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False Claims Act (FCA) › Regulatory Requirements › Reimbursements

Marshall Dennehey

Reimbursement of Pennsylvania Department of Human Services Lien Is Found Not Automatic by Pennsylvania Commonwealth Court

Marshall Dennehey on

Key Points: No formal liability for payment of work-related medical expenses is triggered on the part of the employer/insurer until such expenses are properly submitted in accordance with the terms and provisions of the...more

McDermott Will & Schulte

Hospital Provider-Based Compliance: Top 10 Myths and Truths

McDermott Will & Schulte on

Medicare reimbursement for hospital outpatient services has come under attack in recent years, with a focus on “site neutral” payment policies that would pay hospitals for outpatient services furnished in off-campus locations...more

Proskauer - Health Care Law Brief

Recent Circuit Litigation Continues to Highlight “But-For” Causation Requirement for the Government to Demonstrate an FCA...

Proskauer - Health Care Law Brief on

In recent years, a circuit split among the United States Courts of Appeals has emerged over how courts have interpreted the False Claims Act’s (“FCA”) causation element in cases where a violation of the Anti-Kickback Statute...more

Holland & Hart - Health Law Blog

Prepare for the End of the Public Health Emergency: Compliance Concerns

Holland & Hart - Health Law Blog on

For nearly three years, federal and state agencies have waived or relaxed regulatory requirements and expanded reimbursement for services due to the COVID-19 public health emergency (PHE), but the signs indicate that the...more

Nelson Mullins Riley & Scarborough LLP

Internal Investigations are a MUST for Avoiding False Claims Act Liability

Nelson Mullins Riley & Scarborough LLP on

Many providers are not familiar with their obligations under the “60 Day Rule,” also known as Reverse False Claims liability, which can cause significant financial harm if providers fail to comply with these obligations....more

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