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Whistleblowers Physicians

Dentons

Ep. 64 – Three Communication Strategies to Reduce Whistleblower Risk

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In today’s complex healthcare landscape, whistleblower claims are a major source of regulatory and legal risk for organizations. Last year saw a record number of “qui tam” claims filed under the False Claims Act. While...more

Mintz - Health Care Viewpoints

Noteworthy False Claims Act Settlement Demonstrates DOJ’s Continued Scrutiny of Arrangements Between Hospitals and Physician...

On May 14, 2025, Fresno Community Hospital and Medical Center d/b/a Community Health System (CHS) and its technology partner, Physicians Network Advantage, Inc. (PNA), agreed to pay $31.5 million (the Settlement Agreement)...more

Arnall Golden Gregory LLP

Limitations to the Anti-Kickback Statute? Seventh Circuit Reverses Conviction Finding “Aggressive” Marketing Tactics Insufficient...

On April 14, 2025, the United States Court of Appeals for the Seventh Circuit reversed the conviction of the owner of a durable medical equipment (“DME”) distributor, ruling that there was insufficient evidence to support a...more

Venable LLP

Defense-Friendly Anti-Kickback Statute and False Claims Act Marketing and Advertising Decisions

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On April 14, 2025, the Seventh and Second Circuits each issued opinions narrowing the scope of advertising, marketing, and booking fee activities that run afoul of the federal Anti-Kickback Statute (AKS). See United States v....more

Foley & Lardner LLP

The Northern District of Illinois Endorses “But For” Causation Standard for AKS-Premised False Claims Act Cases

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A circuit split over the causation standard under the federal Anti-Kickback Statute (AKS) could grow wider after a recent Northern District of Illinois (NDIL) decision. In United States ex rel. Jeffrey Wilkerson & Larry...more

A&O Shearman

DOJ Announces Settlement Where Medical Group And Related Parties Will Pay Over $62M To Resolve False Claims Act Suit

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On March 26, the Department of Justice (“DOJ”) announced that a California-headquartered healthcare provider, Seoul Medical Group Inc. (“Seoul Medical”), its former president and majority owner, and a Seoul Medical subsidiary...more

ArentFox Schiff

Investigations Newsletter: Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses

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Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses - On March 26, the US Department of Justice (DOJ) announced that a California-based medical group and related parties...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | January 2025 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for January 2025. This month features long-awaited proposed and final rules regarding the Health Insurance Portability and Accountability...more

Dentons

Ep. 50 – Three Physician Compensation Mistakes to Avoid

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In January, the Department of Justice released its annual fraud statistics summarizing health care fraud settlements and judgments during the 2024 fiscal year. Last year, there were over $2.9 billion in fraud settlements and...more

WilmerHale

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

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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,...

Second Circuit Expands Anti-Kickback Statute Liability: “At Least One Purpose” is Enough

In a significant ruling, the Second Circuit Court of Appeals recently expanded the scope of the Anti-Kickback Statute (AKS).The Court joined other circuit courts across the country in adopting, for the first time, the...more

Holland & Knight LLP

DOJ Scrutinizes Financial Arrangements of Florida Physician Practice

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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

Akerman LLP - Health Law Rx

Zafirov Decision Sets Stage for Appellate Showdown Over Constitutionality of FCA’s Qui Tam Provision

For the first time ever, a judge has ruled that the qui tam provision of the False Claims Act (FCA), which whistleblowers have used to recover $52 billion on behalf of the government since 1986, is unconstitutional....more

Cozen O'Connor

Whistleblower Watch - Summer 2024

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Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

Wiley Rein LLP

Hot Fraud Summer: DOJ’s Latest Criminal Takedown

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The U.S. Department of Justice (DOJ) Criminal Division’s Health Care Fraud Strike Force announced the results of its latest nationwide enforcement action on June 27, 2024, one year (almost to the day) since its last major...more

Dentons

Ep. 12 - Working with Valuation Experts to Substantiate Fair Market Value Compensation

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We often work with valuation experts to ensure compensation payments between healthcare organizations and physicians are fair market value and commercially reasonable for purposes of compliance with the Stark Law and the...more

Goodwin

Charting the DOJ’s Record Breaking Year for False Claims Act Enforcement

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The US Department of Justice (DOJ) and whistleblowers were party to a record number of False Claims Act settlements and judgments in fiscal year 2023. Of the $2.68 billion recovered, more than $1.8 billion related to matters...more

K&L Gates LLP

US Department of Justice Announces US$2.68 Billion in Fiscal Year 2023 False Claims Act Recoveries

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On 22 February 2024, the US Department of Justice (DOJ) published its report (Report) announcing civil recoveries under the False Claims Act (FCA) for Fiscal Year (FY) 2023. The recoveries for FY 2023 exceeded US$2.68...more

Husch Blackwell LLP

How One Hospice Owner Got Convicted of Healthcare Fraud and How You Can Avoid That Fate

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The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this episode of Hospice Insights: The Law and Beyond, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about...more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

Rivkin Radler LLP

Health Network Pays $345 Million for Compensating Physicians Above FMV

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Community Health Network, Inc., based in Indianapolis, Indiana, has paid $345 million to settle alleged violations of the False Claims Act (FCA). The lawsuit was initiated through a whistleblower complaint that was filed in...more

Arnall Golden Gregory LLP

Third Circuit Resurrects FCA Lawsuit Against Hospice Due to Disputed Materiality of Eligibility Documentation

A New Jersey hospice provider must continue its long fight against whistleblowers alleging it violated the False Claims Act (“FCA”) by seeking Medicare reimbursement for patients whose documentation did not support hospice...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)

[Event] 2023 Board & Audit Committee Compliance Conference - October 23rd - 24th, Fort Lauderdale, FL

Discover today's best practices for your role in healthcare compliance oversight - The Office of Inspector General of Health and Human Services expects healthcare board members, board audit/compliance committee members,...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

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