News & Analysis as of

Long Term Care Facilities Healthcare Fraud

Dentons

Ep. 61 – Three Compliance Lessons from a False Claims Act Verdict

Dentons on

In a recent False Claims Act case, a long-term care pharmacy and consulting services provider was found liable for submitting false claims to the government, resulting in a jury verdict of over $135 million in damages. The...more

Baker Donelson

Enhancing Compliance in Nursing Facilities: OIG's New Guidance

Baker Donelson on

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) issued new Nursing Facility Industry Segment-Specific Compliance Program Guidance (Nursing Facility ICPG) for nursing facilities...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

Polsinelli on

Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Troutman Pepper Locke

Lessons for Skilled Nursing and Assisted Living Facilities From the ‘Largest Health Care Fraud Case’

Troutman Pepper Locke on

Phillip Esformes, the alleged mastermind of one of “the largest single criminal health care fraud cases ever brought against individuals by the Department of Justice,”has finally reached a plea deal with the Department of...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q1 2023

On February 7, the Department of Justice (DOJ) issued a press release indicating that settlements and judgments under the False Claims Act (FCA) exceeded $2.2 billion in the fiscal year ending September 30, 2022. Of this...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | July 2022 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant activity between June 21 and July 20, 2022. During this period, the Supreme Court of the United States overturned Roe v. Wade, which historically...more

Dentons

Department of Justice Files False Claims Act Charges Against Nursing Home Chain

Dentons on

The United States Department of Justice (DOJ) has filed another False Claims Act case against a long-term care provider premised on the quality of care provided to its residents. The DOJ is increasingly utilizing substandard...more

Bradley Arant Boult Cummings LLP

DOJ Brings False Claims Act Suit Against Serial LTC Whistleblower

Thomas Prose is the founder and owner of a Michigan-based “post-hospitalist” company named General Medicine P.C. (GM), which purports to specialize in the care of post-acute patients in long-term care facilities by providing...more

Bradley Arant Boult Cummings LLP

Skyline Fraud Charges Serve as a Warning to Inexperienced Operators

In the past month, state and federal prosecutors have separately charged the former CEO of Skyline Healthcare, Joseph Schwartz, with Medicaid and tax fraud. The criminal actions, which represent the latest legal action...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Regional Healthcare Compliance Conference - Columbus, OH - April 30th, 8:25 am - 4:30 pm EDT

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2020

Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more

Shook, Hardy & Bacon L.L.P.

COVID-19 Client Primer | Senior Living Facilities

Senior Care in the Time of COVID-19 - COVID-19’s impact on senior living companies and facilities cannot be overstated. The virus’s propensity for community transmission was not fully appreciated when many senior care...more

The Volkov Law Group

Avanir Pharmaceuticals Pays More than $108 Million to Settle Kickback Violations

The Volkov Law Group on

Just to repeat myself – pharmaceutical and medical device firms face extraordinary risks of enforcement under the False Claims Act.  While everyone likes to write and focus on FCPA or anti-corruption risks for global drug and...more

Baker Donelson

Tips for Providers to Cope with the Challenge of Whistleblower Retaliation Claims

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Operating in the long term care (LTC) industry is undoubtedly challenging. On top of limited reimbursement from government payors, there are stringent regulations, surveys and other forms of regulatory scrutiny, malpractice...more

Baker Donelson

OIG Advisory Opinion 18-01: Excluded Individual May Serve as Marketing Liaison to LTC Pharmacies

Baker Donelson on

In OIG Advisory Opinion 18-01, published February 27, 2018, the OIG concluded a proposed employment arrangement between an excluded individual and a for-profit company selling discounted emergency medications to long term...more

Bass, Berry & Sims PLC

Healthcare Fraud and Abuse Review 2016

Bass, Berry & Sims PLC on

Bass, Berry & Sims is pleased to announce the release of its fifth annual Healthcare Fraud and Abuse Review 2016. The Review, compiled by the firm’s Healthcare Fraud Task Force, is an industry-leading guide to healthcare...more

Holland & Knight LLP

Healthcare Law Update: December 2016

Holland & Knight LLP on

Prompt Payment Discounts Not an Anti-Kickback Statute Violation - In United States of Am. et al. ex rel. Ruscher v. Omnicare, No. 15-20629, 2016 WL 6407128 (5th Cir. Oct. 28, 2016), the court of appeals affirmed summary...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Farella Braun + Martel LLP

Kickback Prosecutions Expanding Beyond Drugs and Devices to Care Networks

The DOJ has recently showed some new muscle by applying anti-kickback laws to care facility owners rather than drug manufacturers. The uptick in federal healthcare fraud prosecutions in 2016 has been well-documented, but...more

Polsinelli

DOJ Targets Nursing Fraud with New Task Forces

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On March 30, 2016, the U.S. Department of Justice launched 10 regional task forces targeting “grossly substandard care” in nursing homes and other long-term care facilities across the country. The task forces combine federal,...more

McGuireWoods LLP

Washington Healthcare Update

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This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

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