Topic
Fraud & Abuse
129 published works
Eye on Enforcement
State False Claims and AKS Statutes Keep Case Alive in 2nd Circuit: Underappreciated State Laws May Present Significant Compliance Risk
Recent years have seen eye-popping judgments and settlements involving cases brought under the federal False Claims Act (FCA) and federal Anti-Kickback Statute (AKS). And healthcare companies have, unsurprisingly, focused their…
Healthcare Law Insights
Not Worth the [Compliance] Risk! OIG’s New Integrated Approach
By Josi Wergin, Natasha Sumner, Kasey Ciolfi
On November 6, 2023, the Office of Inspector General (“OIG”) issued its long-awaited General Compliance Program Guidance (“Guidance”) “to help advance the industry’s voluntary compliance efforts in preventing fraud, waste,…
Triage Health Law
HHS OIG Introduces Managed Care Strategic Plan
In August, the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services (“HHS”) introduced a new “Strategic Plan for Oversight of Managed Care for Medicare…
The Healthcare Investor
CMS Increases Oversight and Scrutiny of Hospices
In its continued effort to curb fraud and abuse in the hospice industry, on Aug. 22, 2023, the Centers for Medicare & Medicaid Services (CMS) announced it was making unannounced site visits…
Inside the False Claims Act
Martin’s Point Health Care Inc.’s $22.4M Settlement Illustrates DOJ’s Focus on Part C Fraud
By Emily Farmer, Lindsey Fetzer
Last week, the U.S. Department of Justice (DOJ) announced a $22.4 million settlement resolving allegations that Martin’s Point Health Care, Inc. (Martin’s Point) violated the False Claims Act (FCA) by…
Health Care and Life Sciences
HHS OIG’s 13 New FAQs Shed Light on Post-Public Health Emergency Enforcement
By Eleanor T. Chung, George B. Breen
On March 22, 2023, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) updated its Frequently Asked Questions (“FAQs”), drafting 13 FAQs aimed at easing the…
Healthcare Law Blog
Recent Developments in Telehealth Enforcement
By Sara Shanti, Danielle Vrabie, Arushi Pandya
The COVID-19 Public Health Emergency (“PHE”) led to a rapid expansion in the utilization of telehealth. Now, almost three years later, governmental entities have focused their attention on telehealth services…
Health Law Blog
Telehealth Update: Telehealth Waivers Post-PHE and Fraud and Abuse
The current Public Health Emergency expiration deadline is this month. However, the Secretary of the Health and Human Services indicated he would provide a 60-day notice before ending the PHE…
Health Industry Washington Watch
Telehealth Under Scrutiny: OIG Special Fraud Alert and DOJ Enforcement Highlights Suspect Characteristics Associated with High-Risk Telemedicine Arrangements
By Nancy Halstead, Vicki Tankle, James F. Hennessy, Arielle Lusardi
The Department of Health and Human Services Office of Inspector General (HHS-OIG) recently published a Special Fraud Alert warning health care providers (e.g., prescribers, pharmacies, durable medical equipment providers, clinical…
Health Law Checkup
OIG issues fraud alert warning practitioners of risks with telemedicine arrangements
By Catherine Feorene, Nicole Jobe
On July 20, 2022, the OIG released a Fraud Alert encouraging practitioners to exercise caution when entering into arrangements with telemedicine companies, given the various fraud and abuse risks associated…