I commented on the recent ruling by the Second Circuit Court of Appeals, which upheld the district court’s rejection of Pfizer’s argument that liability under the Anti-Kickback Statute requires an element of “corrupt” intent.
Continue Reading Court Decision Upholding OIG’s Rejection of Pharmaceutical Company’s Drug Co-Pay Assistance Program
United States Says No Supreme Court Review Needed in False Claims Act Cases
Last week, we posted about the U.S. Supreme Court’s request for input from the Solicitor General on how False Claim Act complaints should be reviewed by courts.
Currently, the plaintiff-relators in two cases—U.S. ex rel. Owsley v. Fazzi Associates, Inc. and Johnson v. Bethany Hospice & Palliative Care, LLC—have submitted petitions for certiorari asking the Supreme Court to resolve what they see as a “long-standing circuit split” on the application of Rule 9(b) in False Claims Act cases.
In the Bethany Hospice case, which was the first to submit a petition, the plaintiff-relator argued that her complaint was dismissed under the Eleventh Circuit’s “rigid” application of Rule 9(b), which in most cases requires the specific details of at least one false claim that was actually submitted to the government, but that her complaint would have easily survived dismissal in many other circuits that only require “reliable indicia” that such claims were submitted.Continue Reading United States Says No Supreme Court Review Needed in False Claims Act Cases
DOJ Releases 2022 FCA Civil Monetary Penalties Inflation Adjustment
On May 9, the Department of Justice (DOJ) published its Final Rule on the Civil Monetary Penalties Inflation Adjustment for 2022. This adjustment comes just five months after the last CMP Inflation Adjustment.
Continue Reading DOJ Releases 2022 FCA Civil Monetary Penalties Inflation Adjustment
DOJ’s Civil Cyber-Fraud Initiative Impact on Healthcare Organizations
Recently, I was interviewed on the Healthcare Strategies podcast about how the Department of Justice (DOJ) is enforcing the Civil Cyber-Fraud Initiative to hold healthcare organizations accountable for cybersecurity matters.
Continue Reading DOJ’s Civil Cyber-Fraud Initiative Impact on Healthcare Organizations
Fifth Circuit Affirms Criminal Healthcare Fraud Convictions of Hospice and Home Health Executives
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
Register Now: Healthcare Fraud & Abuse Annual Review Webinar Replay | April 5 at Noon CT
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
First False Claims Act Settlement under DOJ’s Cyber-Fraud Initiative
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
What Does the DOJ’s New Civil Cyber-Fraud Initiative Mean for You?
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?
Download Now – 10th Annual Healthcare Fraud & Abuse Review
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
Government Contractors Face False Claims Act Liability for Cybersecurity Non-Compliance
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