News & Analysis as of

Fraud Healthcare Enforcement

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
ArentFox Schiff

Navigating OIG’s Advisory Opinion on Medical Device Billing Arrangements and Anti-Kickback Statute Risks

ArentFox Schiff on

On July 1, the US Department of Health and Human Services’ Office of Inspector General (OIG) released Advisory Opinion No. 25-08, issuing an unfavorable determination regarding a proposed arrangement in which a medical device...more

Cranfill Sumner LLP

Navigating Stark Law and the Anti-Kickback Statute (AKS) in 2025: A Snapshot Guide for Medical Practices

Cranfill Sumner LLP on

In today’s healthcare environment, compliance with federal regulations is more than a legal necessity—it’s a cornerstone of ethical and sustainable practice management. Two of the most critical laws that medical practices...more

Goodwin

The Impact of Trump’s Executive Order on Eliminating Information Silos

Goodwin on

Hello, everyone. My name is Allan Medina. I am a partner in Goodwin’s Washington, DC, office, with a practice focus on government investigations. I’m here with Liza Craig, who is also a partner in the DC office. We are...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Second Circuit Expands Anti-Kickback Statute Liability: “At Least One Purpose” is Enough

In a significant ruling, the Second Circuit Court of Appeals recently expanded the scope of the Anti-Kickback Statute (AKS).The Court joined other circuit courts across the country in adopting, for the first time, the...more

King & Spalding

The Trifecta: What to Expect from a Second Trump Administration and a Republican Congress

King & Spalding on

Republicans have swept the 2024 elections, returning Donald Trump to the White House as the 47th President and flipping the Senate to a Republican majority. Having narrowly maintained control of the House of Representatives,...more

ArentFox Schiff

FCA Enforcement & Compliance Digest — Fall 2024 False Claims Act Newsletter

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Welcome to the Fall 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and compliance...more

Foley & Lardner LLP

DOJ Shows its Commitment to Cybersecurity Enforcement Through the False Claims Act

Foley & Lardner LLP on

At one time, False Claims Act (FCA) investigations and enforcement actions were largely focused on health care and defense contracts. While those two areas continue to dominate the FCA landscape, cybersecurity has emerged as...more

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

Foley & Lardner LLP

Health-Care Fraud Scrutiny Heats Up For Companies, Providers

Foley & Lardner LLP on

This year will see a continued proliferation of enforcement against health-care fraud, with old and new theories. Some hot spots for enforcement will involve cases about new technologies; data outliers; entities perceived as...more

Health Care Compliance Association (HCCA)

Final Rule Increases Fines for Grant Fraud, Codifies OIG Authority to Sanction Awardees

Report on Research Compliance Volume 20, no 8 (August 2023) With the publication of a rule finalizing financial penalties for grant fraud and related violations of U.S. law, the HHS Office of Inspector General (OIG) has a...more

Bradley Arant Boult Cummings LLP

2022 Year-End False Claims Act Update

The False Claims Act (FCA) continued to be a key tool in 2022 for the Justice Department and whistleblowers to bring suits against companies, including those in the financial services sector. While the focus stayed largely on...more

Bass, Berry & Sims PLC

DOJ Releases Annual Civil Fraud Recovery Statistics and Results

On February 7, the Department of Justice (DOJ) released its annual report of civil fraud recoveries for the prior fiscal year, along with its accompanying press release highlighting its civil enforcement efforts. Our top ten...more

Morrison & Foerster LLP

Enforcement Against COVID-19 Related Fraud: Two-Year Anniversary Update

On the eve of the pandemic’s two-year anniversary, the U.S. Department of Justice (DOJ) released updated statistics on its efforts to combat COVID-19 related fraud and announced the appointment of a director of COVID-19 Fraud...more

Seyfarth Shaw LLP

Insurers, ERISA Plans and Other Payors:  Beware of COVID-19 Fraud Schemes!

Seyfarth Shaw LLP on

On March 23, 2020, the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) issued an alert to the public about fraud schemes related to the novel coronavirus (COVID-19)....more

Cooley LLP

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

Cooley LLP on

Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

The Volkov Law Group

The Intractable Problem of Medicare Fraud

The Volkov Law Group on

You have to admire the vigilance and dedication of prosecutors and law enforcement investigators who fight Medicare fraud. There is no question that they have ramped up enforcement and promoted a strong message of deterrence....more

Saul Ewing LLP

White Collar Watch - July 2013

Saul Ewing LLP on

In This Issue: - Factors in Forfeiture: Eleventh Circuit Rules in Seizure of Rothstein Ponzi Assets - Health Care False Statement Statute Serves as Backstop for Government In Nearly Failed Prosecution -...more

Baker Donelson

Foundations in Fraud and Abuse: Building Blocks of Health Law

Baker Donelson on

The Ober|Kaler Health Care General Counsel Institute is pleased to introduce its Foundations series, a collection of programs designed to equip in-house counsel with a solid foundation in the cornerstones of health law. The...more

Mintz - Health Care Viewpoints

Health Care Enforcement in 2012: A Year in Review

Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more

The Volkov Law Group

Privatizing Health Insurance Companies For Anti-Fraud Enforcement

The Volkov Law Group on

The federal government faces overwhelming challenges in trying to stem the tide of fraud in the health care system. The problem is massive, and even with the increase in resources, and adoption of new tools to fight fraud,...more

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