The False Claims Act (FCA) remains one of the government’s most powerful tools in combating healthcare fraud, with a growing focus on opioid-related cases and violations of the Anti-Kickback Statute.
Continue Reading False Claims Act Enforcement in Healthcare: Insights from the 13th Annual Fraud & Abuse ReviewDownload Now – 13th Annual Healthcare Fraud & Abuse Review
Our 13th annual Healthcare Fraud & Abuse Review, compiled by the Bass, Berry & Sims Healthcare Fraud & Abuse Task Force, is now available, providing an in-depth look at the key enforcement trends, legal decisions, and settlements shaping the healthcare industry in 2024.
Continue Reading Download Now – 13th Annual Healthcare Fraud & Abuse ReviewRegister Now | Healthcare Fraud & Abuse Annual Review Webinar
Bass, Berry & Sims will release its 13th Annual Healthcare Fraud & Abuse Review the first week of March. As a companion to the Review, we will host a complimentary webinar on Thursday, March 20 from 11:00 a.m. – 1:00 p.m. CT, which will provide an overview and discussion of key focus areas covered in the Review.
Continue Reading Register Now | Healthcare Fraud & Abuse Annual Review WebinarSupreme Court Clarifies “Claim” Definition Under False Claims Act
In Wisconsin Bell, Inc. v. United States ex rel. Heath, the Supreme Court clarified the definition of “claim” under the FCA. The case resolves a split between the Fifth and Seventh Circuits on whether a request for reimbursement under the E-Rate subsidies program meets the statutory definition of a “claim.”
Continue Reading Supreme Court Clarifies “Claim” Definition Under False Claims ActFirst Circuit Adopts “But-For” Causation Standard for Proving Kickback FCA Violations
In a closely watched appeal, the U.S. Court of Appeals for the First Circuit ruled on February 18 that to satisfy the causation requirement in False Claims Act (FCA) actions based on alleged Anti-Kickback Statute (AKS) violations, the government or relator must prove that the alleged kickbacks were the “but-for” cause of the defendant’s allegedly false claims. The First Circuit joins the Sixth and Eighth Circuits in adopting this defendant-favorable standard, with only the Third Circuit requiring a less-stringent showing.
Continue Reading First Circuit Adopts “But-For” Causation Standard for Proving Kickback FCA ViolationsThe Surge in FCA Whistleblower Lawsuits: What’s Driving the Trend and What Comes Next?
Whistleblower-driven False Claims Act (FCA) lawsuits are on the rise, raising critical questions about the factors fueling this trend and its potential impact on enforcement.
Continue Reading The Surge in FCA Whistleblower Lawsuits: What’s Driving the Trend and What Comes Next?Fourth Circuit Holds that Violation of CIA Can Support Reverse False Claims and Adopts Relaxed Rule 9(b) Presentment Requirement
On February 3, the U.S. Court of Appeals for the Fourth Circuit reversed a district court’s grant of a motion to dismiss, holding in relevant part that:
Continue Reading Fourth Circuit Holds that Violation of CIA Can Support Reverse False Claims and Adopts Relaxed Rule 9(b) Presentment RequirementImpact of Trump Administration’s Executive Order on DEI Programs and FCA Liability
As federal contractors and grant recipients navigate the changing landscape of diversity, equity, and inclusion (DEI) programs, the Trump administration’s rescinding of Executive Order No. 11246 (EO) raises new concerns about potential False Claims Act (FCA) liability for non-compliance.
Continue Reading Impact of Trump Administration’s Executive Order on DEI Programs and FCA LiabilityExecutive Order on DEI Programs: Implications for Healthcare and False Claims Act Risks
The Trump administration’s recent executive order targeting diversity, equity, and inclusion (DEI) programs is reshaping the landscape for healthcare providers, with potential legal and regulatory implications that are still unfolding.
Continue Reading Executive Order on DEI Programs: Implications for Healthcare and False Claims Act RisksHHS-OIG Year in Review 2024
In 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) provided useful insights to the healthcare industry regarding how it approaches various fraud and abuse issues in an increasingly complex healthcare environment.
Continue Reading HHS-OIG Year in Review 2024