News & Analysis as of

Whistleblowers Qui Tam Hospitals

Warner Norcross + Judd

Federal Court Flags Stark and Anti-Kickback Risks in Physician Pay, Spotlights FCA Constitutional Questions on Appeal

On July 28, the federal district court in the Southern District of Ohio issued a pair of orders in related whistleblower cases under the False Claims Act (FCA): United States ex rel. Murphy v. TriHealth, Inc., et al., No....more

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

Robinson+Cole Health Law Diagnosis

Connecticut Expands Applicability of State False Claims Act

On June 26, 2023, Connecticut Governor Ned Lamont signed into law Public Act 23-129: “An Act Concerning Liability for False and Fraudulent Claims” (the Act). The Act expands application of Connecticut’s False Claims Act...more

Husch Blackwell LLP

Hospital Turns Tables on Whistleblower: Federal Judge Sends Hospital’s Case Against Whistleblower to Trial

Husch Blackwell LLP on

In the world of qui tams, it is usually the whistleblower pushing cases to trial. But on February 23, 2023, a federal judge in West Virginia set down for trial a hospital’s case against a whistleblower. Now, in a trial set...more

Benesch

Whistleblower Lawsuit Against Fresenius Alleges Unlawful Arrangements with Hospitals and Nephrologists Intended to Induce Dialysis...

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On February 5, 2021 a long-time former Fresenius Medical Care North America (“Fresenius”) employee, Martin Flanagan, filed a qui tam relator amended complaint (“Complaint”) against Fresenius alleging that the company had...more

King & Spalding

Ninth Circuit Holds That Medical Opinions Do Not Automatically Preclude FCA Liability at the Pleading Stage

King & Spalding on

In late March, the United States Court of Appeals for the Ninth Circuit revived a whistleblower lawsuit under the False Claims Act (FCA) in which a former employee accused a healthcare provider of submitting reimbursement...more

ArentFox Schiff

Deputy Associate Attorney General Sheds Light on DOJ’s FCA Priorities at Annual False Claims Act Conference

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“Enforcing the False Claims Act is a top priority for the Department—not just for our office,” said Deputy Associate Attorney General Stephen Cox, the Keynote Speaker for the 2020 Advanced Forum on False Claims and Qui Tam...more

Epstein Becker & Green

Health Care Continues to Drive False Claims Act Recoveries: Thought Leaders in Health Law Video Series

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$3 billion recovered under the False Claims Act (“FCA”). That’s what the US Department of Justice (“DOJ”) reported collecting in FY2019. The health care and life sciences industries accounted for $2.6 billion of the total...more

The Volkov Law Group

Health Management Associates Pays Over $260 Million in Criminal and Civil Penalties for Pervasive False Billing and Kickback...

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Healthcare Management Associates (HMA) settled criminal and civil charges with the Justice Department for illegal fraud and kickback schemes. HMA billed federal government healthcare programs for inpatient services that...more

Holland & Knight LLP

Healthcare Law Update: September 2018

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Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Holland & Knight LLP

EMTALA as a Basis for a Qui Tam Case?

Holland & Knight LLP on

The Emergency Medical Treatment & Labor Act (EMTALA) requires a hospital with an emergency department (ED) to provide "an appropriate medical screening examination" when an individual comes to the ED and a request is made on...more

Mintz

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: June 2018

Mintz on

Overview of Qui Tam Activity - ..We identified 60 health care related qui tam cases that were unsealed in December 2017 and January 2018. ..The government intervened in 14% of those unsealed cases, which is consistent...more

Mintz

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: August 2017

Mintz on

In this issue we report on recent qui tam activity and look at three unsealed cases. One case involves allegations of “up coding” by a hospital that allegedly billed routine transport as emergency transport, reimbursed at...more

Baker Donelson

Court Puts the Brakes on Whistleblower's FCA Parking Claims

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The Department of Justice (DOJ) reports that, in fiscal year 2016 ending September 30, it obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims. More than half of this...more

The Volkov Law Group

Healthcare Compliance: Juggling Risk Mitigation Strategies

The Volkov Law Group on

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk...more

Dickinson Wright

Healthcare Legal News: Volume 5, Number 3

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RESPONDING TO SUBPOENAS AND OTHER REQUESTS FOR PERSONAL HEALTH INFORMATION: TAKE THEM AT FACE VALUE - Healthcare providers and other HIPAA covered entities receive requests for protected health information (“PHI”) from...more

Faegre Drinker Biddle & Reath LLP

Court Adopts Tough Interpretation of 60-Day Repayment Rule

New York’s Mt. Sinai Hospitals can’t seem to catch a break in its long-running battle with whistleblower Bob Kane. First, the government joined the case and wanted not just the $1,000,000 in Medicaid overpayments, but an...more

Mintz

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: June 2015

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Trends & Analysis: ..We have identified 33 health care–related qui tam cases that have been unsealed in whole or in part since the cases covered in our last Qui Tam Update. In addition, we have also identified one case...more

Mintz - Health Care Viewpoints

Mintz Levin Health Care Qui Tam Update - Recent Developments and Unsealed Cases

Trends and Analysis: ..We have identified 20 health care-related qui tam cases unsealed in July 2013. About a quarter of those were filed in 2013. ..Among the cases unsealed in July, the government has declined to...more

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