Bass, Berry & Sims is pleased to announce the release of the 12th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2023. Continue Reading Download Now – 12th Annual Healthcare Fraud & Abuse Review
FCA Alert
DOJ Releases Annual Civil Fraud Recovery Statistics and Results…A Look Behind the Numbers
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
Second Circuit Rejects Insufficient Service-of-Process Argument, Adopts Relator-Friendly Rule
On November 28, the U.S. Court of Appeals for the Second Circuit held that the service-of-process clock for a False Claims Act (FCA) qui tam complaint begins to run when the district court orders the complaint to be served, not when the district court unseals the complaint. Continue Reading Second Circuit Rejects Insufficient Service-of-Process Argument, Adopts Relator-Friendly Rule
False Claims Act Case Unsealed Against Cerebral, Showing Continued Scrutiny of Telehealth Prescriptions
A qui tam False Claims Act (FCA) complaint was recently unsealed against Cerebral, a telehealth startup that provides virtual mental-health therapy, in the U.S. District Court for the Northern District of Iowa. Continue Reading False Claims Act Case Unsealed Against Cerebral, Showing Continued Scrutiny of Telehealth Prescriptions
District Courts Wrestle with Causation in Kickback Cases While Circuit Courts Remain Divided
Two Massachusetts federal district courts recently addressed—and disagreed about—an important False Claims Act (FCA) issue that has also divided the federal circuit courts: when an alleged FCA violation is based on an underlying violation of the Anti-Kickback Statute (AKS), what kind of causal link must the government or a relator show between the alleged AKS violation and the allegedly false claim for payment?
Continue Reading District Courts Wrestle with Causation in Kickback Cases While Circuit Courts Remain Divided
Martin’s Point Health Care Inc.’s $22.4M Settlement Illustrates DOJ’s Focus on Part C Fraud
Last week, the U.S. Department of Justice (DOJ) announced a $22.4 million settlement resolving allegations that Martin’s Point Health Care, Inc. (Martin’s Point) violated the False Claims Act (FCA) by submitting inaccurate diagnosis codes for its Medicare Advantage Plan enrollees. Continue Reading Martin’s Point Health Care Inc.’s $22.4M Settlement Illustrates DOJ’s Focus on Part C Fraud
Expect More Cyber-Enforcement under the False Claims Act
Earlier this month, the White House released the National Cybersecurity Strategy Implementation Plan outlining specific “high impact initiatives” that the federal government will carry out to achieve its cybersecurity objectives. Continue Reading Expect More Cyber-Enforcement under the False Claims Act
CMS Publishes New Data on Self-Referral Disclosure Protocol Settlements
The Centers for Medicare & Medicaid Services (CMS) recently published updated data regarding settlements made under the Voluntary Self-Referral Disclosure Protocol (SRDP), an important mechanism through which providers may disclose actual or potential violations of the federal physician self-referral prohibition commonly known as the Stark Law. Continue Reading CMS Publishes New Data on Self-Referral Disclosure Protocol Settlements
Supreme Court Upholds Broad Government Authority to Dismiss Qui Tam False Claims Act Lawsuits
On June 16, the U.S. Supreme Court issued its opinion in U.S. ex rel. Polansky v. Executive Health Resources, a closely watched case about the government’s power to dismiss a False Claims Act (FCA) qui tam lawsuit over a relator’s objection.Continue Reading Supreme Court Upholds Broad Government Authority to Dismiss Qui Tam False Claims Act Lawsuits
Supreme Court Rejects Safeco, Holds that FCA Scienter Turns on Defendant’s Subjective Belief
On June 1, the U.S. Supreme Court unanimously refused to apply the Safeco objective knowledge standard to the False Claims Act (FCA), holding instead in U.S. ex rel. Schutte v. Supervalu Inc. that the FCA’s scienter element turns on a defendant’s “knowledge and subjective beliefs,” not on “what an objectively reasonable person may have known or believed.”Continue Reading Supreme Court Rejects Safeco, Holds that FCA Scienter Turns on Defendant’s Subjective Belief