A recent decision by the U.S. District Court for the Eastern District of New York illustrates how directors and officers (D&O) policies can provide valuable insurance coverage for defense costs and potential liabilities arising from False Claims Act (FCA) litigation.
The FCA Insider
Insights and updates on False Claims Act Litigation
The FCA Insider, published by McGuireWoods LLP, focuses on legal developments and compliance issues related to healthcare fraud and abuse, particularly under statutes like the False Claims Act, Anti-Kickback Statute, and the Eliminating Kickbacks in Recovery Act (EKRA). The blog covers enforcement actions, regulatory guidance, and court decisions affecting healthcare providers, payors, and related entities. Topics include Medicare and Medicaid billing practices, fraud investigations, compliance risks in remote patient monitoring, marketing and referral arrangements, and settlements involving healthcare providers. It also addresses the implications of government audits and whistleblower actions in the healthcare sector.
Latest from The FCA Insider - Page 5
OIG Recommends Increased RPM Oversight
On September 24, 2024, the Department of Health and Human Services Office of Inspector General (“OIG”) published a report (the “Report), reviewing and recommending increased oversight of remote patient monitoring (“RPM”) services and billing in the Medicare program. In the…
Stark Law Regulations Under the Microscope in a Post-Chevron World
By Timothy Fry
Recently, in United States ex rel. Kyer v. Thomas Health Systems, the judge overseeinga whistleblower’s False Claims Act (FCA) suit against Thomas Health Systems Inc. stalled further decisions until both parties could file supplemental briefs addressing the U.S. Supreme Court’s…
“Call Us Before We Call You”: DOJ’s New Corporate Whistleblower Awards Pilot Program
On Sept. 17, 2024, Deputy Assistant Attorney General Nicole Argentieri stressed the intense focus placed by the U.S. Department of Justice (DOJ) on incentivizing companies to maintain healthy corporate compliance programs – and highlighted key aspects of the Department’s newest…
Key Takeaways From McGuireWoods’ Webinar on Enforcement Against PE Funds in Healthcare
On July 9, 2024, McGuireWoods partners Brett Barnett, Mindy Sauter, Mike Elliott, and Michael Podberesky conducted a solution-oriented discussion of key enforcement and compliance developments that impact private equity (“PE”) funds in healthcare. They also highlighted relevant cases regarding the…
Federal District Court Finds Private-Insurer Relator Can Proceed with False Claims Action
Last month, the U.S. District Court for the District of New Jersey held that a private company, Allstate Insurance Company, could proceed with its whistleblower action against a clinical laboratory, Phoenix Toxicology and Lab Services, LLC, which allegedly submitted false…
CMS Again Settles Record Stark Self-Disclosures in 2023
The Centers for Medicare & Medicaid Services (CMS) recently released data on its 2023 settlements of voluntary self-disclosures related to past violations or potential violations of the physician self-referral law (the Stark Law). In 2023, CMS settled an agency record…
OIG Plans New Guidance for Medicare Advantage and Nursing Homes
On Feb. 21, the Office of Inspector General of the U.S. Department of Health and Human Services announced the first four subsectors for which it will publish industry segment-specific compliance program guidance. Guidance published in 2024 will focus on Medicare…
Deputy Attorney General Monaco Announces New DOJ Whistleblower Program
At the American Bar Association’s 39th National Institute on White Collar Crime on March 7, U.S. Deputy Attorney General Lisa Monaco provided updates on criminal enforcement efforts and announced new Department of Justice initiatives, including a new whistleblower program.
Read…
Off-Label “Free Speech” Theory Does Not Fly for Convicted Former Medical Device Executives in 1st Circuit
A federal appeals court recently upheld misdemeanor convictions of two former executives of Acclarent Inc, a medical device manufacturer, for commercially distributing an adulterated and misbranded medical device by misleading the FDA regarding the intended use of the device. In…