Previous False Claims Act (FCA) Fundamentals posts have examined how violations of certain federal laws can potentially expose entities to FCA liability when they receive money from the government.
Continue Reading False Claims Act Fundamentals: Reverse False Claims
Bass, Berry & Sims released its 11th Annual Healthcare Fraud & Abuse Review in early February 2023. As a companion to the Review, we hosted a complimentary webinar which provided an overview and discussion of key focus areas covered in the Review.
Continue Reading Watch Now | Healthcare Fraud & Abuse Annual Review Webinar
On November 14, Judge Edward Chen in the Northern District of California issued rulings on the pending motions to dismiss in U.S. ex rel. Osnek v. Kaiser Permanente, granting in part and denying in part Kaiser’s motion to dismiss.
Continue Reading Judge Chen’s Message to Medicare Advantage Providers: ICD Guidelines Aren’t Suggestions
When healthcare providers and other government contractors are subject to scrutiny for bills submitted to the government, it is often the result of a whistleblower complaint filed under the qui tam provisions of the False Claims Act.
Continue Reading False Claims Act Fundamentals: Self-Disclosures
Watch the recording of our latest webinar, in which our panel of national healthcare fraud and abuse attorneys will discuss how to disclose a Stark Law violation to CMS.
Continue Reading Watch On-Demand | How to Submit a Stark Law Self-Disclosure Webinar
A favorable advisory opinion from the Office of Inspector General for the United States Department of Health and Human Services (OIG) ensures that the government will not impose sanctions concerning the requesting party’s business arrangement. Requesting an advisory opinion may be a good business decision for stakeholders in the healthcare industry.
Continue Reading Download Now – How to Request an Advisory Opinion (and Why)
Having previously examined the falsity, materiality, and scienter elements of the False Claims Act (FCA) in our FCA Fundamentals series, we now turn to what damages can arise from violations of the False Claims Act. The False Claims Act imposes liability for each false claim. If the alleged scheme is broad, pervasive, or spans an extended period, this can result in many individual false claims and significant damages and penalties. It is essential for defendants to scope damages and consider potential exposure throughout a False Claims Act case, which often requires an expert consultant.
Continue Reading False Claims Act Fundamentals: Damages
Join us for a webinar in which Matt Tormey, EVP Compliance and Risk, Chief Compliance Officer, Ensemble Health Partners, moderates a discussion with two former OIG officials in Bass, Berry & Sims’ healthcare practice group focusing on how, when, and why to submit an advisory opinion request.
As previous False Claims Act (FCA) Fundamentals posts have discussed, the FCA, 31 U.S.C. § 3729, et seq., can be triggered by submitting claims tied to violations of certain federal statutes. This post will explain the basics of two such statutes: the Anti-Kickback Statute (AKS) and the Stark Law.
Continue Reading False Claims Act Fundamentals: Anti-Kickback Statute and the Stark Law
In recent years, the federal government has been particularly aggressive in pursuing civil and criminal enforcement against healthcare entities. The way healthcare companies conduct internal investigations so may mean the difference between a manageable resolution and staggering civil or criminal liability.
Continue Reading Key Considerations: How to Conduct an Effective Internal Investigation