On March 24, the U.S. Court of Appeals for the Fifth Circuit affirmed the criminal healthcare fraud convictions of two individuals who ran a network of home health and hospice centers in Texas. According to the Fifth Circuit, the defendants operated a “reimburse-first-verify-later system” for nearly ten years, under which an estimated 70 to 85 percent of patients were ineligible for the care they received. The Fifth Circuit provided colorful examples to show that “many certifications were not borderline cases”:

Continue Reading Fifth Circuit Affirms Criminal Healthcare Fraud Convictions of Hospice and Home Health Executives

Earlier this year, Bass, Berry & Sims released the 10th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2021.

As a companion to the Review, we will replay a complimentary webinar on Tuesday, April 5, 2022, from 1:00 p.m.-3:00 p.m. ET / 12:00 p.m.-2:00 p.m. CT / 10:00-12:00 a.m. PT, which will provide an overview and discussion of key focus areas covered in the Review.

Continue Reading Register Now: Healthcare Fraud & Abuse Annual Review Webinar Replay | April 5 at Noon CT

On March 8, the Department of Justice (DOJ) announced the first settlement under its Civil Cyber-Fraud Initiative, as Comprehensive Health Services, LLC (CHS), a global medical services provider, agreed to pay $930,000 in part to resolve False Claims Act (FCA) allegations regarding cyber fraud. The government alleged that CHS contracted with the State Department to provide a secure electronic medical record (EMR) system to store patients’ medical records and submitted claims for the costs of this work, but failed to disclose that it had not consistently stored patients’ medical records on a secure EMR system.
Continue Reading First False Claims Act Settlement under DOJ’s Cyber-Fraud Initiative

As discussed in a previous post, the Department of Justice (DOJ) has announced a new Civil Cyber-Fraud Initiative to utilize one of the strongest tools in its toolbox—the False Claims Act—to hold entities receiving federal dollars accountable where it believes they are failing to meet their cybersecurity obligations.
Continue Reading What Does the DOJ’s New Civil Cyber-Fraud Initiative Mean for You?

Bass, Berry & Sims is pleased to announce the release of the 10th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2021. Compiled by the firm’s Healthcare Fraud & Abuse Task Force, the Review provides a comprehensive analysis of enforcement developments affecting the healthcare industry, significant court decisions involving the False Claims Act, and an overview of settlements involving fraud and abuse issues.

Continue Reading Download Now – 10th Annual Healthcare Fraud & Abuse Review

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