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
I was quoted in a recent Law360 article examining the potential impact of the U.S. Supreme Court’s decision to hear a pair of False Claims Act cases about the proper standard for establishing scienter under the False Claims Act.
Continue Reading Supreme Court Review of False Claims Act Scienter StandardIn July 2021, the U.S. District Court for the Eastern District of New York dismissed a False Claims Act complaint filed by CKD Project, LLC, an entity created for the purpose of filing the lawsuit, which alleged that Fresenius violated the federal Anti-Kickback Statute by over-paying physicians for a majority interest in certain dialysis centers in exchange for the physicians’ continued referrals.
Continue Reading Second Circuit Holds False Claims Act Complaint Is Barred by SEC FilingsOn December 14, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that contemplates several changes to, and clarifications of, guidance for the Medicare Advantage (MA) program in coverage year 2024.
Earlier this month, the U.S. District Court for the Northern District of Georgia entered an order critiquing the government’s lack of evidence in a criminal case alleging violations of the Anti-kickback Statute (AKS).
Continue Reading Federal Court Rejects Government’s Evidence of Anti-Kickback Statute Violations
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
I recently provided insight for a Law360 article outlining Pfizer’s request to have the Supreme Court weigh in on the scope of the Anti-Kickback Statute (AKS).
Continue Reading Insight on Request for Supreme Court Review of Anti-Kickback Statute’s Scope
The third quarter of 2022 brought a number of noteworthy False Claims Act (FCA) settlements, including several over $20 million and one in the high nine figures. This post summarizes key settlements of interest to healthcare providers.
Continue Reading False Claims Act Settlements to Know from Q3 2022
On October 17, the U.S. Supreme Court summarily denied three petitions asking the Court to resolve a growing circuit split on the application of Federal Rule of Civil Procedure 9(b) in False Claims Act lawsuits.
Continue Reading Third Time is Not the Charm – Supreme Court Denies Cert. on Rule 9(b) Split Again