Topic
Fraud & Abuse
129 published works
Hall, Render, Killian, Heath & Lyman, P.C. Blog
OIG Offers Contemporary Guidance on Various Discount Constructs in Recent Advisory Opinion
By Hall Render
On December 15, 2025, the Office of Inspector General (“OIG”) issued Advisory Opinion No. 25‑11 (“Advisory Opinion”) and concluded it would not impose administrative sanctions under the federal Anti‑Kickback Statute…
Agricultural Law & Rural Practice | Solo Small Firm & General Practice Section
OIG Solicits Proposals for the Development and Modification of Anti-Kickback Statute Safe Harbors and Special Fraud Alerts
By Hall Render
On December 9, 2025, the Department of Health and Human Services’ (“HHS”) Office of the Inspector General (“OIG”) issued its annual solicitation for proposals and recommendations for developing new or…
Health Industry Washington Watch
CMS Launches WISeR Model to Target Waste by Leveraging (Broken) Prior Authorization System
By Nancy Halstead, Sarah Cummings Stewart, Caitlin Chambers, Alexa Chronister
The Centers for Medicare & Medicaid Services (CMS) recently announced the launch of the Wasteful and Inappropriate Service Reduction (WISeR) Model – a six-year pilot program designed to reduce Medicare…
Original Source
First Circuit Affirms Dismissal of Qui Tam for Failing But-For Test Linking AKS Violations to FCA Liability
By Scott D. Stein, Joseph R. LoCascio, Joseph S. Katz
In U.S. ex rel. Flanagan v. Fresenius Med. Care Holdings, Inc., 23-1305 (1st Cir. June 27, 2025), the First Circuit recently affirmed dismissal of an FCA complaint because it failed…
Simple Justice
The Smell Of Musk
Today marks the putative final day of Elon Musk, special advisor or some such thing and definitely not in charge of the thing he’s entirely in charge of, DOGE, the…
The Right Coast
Elon Musk: Many Bureaucrats, Like Samantha Power, Are Getting Wealthy At Taxpayers Expense | Video | RealClearPolitics
DONALD TRUMP: And also, could you mention some of the things that your team has found? Some of the crazy numbers, including the woman who walked away with about $30…
Inside the False Claims Act
HHS-OIG Year in Review 2024
By Richard Arnholt, Kristin Bohl, Justin Brown, Travis Lloyd, Bill Mathias, Jennifer Michael, Christine Morse
In 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) provided useful insights to the healthcare industry regarding how it approaches various fraud and…
Rivkin Rounds
HHS-OIG Issues Nursing Facility Compliance Program Guidance
By Jeffrey Ehrhardt, Rivkin Rounds Staff
On November 20, 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the “Nursing Facility ICPG,” an industry-specific compliance program guidance for nursing…
Medicaid & Medicare: A Legal Blog
Monitor Mondays Featuring Knicole Emanuel: Hang-up in Healthcare, Medical Relief in Wake of Hurricane, More FCA Fraudsters, 2025 IPPS, and Pay for Illegal Kickbacks Episodes
Nelson Mullins – Monitor Mondays Featuring Knicole Emanuel: Hang-up in Healthcare, Medical Relief in Wake of Hurricane, More FCA Fraudsters, 2025 IPPS, and Pay for Illegal Kickbacks Episodes
Healthcare Law Insights
How to Wear the Investor Hat When Physicians Are the Revenue Generators
Engaging in management and investor conversations about maintaining and growing a business is critical, no matter the industry. Whether you’re discussing normal business sustainability, organic growth, or contemplating a sale,…