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A former federal prosecutor and current co-chair of the firm’s Compliance & Government Investigations Practice Group, Lisa Rivera’s practice focuses on advising healthcare providers, pharmaceutical manufacturers, medical device companies and other clients on matters related to civil and criminal healthcare fraud and abuse, as well as government investigations and enforcement.

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 Review

On December 13, the U.S. Department of Justice (DOJ) intervened in a False Claims Act (FCA) lawsuit alleging that CVS Pharmacy Inc. and its subsidiaries improperly sought federal reimbursement for prescriptions filled in violation of the Controlled Substances Act (CSA).

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On July 10, the Department of Justice (DOJ) announced a nearly $410 million settlement with Rite Aid Corporation to resolve allegations that Rite Aid and its affiliates ignored red flags and knowingly dispensed unlawful controlled substances in violation of the False Claims Act (FCA) and Controlled Substances Act (CSA). Continue Reading Rite Aid and OptumRx Settlements Highlight Enforcement Focus on Pharmacy Corresponding Responsibility for Dispensing Controlled Substances

In a recent McKnight’s Long-Term Care News article, we discussed heighted scrutiny within the long-term care industry related to drug diversion and compliance with the Controlled Substances Act (CSA). Healthcare organizations, and not just diverting employees, are more often being held accountable for diversion of controlled substances.Continue Reading Drug Diversion within Long-Term Care Industry

Please join us on Thursday, July 13 at 12pm CT as we examine how False Claims Act cases ended up before the Supreme Court, the Court’s analysis of these cases, and the lasting impact that these opinions will have for those dealing with False Claims Act-related issues. Continue Reading Register Now: The Supreme Court and the False Claims Act Webinar

I was recently interviewed on the Healthcare Strategies podcast about how the Department of Justice (DOJ) is enforcing the Civil Cyber-Fraud Initiative to hold healthcare organizations accountable for cybersecurity matters. The Initiative, launched by DOJ in October 2021, utilizes the False Claims Act (FCA) to take action against entities that knowingly provide insufficient data security measures.
Continue Reading DOJ’s Civil Cyber-Fraud Initiative Impact on Healthcare Organizations

Last week, the District Court for the Eastern District of California denied the defendant’s motion for summary judgment of a False Claims Act (FCA) count against Aerojet Rocketdyne (Aerojet) for allegedly fraudulently inducing the government to enter into federal contracts when the company knew it was not compliant with cybersecurity requirements.
Continue Reading Government Contractors Face False Claims Act Liability for Cybersecurity Non-Compliance

On December 2, the U.S. District Court for the Western District of Virginia granted a motion to dismiss a False Claims Act (FCA) lawsuit brought by the United States and the Commonwealth of Virginia, which alleged that a Walgreens clinical pharmacy manager falsified hepatitis C drug prior authorization submissions to Virginia Medicaid. See United States v. Walgreen Co., 2021 WL 5760307 (W.D. Va. Dec. 3, 2021).
Continue Reading FCA Lawsuit Against Walgreens Dismissed Because Government Fails to Plead Materiality