On February 22, the Department of Justice (DOJ) released its annual report of civil fraud recoveries for FY2023, along with a press release highlighting DOJ’s civil enforcement efforts. Continue Reading DOJ Releases Annual Civil Fraud Recovery Statistics and Results…A Look Behind the Numbers
Matt Curley is co-chair of the Bass, Berry & Sims Healthcare Fraud Task Force and represents clients in connection with internal and governmental investigations and related civil and criminal proceedings, particularly involving matters of fraud and abuse within the healthcare industry. Matt has considerable experience in litigating matters under the False Claims Act (FCA) and in representing clients in actions and investigations brought by government regulators, including the U.S. Department of Justice (DOJ), the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) and various state agencies.
The Supreme Court recently released important opinions that will shape False Claims Act investigations and litigation for years to come. Continue Reading Register Now: The Supreme Court and the False Claims Act Webinar Replay
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
We were each quoted in a Law360 article examining the status of the Anti-Kickback Statute (AKS) on the 50th anniversary of the law’s passing, and offered our perspective, informed by both our practices advising healthcare providers on AKS issues and our experience as government attorneys dealing with AKS issues, on the legal challenges and disputes among the courts on how to apply the AKS and the current state of the enforcement environment encountered by healthcare providers as it relates specifically to AKS issues. Continue Reading Impact of Anti-Kickback Statute on Its 50th Anniversary
Bass Berry & Sims recently secured dismissals on behalf of healthcare providers in three separate False Claims Act (FCA) qui tam lawsuits in a matter of a week’s time. Continue Reading Bass, Berry & Sims Notches Wins for Clients in Trio of False Claims Act Qui Tam Lawsuits
We wanted to update readers on improvements to our blog that you will see over the next few months.
Along with giving the web page a new look, we will be publishing a series of posts to enhance our readers’ understanding of key False Claims Act issues. Each series will serve a different purpose, and the series will focus on the following:Continue Reading A New Year of Changes at Inside the FCA
We explored the impact of the Supreme Court’s decision in Universal Health Servs., Inc. v. U.S. ex rel. Escobar to mark the fifth anniversary of this key False Claims Act opinion in a recent article for Law360. As we point out in the article, the Supreme Court’s decision “continues to have a profound impact on…
For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA) liability. The question of whether the FCA requires a showing of objective falsity has divided appellate courts in a number of recent high-profile cases.
For their part, practitioners have kept a close eye on whether the Supreme Court might bring much-needed clarity to this issue. On February 22, the Supreme Court declined to do so, denying a petition for certiorari with respect to the Third Circuit’s opinion in U.S. ex rel. Druding v. Care Alternatives.
In Druding, the relators, who were former employees of a hospice provider, filed a qui tam action alleging that the hospice provider submitted false claims by routinely certifying patients who were not terminally ill for hospice care. During the litigation, the relators’ expert examined the medical records of nearly 50 patients and concluded that the documentation did not support a certification of terminal illness for approximately 35% of those patients. The hospice provider produced its own expert who testified a physician could have reasonably concluded that the patients at issue were terminally ill and needed hospice care.Continue Reading Supreme Court Declines to Weigh in on Key Falsity Question
Bass, Berry & Sims is pleased to announce the release of the newest edition of its Healthcare Fraud & Abuse Annual Review examining important healthcare fraud developments in 2020. Compiled by the firm’s Healthcare Fraud Task Force, the Review provides an in-depth and comprehensive analysis of the past year’s court decisions involving the False…
One of the first indicators that may tip off a healthcare provider or government contractor that their organization may be the subject of a False Claims Act (FCA) investigation is contact with a government investigator. That contact may take many forms – service of a subpoena or Civil Investigative Demand (CID), an interview of an employee, or simply a phone call by a government regulator or investigator. How an organization responds to those earliest contacts often sets the tone for how the government investigation unfolds.
Organizations with well-developed policies and procedures addressing how the organization will respond to contacts by government regulators often have a more orderly process to guide the organization in responding to government investigations (referred to herein as a Government Response Policy). A Government Response Policy can set a clear tone of cooperation by the organization with any appropriately authorized government inquiry, while at the same time making clear that the organization will assert all protections afforded by law in any such investigation or inquiry. And, a well-crafted Government Response Policy also can make clear to employees that concealment, alteration or destruction of information or the making of false or misleading statements to regulators will not be tolerated.
An effective Government Response Policy depends upon educating employees regarding the types of contacts that an organization or an employee may receive from government regulators and on establishing clear points of contact and lines of communication within the organization. Typically, the organization will establish its legal department as a central point of contact for government inquiries or investigations (and organizations without a legal department would have to think through an alternative appropriate point of contact) as the entity within the organization best suited to coordinate the organization’s response either directly or through outside counsel. Below we provide broad principles and guidelines that should be considered in preparing an organization’s Government Response Policy.
This post contains five parts and looks at the following:
- Responding to a subpoena or CID.
- Responding to visits by investigators at an office/facility.
- Responding to a search warrant.
- Responding to an interview request.
- Responding to inbound calls from government officials.