News & Analysis as of

Hospitals False Claims Act (FCA)

Buchalter

Blame It on the Bot: Health Care Fraud and Compliance in theAge of AI

Buchalter on

A large health system implements an Artificial Intelligence (AI)-powered clinical decision support tool that promises to ensure “complete and accurate” diagnosis documentation. Within six months, the system’s Medicare...more

Harris Beach Murtha PLLC

Scrutiny of Hospital–Physician Relationships Continues

Despite changes in many priorities, the federal government’s scrutiny of relationships between hospitals and physicians continues well into 2025. Last month, Community Health System (CHS) in California and its affiliate,...more

Epstein Becker & Green

DOJ Civil Division Announces 2025 Priorities: Promises “Aggressive” False Claims Act Enforcement of Civil Rights Violations and...

Epstein Becker & Green on

On June 11, 2025, Assistant Attorney General Brett A. Shumate issued an internal memorandum (the “Shumate memo”) to all Civil Division employees of the U.S. Department of Justice (“DOJ”), describing the Division’s enforcement...more

Dentons

Ep. 64 – Three Communication Strategies to Reduce Whistleblower Risk

Dentons on

In today’s complex healthcare landscape, whistleblower claims are a major source of regulatory and legal risk for organizations. Last year saw a record number of “qui tam” claims filed under the False Claims Act. While...more

Goodwin

Health Headlines: May 2025

Goodwin on

On May 14, 2025, Pennsylvania State Sen. Tim Kearney and State Rep. Lisa Borowski introduced legislation addressing private equity and corporate interests in healthcare. Pennsylvania Gov. Josh Shapiro is touting the companion...more

Greenbaum, Rowe, Smith & Davis LLP

Legal Risks and Challenges for Private Equity in Healthcare Acquisitions

Private Equity (PE) firms continue to be significant players in U.S. healthcare, acquiring assets across various sectors such as physician practices, home health, behavioral health, and urgent care. However, recent legal...more

Husch Blackwell LLP

Attorney General Pam Bondi’s Memo Concerning Healthcare Treatment for Transgender Minors: Implications for Providers

Husch Blackwell LLP on

Recently, Attorney General Pam Bondi purportedly issued an internal memorandum in response to Executive Order 14187 (“Protecting Children from Chemical and Surgical Mutilation”) concerning the treatment of transgender minors...more

Mintz - Health Care Viewpoints

Noteworthy False Claims Act Settlement Demonstrates DOJ’s Continued Scrutiny of Arrangements Between Hospitals and Physician...

On May 14, 2025, Fresno Community Hospital and Medical Center d/b/a Community Health System (CHS) and its technology partner, Physicians Network Advantage, Inc. (PNA), agreed to pay $31.5 million (the Settlement Agreement)...more

Paul Hastings LLP

Check-Up and Diagnosis: The Ongoing Scrutiny of Private Equity Healthcare Investments

Paul Hastings LLP on

In 2024 alone, over 676 private equity firms and related investors acquired healthcare companies or related assets. The growing influence of private equity in the healthcare industry has not gone unnoticed on either of the...more

Epstein Becker & Green

Criminal Health Care Fraud Enforcement: Projections for 2025 and Beyond – Diagnosing Health Care Video Podcast

Since Pam Bondi was appointed U.S. Attorney General, we’ve seen notable shifts in the U.S. Department of Justice’s criminal enforcement priorities. How significant are some of these changes, and how might they affect your...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | February 2025 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for February 2025, including long-awaited proposed and final rules regarding the Health Insurance Portability and Accountability Act...more

WilmerHale

DOJ Settles False Claims Act Suit Against Medicare Advantage Provider

WilmerHale on

On March 26, 2025, the U.S. Department of Justice (DOJ) announced that it settled a False Claims Act (FCA) action against a California-based healthcare provider and a separate radiology group for allegedly submitting and...more

Bass, Berry & Sims PLC

Connecticut and Maine Propose New Restrictions on Private Equity and REITs in Health Care Transactions

Bass, Berry & Sims PLC on

Since our recent updates, additional bills have been introduced that, if passed, will impact transactions across the healthcare industry.  This alert contains an overview of legislation recently introduced in Connecticut and...more

Bass, Berry & Sims PLC

False Claims Act Enforcement in Healthcare: Insights from the 13th Annual Fraud & Abuse Review

Bass, Berry & Sims PLC on

The False Claims Act (FCA) remains one of the government’s most powerful tools in combating healthcare fraud, with a growing focus on opioid-related cases and violations of the Anti-Kickback Statute....more

Husch Blackwell LLP

What Medical Schools and Hospitals Should Know About HHS OCR’s Newly Announced DEI-Targeted Investigations

Husch Blackwell LLP on

On March 7, 2025, the U.S. Department of Health and Human Services (HHS) announced that its Office for Civil Rights (OCR) had initiated four investigations into unnamed medical schools and hospitals over allegations that the...more

Mintz

[Podcast] Health Law Diagnosed – Understanding the New Massachusetts Health Care Market Review Law

Mintz on

In the latest episode of Health Law Diagnosed, host Bridgette Keller discusses the new Massachusetts Health Care Market Review Law and what this means for health care providers, investors, and other key stakeholders. She is...more

Bass, Berry & Sims PLC

13th Annual Healthcare Fraud & Abuse Review - 2024

Bass, Berry & Sims is pleased to announce the release of the 13th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2024. Compiled by the firm's Healthcare Fraud & Abuse Task Force,...more

Bradley Arant Boult Cummings LLP

False Claims Act: 2024 Year in Review

Bradley’s Government Enforcement and Investigations Practice Group is pleased to present the False Claims Act: 2024 Year in Review, our annual review of significant False Claims Act (FCA) cases, developments and trends. ...more

WilmerHale

Lessons from Hospital Criminal Prosecution for Larger Health Systems and Provider Groups

WilmerHale on

On January 8, 2025, the U.S. Department of Justice (DOJ) announced that a federal grand jury indicted the Chesapeake Regional Medical Center (CRMC) in Virginia for conspiracy to defraud the United States and health care...more

Verrill

Massachusetts Enacts Largest Health Care Transactions and Financial Oversight Legislation In a Decade, Private Investors and...

Verrill on

Health care sector stakeholders take notice: On January 8, 2025, Massachusetts Governor Healy signed sweeping new health care legislation with transactional, financial, and ongoing operational compliance ramifications for...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

The Emergency Room—The Front Door to the Hospital (Fraud Schemes)?

Fraud related to hospital services – both inpatient and outpatient – has led to over $511 million in damages and hundreds of millions of dollars in False Claims Act (FCA) settlements over the past 15 years. The ER has been...more

Rivkin Radler LLP

Hospital CEO Jailed for Conspiracy to Violate AKS

Rivkin Radler LLP on

The U.S. Department of Justice announced on January 15 that Jeffrey Paul Madison, the former chief executive officer of a Texas hospital, was sentenced to 36 months in federal prison for conspiring to violate the federal...more

McDermott Will & Emery

Hospital Provider-Based Compliance: Top 10 Myths and Truths

McDermott Will & Emery 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

Mintz - Health Care Viewpoints

EnforceMintz — 2024’s Key False Claims Act Settlements Involving Hospitals and Health Systems: Continued Focus on Stark Law and...

In 2024, the Department of Justice (DOJ) resolved several noteworthy False Claims Act (FCA) cases against hospitals and health systems. In particular, DOJ obtained a number of large recoveries in cases where Stark Law and...more

Ropes & Gray LLP

Massachusetts Passes Act Implementing Broad Oversight into For-Profit Investment in Health Care

Ropes & Gray LLP on

On January 8, 2025, Massachusetts Governor Maura Healey signed House Bill 5159, An Act Enhancing the Market Review Process (the “Act”) into law, effective April 8, 2025. The Act is a compromise redraft of the separate health...more

299 Results
 / 
View per page
Page: of 12

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide