News & Analysis as of

Physicians Medicaid False Claims Act (FCA)

Sheppard Mullin Richter & Hampton LLP

Potential False Claims Act Liability for Providers of Gender-Affirming Care for Minors

On July 9, 2025, the U.S. Department of Justice (“DOJ”) announced it sent more than 20 subpoenas to physicians and clinics involved in providing gender-affirming care to minors, and that the subpoenas related to...more

Miles & Stockbridge P.C.

DOJ Remains Focused on Domestic Health Care Fraud

The Department of Justice (DOJ) recently issued its annual Health Care Fraud Takedown results, announcing a record-breaking 324 defendants, including 96 doctors and licensed professionals, as well as more than $14.6 billion...more

BakerHostetler

DOJ and HHS Launch New False Claims Act Working Group to Target Healthcare Fraud

BakerHostetler on

In a joint announcement, the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) unveiled the formation of the new DOJ-HHS False Claims Act Working Group (Working Group) – a strategic...more

Cole Schotz

“First Do No Harm” Considerations for Healthcare Providers in Light of Historic Healthcare Fraud Enforcement Announcement by the...

Cole Schotz on

On Monday, the Department of Justice Criminal Division, led by Matthew R. Galeotti, announced its largest healthcare fraud enforcement charging individuals and entities across the globe in allegedly $14.6 billion criminal and...more

Husch Blackwell LLP

Navigating Compliance Risks in Laboratory Operations—Key Lessons from a Recent FCA Case

Husch Blackwell LLP on

A recent False Claims Act (FCA) litigation—Jensen ex rel. United States of America v. Genesis Laboratory—highlights critical compliance risks for laboratories. This case reinforces the need for laboratories to ensure...more

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

ArentFox Schiff

Investigations Newsletter: Long Island Businessman Arrested in $22 Million Medicare Fraud Scheme

ArentFox Schiff on

Long Island Businessman Arrested in $22 Million Medicare Fraud Scheme - A Long Island, New York, businessman was arrested on conspiracy, kickback, and money laundering charges stemming from an alleged scheme to defraud...more

WilmerHale

Lessons from Hospital Criminal Prosecution for Larger Health Systems and Provider Groups

WilmerHale on

On January 8, 2025, the U.S. Department of Justice (DOJ) announced that a federal grand jury indicted the Chesapeake Regional Medical Center (CRMC) in Virginia for conspiracy to defraud the United States and health care...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

The Emergency Room—The Front Door to the Hospital (Fraud Schemes)?

Fraud related to hospital services – both inpatient and outpatient – has led to over $511 million in damages and hundreds of millions of dollars in False Claims Act (FCA) settlements over the past 15 years. The ER has been...more

Mintz - Health Care Viewpoints

EnforceMintz — 2024’s Key False Claims Act Settlements Involving Hospitals and Health Systems: Continued Focus on Stark Law and...

In 2024, the Department of Justice (DOJ) resolved several noteworthy False Claims Act (FCA) cases against hospitals and health systems. In particular, DOJ obtained a number of large recoveries in cases where Stark Law and...more

Husch Blackwell LLP

Forget the False Claims Act—How a Virginia Hospital Got Criminally Charged

Husch Blackwell LLP on

On January 8, 2025, a federal grand jury in Virginia returned an indictment against a hospital. This rare criminal event in healthcare alleges that Chesapeake Regional Medical Center conspired to defraud the United States and...more

Holland & Knight LLP

DOJ Scrutinizes Financial Arrangements of Florida Physician Practice

Holland & Knight LLP on

The U.S. Department of Justice (DOJ) announced in a Nov. 12, 2024, press release that an ophthalmology practice with offices located in West Central Florida (the Provider) entered into an approximately $1.3 million settlement...more

Troutman Pepper Locke

Precision Toxicology Agrees to Pay $27M Over Drug Testing and Kickback Allegations

Troutman Pepper Locke on

On October 15, Maryland Attorney General Anthony G. Brown announced that his office reached a $27 million settlement with Precision Toxicology to resolve allegations that it submitted false claims to government health...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - May 9th - 10th, San Juan, Puerto Rico

Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...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

Hendershot Cowart P.C.

Doctors: Don’t Fall Victim To Telemedicine Fraud Schemes

Hendershot Cowart P.C. on

Telemedicine companies are supposed to facilitate medically necessary services to beneficiaries over the telephone via licensed medical professionals. In reality, however, many of these “telemedicine companies” are...more

Mintz

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

Mintz on

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

Harris Beach Murtha PLLC

OIG January 2024 Enforcement Summary

The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

Health Care Compliance Association (HCCA)

News Briefs: July 2023

Report on Medicare Compliance Volume 32, no 25 (July 2023) Hospices in four states will face heightened oversight. “CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional...more

Husch Blackwell LLP

Justice Department Sues Iowa Surgeon Under False Claims Act for Masking Non-Covered Cosmetic Procedures as Covered Surgeries

Husch Blackwell LLP on

Cosmetic surgeries are on the rise. One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. Facelifts were up 54...more

Dickinson Wright

Sixth Circuit Defines False Claims Standards

Dickinson Wright on

The Federal False Claims Act (“FCA”) imposes civil liability for presenting a false claim to the government for payment. The Federal Anti-Kickback Statue (“AKS”) prohibits medical providers from making referrals in return for...more

Rivkin Radler LLP

Surgeon Settles Simultaneous Surgery Suit

Rivkin Radler LLP on

The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

The Volkov Law Group

Modernizing Medicine Settles False Claims Act Violations for $45 Million

The Volkov Law Group on

The Justice Department continues to pile up healthcare enforcement actions — false claims, anti-kickback, and fraud.  DOJ is on its way to a record year....more

74 Results
 / 
View per page
Page: of 3

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide