The Department of Justice (DOJ) recently announced the largest National Health Care Fraud Takedown in its history, charging 455 defendants—including 90 physicians and other licensed medical professionals—in schemes involving more than $6.5 billion in alleged false claims.
Continue Reading DOJ’s $6.5 Billion National Health Care Fraud Takedown Signals a New Era of Data-Driven EnforcementSmoke is Not Fire: Fourth Circuit Rejects Stark and AKS Theories Built on Ordinary Business Practices and Conclusory Allegations
It is not every day that an 83-page qui tam complaint alleging Stark Law and Anti-Kickback Statute (AKS) violations is dismissed at the pleading stage, particularly when filed by experienced relator’s counsel and accompanied by more than 30 pages of detailed claims data. But that was exactly the result in U.S. ex rel. Kyer v. Thomas Health System, a June 4 decision from a unanimous Fourth Circuit panel.
Federal Court Seizes $2 Million from Wound Care Clinic: What Providers, Distributors, and Manufacturers Need to Know
Skin substitutes, bioengineered or natural materials designed to promote healing by replacing or supporting damaged skin, have become a key component of advanced wound care. But the significant Medicare reimbursement of these products commanded over the last few years has made them a prime target for enforcement by the Department of Justice and the Department of Health and Human Services Office of Inspector General (OIG).
Continue Reading Federal Court Seizes $2 Million from Wound Care Clinic: What Providers, Distributors, and Manufacturers Need to KnowDownload Now | 14th Annual Healthcare Fraud & Abuse Review
Ensuring compliance with the False Claims Act has never been more important for healthcare providers.
Bass, Berry & Sims is pleased to announce the release of the 14th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2025.
Continue Reading Download Now | 14th Annual Healthcare Fraud & Abuse ReviewWatch Now | Healthcare Fraud & Abuse Annual Review Webinar
Bass, Berry & Sims released its 14th Annual Healthcare Fraud & Abuse Review in mid-February. As a companion to the Review, hosted a complimentary webinar, which provided an overview and discussion of key focus areas covered in the Review.
Continue Reading Watch Now | Healthcare Fraud & Abuse Annual Review WebinarDOJ Releases Record-Setting Civil Fraud Recovery Statistics and Results…Our Annual Look Behind the Numbers
On January 16, the U.S. Department of Justice (DOJ) released its annual report on civil fraud recoveries (settlements and judgments) for FY2025, along with a press release highlighting DOJ’s civil enforcement efforts.
Continue Reading DOJ Releases Record-Setting Civil Fraud Recovery Statistics and Results…Our Annual Look Behind the NumbersFalse Claims Act Settlements to Know from the First Half of 2025
With the first half of 2025 in the rearview mirror, the government’s continued focus on False Claims Act (FCA) enforcement shows no signs of slowing. In fact, the Department of Justice recently announced the results of a record-setting National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants for alleged healthcare fraud schemes involving over $14.6 billion.
Continue Reading False Claims Act Settlements to Know from the First Half of 2025Ninth Circuit Ruling Outlining Kickback Limits Under EKRA
I commented on a recent Ninth Circuit ruling clarifying a 2018 law that prohibits kickbacks for referring patients to medical testing labs and addiction treatment centers under the Eliminating Kickbacks in Recovery Act (EKRA).
Continue Reading Ninth Circuit Ruling Outlining Kickback Limits Under EKRAFalse Claims Act Enforcement in Healthcare: Insights from the 13th Annual Fraud & Abuse Review
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 Review