The False Claims Act (FCA) remains one of the government’s most powerful tools in combating healthcare fraud, with a growing focus on opioid-related cases and violations of the Anti-Kickback Statute. Continue Reading False Claims Act Enforcement in Healthcare: Insights from the 13th Annual Fraud & Abuse Review
Medicare/Medicaid
Impact of Trump Administration’s Executive Order on DEI Programs and FCA Liability
As federal contractors and grant recipients navigate the changing landscape of diversity, equity, and inclusion (DEI) programs, the Trump administration’s rescinding of Executive Order No. 11246 (EO) raises new concerns about potential False Claims Act (FCA) liability for non-compliance.Continue Reading Impact of Trump Administration’s Executive Order on DEI Programs and FCA Liability
Executive Order on DEI Programs: Implications for Healthcare and False Claims Act Risks
The Trump administration’s recent executive order targeting diversity, equity, and inclusion (DEI) programs is reshaping the landscape for healthcare providers, with potential legal and regulatory implications that are still unfolding. Continue Reading Executive Order on DEI Programs: Implications for Healthcare and False Claims Act Risks
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
Watch On-Demand | How to Submit a Stark Law Self-Disclosure Webinar
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
Seventh Circuit Signals Ongoing Importance of Compliance with Medicare “Bad Debt” Regulations
In a recent decision, U.S. ex rel. Sibley v. Univ. of Chicago Medical Center, the U.S. Court of Appeals for the Seventh Circuit considered allegations that two medical billing and debt collection companies, Medical Business Office Corp. (MBO) and Trustmark Recovery Services, Inc. (Trustmark), and the University of Chicago Medical Center (UCMC), a client of one of the debt collection companies, violated the False Claims Act (FCA) by seeking inappropriate reimbursement from the Centers for Medicare and Medicaid Services (CMS) for Medicare “bad debts.”
Continue Reading Seventh Circuit Signals Ongoing Importance of Compliance with Medicare “Bad Debt” Regulations
Court Decision Upholding OIG’s Rejection of Pharmaceutical Company’s Drug Co-Pay Assistance Program
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
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
Join Us | Nashville Healthcare Fraud Conference | December 5, 2019
Bass, Berry & Sims and the Tennessee Hospital Association invite you to join us for a complimentary day-long CLE program featuring leading government officials, industry experts and experienced counsel as we discuss the most significant fraud and abuse issues currently facing the healthcare industry. Our panelists will cover topics including:
- Year in Review: Looking Back on Healthcare Fraud Issues in 2019
- Medicaid Enforcement Update
- Enforcement Considerations for a Value-Based World
- Managed Care Enforcement
- A View from the U.S. Attorney’s Offices
- DOJ Cooperation Guidance
- When the News Gets Out: Crisis Management for Investigations
- HR Implications of FCA Investigations
- Settlement Considerations for Enforcement Matters
- Effectively Managing Internal Investigations
Continue Reading Join Us | Nashville Healthcare Fraud Conference | December 5, 2019
Recent FCA Case Ruling Involving Illegal Kickbacks
Bass, Berry & Sims attorney Taylor Chenery discussed the implications of a recent court ruling demonstrating how a court should analyze multiple different types of alleged claims under the False Claim Act at the motion to dismiss phase of the case. The case involves Boston Heart Diagnostics Corp., who is facing allegations from a former…