Earlier this week, the U.S. Supreme Court solicited input from the Department of Justice (DOJ) regarding the scrutiny with which courts should view False Claims Act complaints—particularly those filed by private plaintiff-relators.
Continue Reading Supreme Court Taking Hard Look at Rule 9(b) Standard
Tennessee Healthcare Fraud and Abuse Laws
I recently outlined healthcare-related fraud and abuse laws in Tennessee as part of Thomson Reuters’ Practical Law survey. My content focused on Tennessee is part of a series that examines state-by-state laws and regulations addressing civil and criminal actions, consequences for violation, and Medicaid program integrity provisions.
Continue Reading Tennessee Healthcare Fraud and Abuse Laws
Fourth Circuit Adopts Safeco’s Objective Reasonableness Standard for False Claims Act
On January 25, in a 2-1 decision in U.S. ex rel. Sheldon v. Allergan Sales, LLC, 2022 WL 211172, the Fourth Circuit became the most recent federal appellate court to hold that the objective scienter standard in the Supreme Court’s Safeco decision applies to the False Claims Act (FCA). Under the Fourth Circuit’s decision, the FCA’s scienter element cannot be met if the defendant’s interpretation of applicable statutory or regulatory requirements was objectively reasonable and no authoritative guidance from a circuit court or government agency warned the defendant away from its interpretation.
Continue Reading Fourth Circuit Adopts Safeco’s Objective Reasonableness Standard for False Claims Act
[WEBINAR] Healthcare Fraud & Abuse Annual Review
Read the most recent issue of the Healthcare Fraud & Abuse Annual Review.
Continue Reading [WEBINAR] Healthcare Fraud & Abuse Annual Review
Seventh Annual Healthcare Fraud Conference Highlights Key Risk Areas and Enforcement Developments for Healthcare Providers
Bass, Berry & Sims and the Tennessee Hospital Association hosted the Seventh Annual Healthcare Fraud Conference on December 1 and 2. The virtual conference featured more than 40 speakers and 500 attendees from over 40 states and the District of Columbia.
“The healthcare industry remains under intense scrutiny, making it more important than ever for providers to stay up to date on the latest developments concerning the FCA and fraud and abuse,” said Brian Roark, chair of the Bass, Berry & Sims Healthcare Fraud Task Force. “This conference examines those developments, provides practical solutions, and forecasts the most pressing issues ahead for healthcare providers.”
Topics Covered During Conference
Day 1 sessions covered conducting effective investigative interviews, navigating privilege issues in investigations, building effective compliance programs, navigating challenges posed by whistleblowers, understanding recent Stark Law and Anti-Kickback Statute developments, and False Claims Act self-disclosure considerations.
Day 2 kicked off with a review of the past year’s key healthcare fraud developments and looked at the future of the False Claims Act. Other sessions covered litigating healthcare fraud enforcement cases, provider relief fund audits and investigations, navigating contractor audits and administrative enforcement remedies, and hot topics in healthcare fraud. The day concluded with a 90-minute healthcare fraud hypothetical.
Click to access a recording of the conference. On-demand CLE is available for those that are interested.
[Virtual Event] 7th Annual Healthcare Fraud Conference
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.
Topics include:
- 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
Reminder: When Are Communications with Corporate Counsel Privileged?
To foster open and honest communications with counsel, it is critically important that those communications are protected from disclosure by the attorney-client privilege. But, not every communication with counsel is privileged, and knowing when a communication with counsel is protected can sometimes prove difficult. Given an increasingly complex regulatory landscape, more and more attorneys—particularly in-house attorneys—are wearing dual hats as both lawyers and business advisors. As a lawyer, communications may be privileged; but if acting as a business advisor, communications may be subject to disclosure.
Since the corporate setting doesn’t lend itself to bifurcating legal and business communications, what happens when the lines are blurred or when a communication serves both purposes?
The “Primary Purpose” Test
Many courts, like the U.S. Courts of Appeal for the Second, Fifth, Sixth, and D.C. Circuits, require that for a communication to be protected by the attorney-client privilege, the “primary purpose” of the communication must be to give or receive legal advice. Attorney-client privilege does not apply to business, commercial, or tax advice. Under this method of analysis, courts look to the content of a communication to determine its predominant or primary purpose.
Continue Reading Reminder: When Are Communications with Corporate Counsel Privileged?
Impact of Supreme Court’s Escobar Decision on Fifth Anniversary
We explored the impact of the Supreme Court’s decision in Universal Health Servs., Inc. v. U.S. ex rel. Escobar to mark the fifth anniversary of this key False Claims Act opinion in a recent article for Law360. As we point out in the article, the Supreme Court’s decision “continues to have a profound impact on
Register Now for the Healthcare Fraud & Abuse Review Webinar
We released our Healthcare Fraud & Abuse Annual Review earlier this month. To serve as a companion to the Review, we’re hosting a complimentary webinar on Thursday, February 18, 2021 from 8:00-10:00 a.m. PT / 10:00 a.m.-12:00 p.m. CT / 11:00 a.m.-1:00 p.m. ET. that will take a deeper dive into key focus areas covered
Download and Register Now – Healthcare Fraud & Abuse Review and Webinar from Bass, Berry & Sims
Bass, Berry & Sims is pleased to announce the release of the newest edition of its Healthcare Fraud & Abuse Annual Review examining important healthcare fraud developments in 2020. Compiled by the firm’s Healthcare Fraud Task Force, the Review provides an in-depth and comprehensive analysis of the past year’s court decisions involving the False