News & Analysis as of

Medicare Liability

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

JUSTICENTER

Basic Personal Injury Settlement Breakdown: How Much Goes in My Pocket?

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Getting a personal injury settlement can feel like a huge relief after an accident. But many people wonder, “How much of this settlement will I actually get?” Understanding how settlements are broken down can help you know...more

Dentons

Ep. 45 – Update Your Return of Overpayments Policy to Align With CMS Changes to the 60-day Rule

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Providers are required by federal law to return Medicare and Medicaid overpayments within 60 days of identifying the overpayment or they can be liable under the False Claims Act. Since 2016, providers have relied on Centers...more

Tyson & Mendes LLP

Audish v. Macias Builds Upon the Foundation Started in Howell v. Hamilton Meats & Provision, Inc.

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Earlier this year, the Fourth District Court of Appeal decided Audish v. Macias. This groundbreaking case builds upon the foundation started in Howell v. Hamilton Meats & Provision, Inc. by clarifying the application of the...more

Holland & Hart LLP

the buzz: Cannabis News & Policy Update - December 2024

Holland & Hart LLP on

Welcome back to the buzz, our monthly cannabis news and policy update. Your at-a-glance source for regulatory developments, agency announcements, and trends impacting the cannabis industry. In this edition of the buzz,...more

ArentFox Schiff

Investigations Newsletter: Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties

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Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties - A Connecticut Superior Court judge found Assured Rx, LLC, a Florida-based pharmacy, liable for violating the Connecticut...more

Arnall Golden Gregory LLP

Seventh Circuit Affirms Liability in AKS-Based FCA Suit But Vacates Award of Damages

The United States Court of Appeals for the Seventh Circuit recently considered a district court’s nearly $6 million judgment in a qui tam False Claims Act (“FCA”) suit based on Anti-Kickback Statute (“AKS”) violations. The...more

Mintz

EnforceMintz — Some of 2023’s Largest FCA Resolutions Involved Stark Law Allegations

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The Physician Self-Referral Law — known as the “Stark Law” — broadly prohibits physicians from profiting from self-referrals for “designated health services” (DHS) payable by Medicare or Medicaid. For example, the Stark Law...more

Snell & Wilmer

Scope of FCA Liability Illustrated In Recent Actions Against Higher Education Institutions

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In the past five years, the Federal Government and “Qui Tam” Realtors have ramped up False Claims Act (“FCA”) actions against higher education institutions. These actions highlight the scope and breadth of potential FCA...more

White and Williams LLP

Pennsylvania Hospitals Provided a Path to Offset Ostensible Agent Liability

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A recent Pennsylvania Supreme Court decision provided hospitals a path to offset liability for their ostensible agents’ negligence. In McLaughlin v. Nahata, the Court recognized that a defendant hospital could seek...more

Marshall Dennehey

Plaintiff Does Not Have to Pay for It and Neither Should You: Preventing Plaintiff’s Introduction of Past Medical Expenses that...

Marshall Dennehey on

Key Points: Evidence of past medical bill charges that have been paid, adjusted, or written off are not relevant. Florida case law establishes that Medicare/Medicaid recipients are precluded from showing evidence of medical...more

King & Spalding

Florida Enacts Transformative Tort Reform Legislation

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On Friday, March 24, 2023, Governor Ron DeSantis signed into law House Bill 837, providing an overhaul to tort law in the state of Florida. The new legislation makes transformative changes, including reducing the statute of...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Damages

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Having previously examined the falsity, materiality, and scienter elements of the False Claims Act (FCA) in our FCA Fundamentals series, we now turn to what damages can arise from violations of the False Claims Act...more

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