News & Analysis as of

Medicaid Reimbursements False Claims Act (FCA)

Troutman Pepper Locke

Massachusetts AG Indicts Health Care Providers and Owners for Submission of Allegedly False Medicaid Claims

Troutman Pepper Locke on

The Office of Massachusetts Attorney General (AG) Andrea Campbell announced the criminal indictment of several Massachusetts-based health care providers and their owners in connection with allegedly false claims they...more

Hinshaw & Culbertson - Health Care

California Appellate Court Rules Federally Qualified Health Center Outreach Expenses Don't Qualify For Cost-Based Reimbursement

Family Health Centers of San Diego (Health Center) operates a federally qualified health center (FQHC) that has 49 locations throughout San Diego County, California, and provides a comprehensive range of primary and...more

Pullman & Comley - Connecticut Health Law

Health Care Billing Enforcement Not Stymied by COVID-19

Doctors, nurses, hospitals and other health care providers, should know that the pandemic has not deterred federal or state authorities from prosecuting false claims, HIPAA and other types of enforcement actions in...more

Mintz - Health Care Viewpoints

Texas: A Cautionary Tale for Medicaid Management and Managed Care Companies

State Medicaid Agencies have historically engaged in an epic balancing act. Federal law requires State Medicaid Agencies to ensure beneficiaries have access to medically necessary services. Federal law also requires State...more

Sheppard Mullin Richter & Hampton LLP

In Case Alleging Nationwide Pharmacy Fraud, Kmart Scores Narrow Settlement

As described in an April 17, 2018 article originally posted on the Sheppard Mullin Richter and Hampton, LLP False Claims Act Defense Blog, Kmart Corporation and the U.S. Department of Justice entered into a False Claims Act...more

Holland & Knight LLP

Healthcare Law Update: September 2017

Holland & Knight LLP on

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

Farrell Fritz, P.C.

Second Circuit Sets False Claims Act Pleading Standard For Claim Information

Farrell Fritz, P.C. on

Last week, the Second Circuit held that a False Claims Act relator does not have to plead details of specific alleged false billings or invoices to the government, as long as he can allege facts leading to a strong inference...more

Alston & Bird

Supreme Court Seeks Meaning in Falsity and Fraud in the False Claims Act

Alston & Bird on

Oral arguments were heard Tuesday, April 19th by the U.S. Supreme Court in one of the most significant False Claims Act (FCA) cases the Court has dealt with in decades on an issue with very real impact on whistleblower suits...more

BakerHostetler

Implied Certification and the FCA: Legally False or a False Legality? The Supreme Court Is Set to Decide

BakerHostetler on

The United States Supreme Court recently granted certiorari in the case of Universal Health Services, Inc. v. U.S. ex rel. Escobar, No. 15-7, which places implied certification under the False Claims Act (FCA) squarely in the...more

Carlton Fields

Kane v. Healthfirst and the 60-day Repayment Rule

Carlton Fields on

Case: Kane v.Healthfirst, Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., case number1:11-cv-02325, in the U.S. District Court for the Southern District of New York. As part of the Affordable Care Act...more

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