the U.S Department of Justice (DOJ) announced a $45.6 million consent judgment (Settlement) with six skilled nursing facilities (SNFs), as well as the owner of the SNFs and its management company which...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q1 2023

On February 7, the Department of Justice (DOJ) issued a press release indicating that settlements and judgments under the False Claims Act (FCA) exceeded $2.2 billion in the fiscal year ending September 30, 2022. Of this...more

Womble Bond Dickinson

[Webinar] First Annual Health Care Fraud Symposium - March 14th, 12:00 pm - 1:30 pm ET

Womble Bond Dickinson on

Health Care fraud is a growing national issue. The National Heath Care Anti-Fraud Association estimates that health care fraud costs the nation about $68 billion annually — about 3 percent of the nation's $2.26 trillion in...more

ArentFox Schiff

Investigations Newsletter: Jury Orders Eli Lilly To Pay $61 Million

ArentFox Schiff on

Jury Orders Eli Lilly To Pay $61 Million - A federal jury in Illinois found that, beginning around 2004, drug manufacturer Eli Lilly deliberately underpaid rebates to Medicare programs by excluding retroactive drug prices...more

Bradley Arant Boult Cummings LLP

Skyline Fraud Charges Serve as a Warning to Inexperienced Operators

In the past month, state and federal prosecutors have separately charged the former CEO of Skyline Healthcare, Joseph Schwartz, with Medicaid and tax fraud. The criminal actions, which represent the latest legal action...more

Fox Rothschild LLP

Proposed Amendments To False Claims Act Would Tilt The Playing Field

Fox Rothschild LLP on

A bipartisan bill introduced this summer would impact residential and behavioral health facilities and other health care providers sued under the federal False Claims Act (FCA), making defense of these actions more expensive...more

Poyner Spruill LLP

Potential False Claims Act Liability For Nursing Homes

Poyner Spruill LLP on

The  FCA is the Department of Justice’s Key Tool in Combating Health Care Fraud and Abuse - The False Claims Act (“FCA”) provides a remedy of civil damages when a party 1) makes a false statement or engages in a...more

ArentFox Schiff

Investigations Newsletter: Texas Man Charged for Allegedly Filing False PPP Loan Applications

ArentFox Schiff on

COVID Relief Program Fraud Charges - DOJ continues to announce charges against defendants accused of fraud in connection with allegedly false loan applications submitted under the Paycheck Protection Program (PPP)...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

King & Spalding

Signature HealthCARE to Pay $30 Million to Resolve Medicare Fraud Allegations

King & Spalding on

Signature HealthCARE (Signature), a Kentucky-based owner and operator of 115 skilled nursing facilities across ten states, has reached an agreement with the HHS OIG to settle a False Claims Act lawsuit in which it was accused...more

Polsinelli

DOJ Targets Nursing Fraud with New Task Forces

Polsinelli on

On March 30, 2016, the U.S. Department of Justice launched 10 regional task forces targeting “grossly substandard care” in nursing homes and other long-term care facilities across the country. The task forces combine federal,...more

Seyfarth Shaw LLP

Record $17M Settlement Of False Claims Act Lawsuit Alleging Doctor Kickbacks

Seyfarth Shaw LLP on

Hailed as “another achievement” for the government’s Health Care Fraud Prevention and Enforcement Action Team (referred to as “HEAT”), the U.S. Department of Justice has announced that a Florida skilled nursing company and...more

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