We authored an article published in the June 2023 issue of the American Bar Association’s (ABA) Health Lawyer addressing government scrutiny of COVID-19 relief funds. Continue Reading Government Scrutiny of COVID-19 Relief Funds
On February 7, the Department of Justice (DOJ) released its annual report of civil fraud recoveries for the prior fiscal year, along with its accompanying press release highlighting its civil enforcement efforts. Our top ten observations from DOJ’s release include:Continue Reading DOJ Releases Annual Civil Fraud Recovery Statistics and Results
Please join us for the 8th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this complimentary program will take place on December 8th in Nashville (full day). The conference will be broadcast virtually the mornings of December 15th and 16th.
Continue Reading Register Now | 8th Annual Nashville Healthcare Fraud Conference
The Department of Justice (DOJ) announced on September 12, the first-ever False Claims Act (FCA) settlement with a Paycheck Protection Program (PPP) lender.
Continue Reading Government Announces First FCA Settlement with PPP Lender
The Paycheck Protection Program (PPP) was intended to provide a fast influx of assistance to small businesses during the economic shock created by the COVID-19 pandemic. The speed with which loans were distributed to businesses nationwide was striking, and so was the speed with which the Department of Justice (DOJ) began prosecuting those abusing the program. Reports of corporations and individuals seeking to take advantage of the PPP prompted a vigorous law enforcement response that has broadened its scope in recent months. As we highlighted last year, the DOJ has taken aggressive action to pursue those who engaged in misconduct involving the PPP and other CARES Act stimulus programs.
Continue Reading PPP Enforcement Actions Gather Steam
The 7th Annual Healthcare Fraud Conference was hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Because we are unable to provide an in-person forum due to ongoing concerns resulting from the COVID-19 pandemic, we once again hosted the conference virtually.
This year’s complimentary CLE program, provides the same caliber of practical advice, insight into significant fraud and abuse issues facing healthcare professionals, and thoughtful discussion from industry panelists for which this conference is known.
- Healthcare Fraud Year in Review
- Hot Topics in Healthcare Fraud: Today and Tomorrow
- The Future of the False Claims Act
- Provider Relief Fund Audits and Investigations
- Navigating Corporate Integrity Agreements and Administrative Remedies
- Litigating Healthcare Fraud Enforcement Cases
- Stark Law and Anti-Kickback Statute Enforcement Developments
- FCA Self-Disclosure Considerations
This year’s conference was held on Wednesday, December 1 and Thursday, December 2. To watch the conference on-demand, please click here.
Click here to view the agenda and presenters.Continue Reading [Virtual Event] 7th Annual Healthcare Fraud Conference
We are excited for this year’s complimentary CLE program, which will provide the same caliber of practical advice, insight into government developments, and thoughtful discussion from industry panelists you have come to expect from this seminar. This year’s topics include:
- Inside Scoop: Top Issues In-House Counsel Currently Face
- Update on International Trade Regulations and Enforcement
- SEC Update: Key Enforcement and Regulatory Priorities
- Running an Investigation
- Antitrust Is Back: DOJ and FTC Signal Significant Increase in Antitrust Enforcement
- Data Privacy Update
- Healthcare Fraud Enforcement Updates
- Hot Topics in Procurement Fraud in 2021 and Beyond
- COVID-19 Funding Fallout: Preparation for Government Scrutiny
This year’s seminar will be held from 8:30 a.m.–3:45 p.m. CDT on Tuesday, September 28. To register, please click here.
We are looking forward to our involvement in the American Health Law Association Annual Fraud and Compliance Forum 2021 next month. Compliance & Government Investigations attorney John Kelly is serving as co-chair of the program, which will address emerging regulatory and enforcement trends, recent case law and legislative developments and best compliance practices in healthcare.…
In the last year, the Department of Justice (DOJ) has brought more than 100 criminal cases relating to Paycheck Protection Program (PPP) Fraud. These criminal prosecutions started at a blistering pace, with the first indictments coming within the very first months of the program’s inception. This wave of criminal prosecutions and convictions related to some of the more flagrant abuses – individuals who fraudulently obtained funds from the program and then went on spending sprees for things like Lamborghinis, mansions, and private jet travel.
These prosecutions focused on individuals and organized groups who obtained or used PPP funds fraudulently, often including charges for false statements (18 U.S.C. § 1001), aggravated identify theft (18 U.S.C. § 1028A(a)(1)), false statements in a loan application (18 U.S.C. § 1014), wire fraud (18 U.S.C. § 1343), bank fraud (18 U.S.C. § 1344), and Title 26 tax charges. Along with these prosecutions came significant resources, including new fraud coordinators and data analytics teams across the country.
Now, we are starting to see the first civil enforcement actions relating to the program. This signals a new phase of enforcement for the DOJ and all organizations who benefited from the program must pay close attention.Continue Reading PPP Investigations, Settlements and Litigation on the Horizon
Improper billing for electro-acupuncture using a “P-Stim” device (or peri-auricular stimulation device) has been the subject of two False Claims Act (FCA) settlements already in 2021, following a trend of such enforcement actions within the past year.
Each of the recent settlements, detailed further below, involve providers billing federal healthcare programs for acupuncture using P-Stim devices under HCPCS Code L8649. Unlike P-Stim devices, though, which are attached to the ears of a patient using needles and adhesives without surgery or anesthesia, HCPCS Code L8649 applies to a product that is surgically implanted into a patient using anesthesia. Medicare, TRICARE and the Federal Employees Health Benefit Program (FEHBP) do not reimburse for acupuncture devices like P-Stim, nor do they reimburse for P-Stim as a neurostimulator or an implantation of neurostimulator electrodes. In addition to P-Stim, the brand names for these devices include ANSiStim, E-pulse, Stivax and NeuroStim.
Notably, none of these enforcement actions originated from qui tam whistleblowers but rather were the product of affirmative government investigations by the U.S. Department of Justice, U.S. Attorneys’ Offices, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), and CMS’s Center for Program Integrity. These settlements—coming from different jurisdictions and concerning different types of providers and practices—demonstrate the government’s ongoing, nationwide effort to investigate the improper billing of electro-acupuncture devices:Continue Reading Improper Billing of “P-Stim” Devices is Focus of Recent FCA Settlements