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
In what it describes as a “First-of-its-Kind Healthcare Generative AI Investigation”, the Texas Attorney General (AGO) recently reached a settlement agreement with an artificial intelligence (AI) healthcare technology...more
On October 15, Maryland Attorney General Anthony G. Brown announced that his office reached a $27 million settlement with Precision Toxicology to resolve allegations that it submitted false claims to government health...more
DOJ Announces Agreement With Rite Aid to Settle Allegations of Violating the FCA and CSA in Relation to Opioid Dispensing - On July 10, the US Department of Justice (DOJ) announced that Rite Aid Corporation and 10 of its...more
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
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
The Department of Justice ("DOJ") recently announced a $1.75 million false claims settlement with a contractor that "improperly obtained government contracts that were set-aside for small businesses." The DOJ settlement...more
Report on Medicare Compliance Volume 32, no 29 (August 2023) In a new Medicare transmittal (12,202), CMS introduced a new place of service (POS) code (27) for “Outreach Site/Street.” POS 27 is defined as “a non-permanent...more
On Friday, July 21, 2023, DOJ announced it has reached a $377,453,150 settlement with Booz Allen Hamilton Holding Corporation (Booz Allen), the parent company of Booz Allen Hamilton, Inc., the large government and military...more
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
Report on Medicare Compliance Volume 32, no 25 (July 2023) Hospices in four states will face heightened oversight. “CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional...more
The U.S. Supreme Court will soon clarify the knowledge requirement for False Claims Act (FCA) cases. Specifically, the Court will determine whether FCA liability should be rejected wherever there is an objectively reasonable...more
Several days ago, Biogen Inc. announced that it had reached a settlement to resolve a whistleblower lawsuit under the False Claims Act (FCA). Relator’s claims were based on allegations that Biogen’s speaker and consultant...more
Report on Medicare Compliance 31 no. 18 (May 16, 2022) - In a new report, the HHS Office of Inspector General (OIG) said 25% of Medicare beneficiaries experienced patient harm (adverse events and temporary harm events)...more
John Peter Smith Hospital (JPS) agreed to pay more than $3.3 million to settle allegations that it violated the False Claims Act by upcoding hundreds of claims submitted to federal healthcare programs. Texas Hospital to...more
Report on Medicare Compliance 29, no. 25 (July 13, 2020) - Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more
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
After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more
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
New York State Attorney General Eric Schneiderman recently announced that his office had reached a $2.5 million settlement in a federal False Claims Act (FCA) case with Trinity HomeCare and its related entities. The case,...more
The Department of Justice and dialysis provider DaVita Healthcare Partners recently finalized a $450 million agreement settling claims that the company intentionally inflated Medicare billings. The parties had filed a joint...more