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Hospitals Fraud Health Care Providers

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

Lowenstein Sandler LLP

Virginia Hospital Indicted for Allegedly Turning a Blind Eye to Doctor’s Crimes

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In an unusual criminal prosecution, the Chesapeake Regional Medical Center (CRMC), a hospital in Chesapeake, Virginia, was indicted last week by a federal grand jury in Virginia for conspiring to defraud the United States and...more

Robinson & Cole LLP

Legal Update: Key Takeaways: HHS and DOJ’s Health Care Fraud and Abuse Control Program Report

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On December 6, 2024, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) released the Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2023 (the Report). The Report...more

Foley Hoag LLP - White Collar Law &...

Hospital Avoids Admissions in False Claims Act Settlement, While Repeat Relator and Government Cash in on Medical Necessity...

There was a noteworthy False Claims Act (FCA) settlement made public yesterday out of the Eastern District of California involving Oroville Hospital. The government accused the Hospital of submitting false claims to Medicare...more

MG+M The Law Firm

Blue Cross Blue Shield to Pay Record $2.8 Billion in Proposed Antitrust Settlement with Healthcare Providers

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On October 14, 2024, a class of thousands of hospitals, physician groups and other healthcare providers filed a proposed settlement in a twelve-year antitrust lawsuit against the Blue Cross Blue Shield (BCBS) network. BCBS...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | January 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity and developments occurring in January 2023, including several criminal and civil enforcement actions related to the federal...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 25. News Briefs: July 2020

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  -  Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more

King & Spalding

Ninth Circuit Holds That Medical Opinions Do Not Automatically Preclude FCA Liability at the Pleading Stage

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In late March, the United States Court of Appeals for the Ninth Circuit revived a whistleblower lawsuit under the False Claims Act (FCA) in which a former employee accused a healthcare provider of submitting reimbursement...more

Dorsey & Whitney LLP

Escobar in Action: Physician-owners’ fraud claims against hospital defeated in Fifth Circuit appeal for lack of materiality

Dorsey & Whitney LLP on

Following the passage of the Affordable Care Act (“ACA”), which placed new limits on physician-owned hospitals, St. Luke’s Health System (“System”) took action to change one of its hospital’s ownership structures through a...more

Benesch

Benesch Market Intelligence: Health Care Quarterly Report - Q3 2019

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Shepherd Premier Aims to Open 30 Small-Home Communities By 2022 - Aug 11th, 2019 via Senior Housing News. Small-home senior living provider, Shepherd Premier Senior Living, offers an alternative to traditional large-scale...more

Bass, Berry & Sims PLC

FCA Deeper Dive: Pleading the Alleged Fraud Scheme

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The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we are...more

Mintz - Health Care Viewpoints

Another Court Agrees That A Difference Of Opinion On Medical Necessity Is Insufficient to Show Falsity Under the False Claims Act

Last month, the U.S. District Court for the District of Utah joined the AseraCare court and others in finding that a relator cannot successfully allege violations of the False Claims Act (“FCA”) based on a purported lack of...more

BakerHostetler

The Deeper Dive in Texas: Recent Appellate Court Decisions Affecting Providers

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For this edition of the Deeper Dive, we travel to Texas for a look at some interesting cases involving healthcare providers decided on appeal in 2015. Some of these decisions may be surprising – and perhaps even troubling –...more

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