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Litigation Strategies Centers for Medicare & Medicaid Services (CMS)

Paul Hastings LLP

The Verdict Is In: SuperValu Wins at Trial Despite Knowingly Submitting False Claims

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In 2023, we wrote about the Supreme Court’s decision in United States ex. rel. Schutte v. SuperValu Inc. interpreting the False Claims Act’s (FCA) scienter standard to require inquiry into a defendant’s subjective knowledge....more

McDermott+

Breaking Down the New No Surprises Act FAQs Post-TMA III (June 2025 Update)

McDermott+ on

UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more

Epiq

How Plaintiff and Defense Attorneys Can Protect Beneficiaries’ Finances and Health Care in MMSEA Section 111 Reporting

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Insufficient collaboration between plaintiff and defense attorneys regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting requirements creates administrative complications which can negatively...more

Sheppard Mullin Richter & Hampton LLP

Proving Fraud is and Should Be Hard: Lessons from a Recent Medicare Advantage False Claims Act Decision

The litigator’s adage “it’s easy to plead, it’s hard to prove” once again came true in the long-running False Claims Act (FCA) case targeting Medicare Advantage (“MA”) plans operated by UnitedHealth (United). Eight years...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Enforcement Compliance Conference - November 3rd-6th, Washington , DC

Prepare your organization to respond to the ever-increasing emphasis on healthcare compliance issues by enforcement authorities. Hear first-hand from government officials about regulatory changes, expectations, and key...more

Butler Snow LLP

Pro Te: Solutio – Vol. 12, No. 3

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Summer is winding down, and Fall texted to say she is on her way. This means that Pro Te: Solutio is returning for its third edition of 2019. As always, our authors have taken the time to research and address current issues...more

Mintz - Health Care Viewpoints

DOJ Updates its Justice Manual to Include Section Limiting Use of Guidance Documents in Litigation

Nearly one year ago, on January 25, 2018, the Department of Justice’s (DOJ) Regulatory Reform Task Force issued a memorandum entitled “Limiting Use of Agency Guidance Documents In Affirmative Civil Enforcement Cases.” Many...more

American Conference Institute (ACI)

[Event] Long Term Care and Senior Care Compliance, Risk Management, and Litigation Strategies - January 23rd-25th, Miami, FL

Join us as they share their insights on risk management, compliance, and litigation and help you develop the necessary strategies to avoid mistakes that cost facilities millions in jury verdicts annually. This year’s...more

NAM (National Arbitration and Mediation)

Resolve Thorny Issues Before Coming To Mediation

Assume that you are involved as a plaintiff or a defendant (carrier) in a serious injury case and that the injured party has collected workers’ compensation so the issue of a lien payback will be part of any settlement. Also...more

Jones Day

DOJ Limits the Use of Agencies' Guidance Documents in Civil Enforcement Actions

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The Department of Justice ("DOJ") recently issued a memorandum limiting the ability of its litigators to use agency guidance documents in civil enforcement actions against private parties. The memo expands on a directive...more

Akin Gump Strauss Hauer & Feld LLP

DOJ Limits Use of Guidance Documents in Affirmative Civil Enforcement Actions

On January 25, 2018, the Associate Attorney General directed the Department of Justice (DOJ) not to rely on agency guidance documents to establish a violation in affirmative civil enforcement (“ACE”) cases. She issued the...more

Holland & Knight LLP

Healthcare Law Update: September 2017

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OIG Advisory Opinions - Manufacturer's Free Replacement of Spoiled Pharmaceutical Products Authorized - On Aug. 25, 2017, the U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG)...more

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