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Health Care Providers Healthcare Fraud Federal Contractors

ArentFox Schiff

Investigations Newsletter: Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses

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Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses - On March 26, the US Department of Justice (DOJ) announced that a California-based medical group and related parties...more

Fox Rothschild LLP

FCA 101: Falsity

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To prove a False Claim under the False Claims Act (FCA), the government or relator must establish three elements: 1.Falsity; - 2.Knowledge; and - 3.Materiality. In this blog post, we will explore the Falsity element. ...more

Fox Rothschild LLP

FCA Enforcement Remains Fixed on Healthcare and Cybersecurity

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On February 22, 2024, the U.S. Department of Justice (“DOJ”) released its Fiscal Year 2023 False Claims Act (“FCA”) statistics showing recoveries of almost $2.7 billion. Last year’s recoveries exceeded 2022’s $2.2 billion...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - December 2024

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

Cozen O'Connor

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

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Summer 2023- 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...more

McGuireWoods LLP

Supreme Court Clarifies the False Claims Act’s Knowledge Requirement, Eliminating a Potential Defense for Government Contractors...

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On June 1, 2023, the Supreme Court unanimously ruled in favor of whistleblower plaintiffs (referred to as “relators”) in consolidated False Claims Act (“FCA”) cases in a decision that clarified the application of the FCA’s...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Self-Disclosures

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When healthcare providers and other government contractors are subject to scrutiny for bills submitted to the government, it is often the result of a whistleblower complaint filed under the qui tam provisions of the False...more

Proskauer - Whistleblower Defense

Florida District Court Limits Scope of Protected Activity under the FCA

On March 29, 2022, the U.S. District Court for the Southern District of Florida held that in order to engage in protected conduct under the False Claims Act (“FCA”), a plaintiff must specifically suspect that their employer...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q1 2022

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The first quarter of 2022 brought news of several noteworthy False Claims Act (FCA) settlements, including several settlements by physicians regarding arrangements deemed to be unlawful kickbacks and the first settlement...more

ArentFox Schiff

Investigations Newsletter: DOJ Civil Cyber-fraud Initiative Obtains First Settlement 

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Headlines that Matter for Companies and Executives in Regulated Industries. DOJ Civil Cyber-fraud Initiative Obtains First Settlement - The Department of Justice announced on Tuesday, March 8th, that Comprehensive...more

Foley Hoag LLP - White Collar Law &...

Health Care Enforcement – A Look Ahead

This is the first post in this year’s series examining important trends in white collar law and investigations. Join us in the weeks ahead as we provide updates on new developments and emerging trends in a number of white...more

Wiley Rein LLP

2021 FCA Recoveries Bounce Back from Decade-Low . . . Maybe

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On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more

Steptoe & Johnson PLLC

Federal Authorities Ramping Up COVID-19 Related Health Care Fraud Prosecutions

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Recently announced Department of Justice (DOJ) priorities include a reinvigoration of health care fraud prosecutions. The COVID-19 crisis created fertile ground for not only fraud related to the Paycheck Protection Program...more

American Conference Institute (ACI)

[Virtual Event] 8th Annual Advanced Forum on False Claims and Qui Tam Enforcement - March 24th - 25th, 8:15 am - 4:45 pm...

THE ONLY EVENT WHERE YOU'LL HEAR FROM Government, In-house Counsel, The Judiciary, the Defense & Relator’s Bar - ACI’s 8th Annual Advanced Forum on False Claims and Qui Tam Enforcement will address the underlying...more

Miles & Stockbridge P.C.

Federal False Claims Act Wrap Up - September 2020

This week we take look at two recent federal decisions concerning the False Claims Act (“FCA”). The first case, Ndoromo v. Barr, is interesting because of the billion dollars in alleged damages....more

ArentFox Schiff

Deputy Associate Attorney General Sheds Light on DOJ’s FCA Priorities at Annual False Claims Act Conference

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“Enforcing the False Claims Act is a top priority for the Department—not just for our office,” said Deputy Associate Attorney General Stephen Cox, the Keynote Speaker for the 2020 Advanced Forum on False Claims and Qui Tam...more

PilieroMazza PLLC

The FCA Continues to Pay (For the Government): Key Takeaways from DOJ's FY 2019 Fraud Statistics

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On January 9, 2020, the Department of Justice (DOJ) announced that it recovered more than $3 billion in settlements and judgments from civil cases involving fraud and the False Claims Act (FCA) in Fiscal Year (FY) 2019, which...more

Perkins Coie

DOJ Recovers More Than $3 Billion in False Claims Act Cases in FY 2019

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The Department of Justice (DOJ) recovered more than $3 billion in settlements and judgments from civil cases involving the False Claims Act (FCA) in the fiscal year ending September 30, 2019, according to statistics released...more

American Conference Institute (ACI)

[Event] False Claims and Qui Tam Enforcement Forum – Strategies to Respond to the Rapidly Changing Landscape of False Claims Act...

With more than 34.8 billion recovered by the government since 2010 under the federal False Claims Act, it has never been more crucial for private practitioners and corporate in-house counsel to keep abreast of the changes and...more

Akin Gump Strauss Hauer & Feld LLP

11th Circuit’s Decision in AseraCare: Important in Determining When Clinical Judgment Regarding Medical Necessity Can Result in an...

• Reasonable disagreement among clinicians, by itself, does not result in a false claim. • Clinical judgment must be objectively false to constitute an FCA violation. • A clinical judgment may only be objectively false...more

Baker Donelson

False Claims Act Liability Without Submitting False Claims? Yes, That's a Thing

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Most health care providers recognize that submitting a knowingly false claim to a federally funded health care program violates the False Claims Act (FCA). However, it is less well known that indirectly "causing" someone else...more

Baker Donelson

Disagreements over a Medical Judgment Cannot Form the Basis for Liability Under the False Claims Act

Baker Donelson on

A new federal court decision offers a ray of light to those providers defending false claims actions based on an alleged lack of medical necessity. On September 9, 2019, the United States Court of Appeals for the Eleventh...more

ArentFox Schiff

Investigations Newsletter: Patient Recruiter Convicted in $1.3 Million Kickback Conspiracy Scheme

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Patient Recruiter Convicted in $1.3 Million Kickback Conspiracy Scheme - After a six-day trial, a federal jury in Detroit found a patient recruiter guilty of one count of conspiracy to pay and receive health care...more

Nossaman LLP

We Received a Civil Investigative Demand from a Federal Agency: Now What?

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A Civil Investigative Demand, often referred to as a “CID,” is a pre-litigation mechanism used to collect information and evidence for use in civil false claims act and other investigations. ...more

Holland & Knight LLP

DOJ Releases 2018 False Claims Act Report and Statistics

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In December 2018, the U.S. Department of Justice (DOJ) released its annual statistics for its civil False Claims Act (FCA) and fraud cases from the fiscal year ending Sept. 30, 2018 (fiscal year 2018). The DOJ reports it...more

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