News & Analysis as of

Health Care Providers Patient Referrals Healthcare Fraud

Pietragallo Gordon Alfano Bosick & Raspanti,...

New Jersey Enacts Key Legislation Addressing Kickbacks and Deceptive Marketing Practices in the Substance Use Disorder Treatment...

On August 11, 2025, New Jersey’s Acting Governor, Tahesha Way, signed into law two bills to combat patient brokering and deceptive marketing practices in the Substance Use Disorder (“SUD”) treatment industry. The legislation,...more

King & Spalding

OIG Issues Favorable Advisory Opinion Permitting a Community Health Center to Refer Primary Care Services During Provision of...

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On April 9, 2025, OIG posted Advisory Opinion No. 25-02, a favorable advisory opinion allowing a community health center operating under Section 330 of the Public Health Service Act (the Requestor) to ask individuals, to whom...more

Hendershot Cowart P.C.

Texas Healthcare Providers Paid $21.3 Million to Resolve Stark Law Violations in 2024

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Healthcare fraud enforcement continues to be a top priority for federal authorities, with Stark Law violations remaining under particular scrutiny. The complex nature of physician self-referral regulations, combined with...more

Quarles & Brady LLP

Legal Marketing Tactics or an Illegal Kickback Scheme? The Seventh Circuit’s Impending Decision on the Expansiveness of the...

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On December 4, the U.S. Court of Appeals for the Seventh Circuit heard oral arguments in USA v. Mark Sorensen, case number 24-1557, and it is now taking under advisement a case that could have widespread effects as to what...more

Rivkin Radler LLP

Radiology Practice to Pay $8.9M to Resolve FCA/AKS Claims

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The U.S. Attorney’s Office for the Southern District of Texas announced on August 20 that National Interventional Radiology Partners PLLC (NIRP) and its founder and CEO will pay $8,884,091 to the United States to resolve...more

Cozen O'Connor

Whistleblower Watch - Summer 2024

Cozen O'Connor on

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 most notable...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

Rivkin Radler LLP

Brooklyn Cardiologist Hit with Fraud Charges

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On December 14, the U.S. Attorney’s Office for the Southern District of New York and other agencies announced the indictment of Niranjan Mittal, a Brooklyn cardiologist, on multiple fraud charges. Mittal allegedly fabricated...more

Nelson Mullins Riley & Scarborough LLP

The Impact of the Decision in U.S. v. Holland on the One Purpose Test

The Court’s decision in U.S. v. Holland highlights the apparent contradiction between the judicially created and often relied upon “one purpose test” involving criminal and civil enforcement actions under the Federal...more

Oberheiden P.C.

Tips and Insights for Clinical Lab Compliance in 2025

Oberheiden P.C. on

The COVID-19 pandemic increased the business opportunities available to clinical labs, including molecular and respiratory labs. As the nation—and the world—struggled to develop adequate testing infrastructure, the federal...more

Dorsey & Whitney LLP

OIG Advisory Opinion No. 21-02 Provides Helpful Insights into Risk Mitigation Factors Regarding Health System-, Physician-, and...

Dorsey & Whitney LLP on

On April 26, 2021, the Department of Health and Human Services Office of Inspector General (“OIG”) issued favorable Advisory Opinion No. 21-02 regarding a proposed investment in an ambulatory surgery center (“ASC”) by a...more

Hogan Lovells

HHS Regulatory Sprint takes final shape: Part 1: Substantial Stark Law regulatory revisions adopted

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Along with proposed Stark Law exceptions designed to accommodate value-based care models, the Centers for Medicare & Medicaid Services (CMS or the agency) adopted additional revisions to the Stark Law regulations (the final...more

Mintz - Health Care Viewpoints

West Virginia Hospital Enters into a $50 Million Settlement to Resolve Allegations over Excessive Compensation Paid to Referring...

On September 9, 2020, the Department of Justice (DOJ) announced a $50 million settlement with Wheeling Hospital, Inc. of West Virginia to resolve False Claims Act allegations that Wheeling Hospital violated the Anti-Kickback...more

K&L Gates LLP

K&L Gates Triage: EKRA - New Fraud and Abuse Considerations for Clinically Integrated Networks

K&L Gates LLP on

In this week's episode, Limo Cherian, Carla Dewberry, and Steve Pine discuss EKRA - the 'Eliminating Kickbacks in Recovery Act of 2018,' which introduces new criminal penalties for kickbacks associated with referrals to...more

The Volkov Law Group

Boston Heart Diagnostics Pays $26.67 Million to Settle False Claims Act Case

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Boston Heart Diagnostics, a Massachusetts company, agree to pay $26.7 million to settle a False Claims Act case involving allegations of paying illegal kickbacks to physicians....more

Robinson+Cole Health Law Diagnosis

CMS Proposes to Newly Define Commercially Reasonable, and Tweak Definition of Fair Market Value, in New Physician Self-Referral...

On October 17, 2019, the Centers for Medicare & Medicaid Services (CMS) formally published its proposed rule (the PSR Rule) to update exceptions to the Physician Self-Referral Law (PSR Law, also known as the Stark Law). For...more

K&L Gates LLP

Lessons from Forest Park: What Providers Need to Know About New Health Care Fraud Risks

K&L Gates LLP on

Introduction - Last month, a jury found seven defendants guilty in a federal bribery case that has caught the attention of the health care law world due to its novel approach to prosecuting fraud and abuse. ...more

Holland & Knight LLP

Hospitals, Doctors (and Others) Beware: DOJ May Apply Travel Act to Healthcare Prosecutions - Arrangements Viewed Under the...

Holland & Knight LLP on

• A recent federal jury verdict in Dallas affirms the U.S. Department of Justice's determination to extend federal prosecutions to healthcare arrangements involving commercial payers by utilizing the federal Travel Act, which...more

The Volkov Law Group

Doctor and Two Medical Equipment Officers Head to Jail for Illegal Kickback Scheme

The Volkov Law Group on

The Justice Department’s commitment – resources and public statements – has continued at a steady pace in the Trump Administration. Some might diminish the effort by recognizing that fraud is so pervasive that it is like...more

The Volkov Law Group

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

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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

Farrell Fritz, P.C.

Kickback Arrangements – Cause for Alarm Beyond Federal Healthcare Programs

Farrell Fritz, P.C. on

Few, if any, in the medical industry are unfamiliar with the federal Anti-Kickback Statute (“AKS”). Under AKS, those giving or receiving compensation for referrals for items or services reimbursed by the federal healthcare...more

Baker Donelson

Court Puts the Brakes on Whistleblower's FCA Parking Claims

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The Department of Justice (DOJ) reports that, in fiscal year 2016 ending September 30, it obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims. More than half of this...more

Carlton Fields

Health Care Fraud and Abuse in the Middle District of Florida in 2016 - a Year in Review

Carlton Fields on

The United States Attorney’s Office (USAO) for the Middle District of Florida (USAO-MDFL) prosecuted several civil health care fraud matters in 2016 and issued related press releases. A review of the USAO-MDFL’s criminal and...more

Arnall Golden Gregory LLP

Department Of Justice Announces The Indictment Of 21 Individuals Affiliated With Forest Park Medical Center

On December 1, 2016, the United States Attorney’s Office for the Northern District of Texas announced the indictment of 21 executives, physicians, surgeons, and others affiliated with Forest Park Medical Center (FPMC) in...more

McDermott Will & Emery

Tuomey’s Appeal of $237M False Claims Act Judgment Denied by the Fourth Circuit

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In This Issue: - Background - Tuomey’s Second Appeal to the Fourth Circuit - The Trial Court’s Grant of a New Trial - Tuomey’s Request for Judgement as a Matter of Law on the Stark Law and FCA Issues ...more

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