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Documents on White Collar Crime, Health Care
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|Record-High $5.7 Billion Recovery in 2014 for US False Claims Act Cases—Health Care Fraud Recoveries More Than $2 Billion for Fifth Straight Year|
Laura R. Hammargren, Michael Martinez, William Michael Jr.; Mayer Brown LLP;
January 12, 2015, previously published on December 2, 2014The US Department of Justice (DOJ) reported in late November that it recovered a record $5.69 billion from settlements and judgments in civil False Claims Act (FCA) cases in fiscal year 2014. This marks the first time that recoveries have exceeded $5 billion, and brings the total recoveries since...
|Civil Consequences of Criminal Cases|
Mohamed N. Bakry, Kevin E. Hexstall; Marshall Dennehey Warner Coleman & Goggin, P.C.;
September 5, 2014, previously published on September 1, 2014The disposition of a criminal case may affect the criminal defendant and/or his employer (company) in later civil litigation. Any defense strategy should consider the potential collateral consequences of the criminal case. The disposition of the criminal case may affect a later civil suit regarding...
|FDA Promises Guidance on Lawful Off-Label Promotion|
Michael F. Buchanan, William F. Cavanaugh, Joshua A. Goldberg, Erik Haas, Daniel S. Ruzumna; Patterson Belknap Webb & Tyler LLP;
July 17, 2014, previously published on June 2014Earlier this month, the U.S. Food and Drug Administration (the “FDA”) announced that by the end of the year, the agency would issue a draft guidance document addressing the contours of lawful and unlawful off-label promotion. The healthcare industry has heralded this announcement as a...
|Is the DOJ FCPA Enforcement Hegemony Dead?|
Alexandra M. Gorman, Michael K. Loucks; Skadden, Arps, Slate, Meagher & Flom LLP;
July 3, 2014, previously published on June 26, 2014For nearly 15 years, the United States has had the worldwide corruption enforcement stage to itself, reaping billions of dollars in fines and settlement payments from companies that have acknowledged engaging in bribery in foreign countries. That monopoly, however, may soon end. In a report...
|CMS Releases Medicare Part B Supplier Billing and Payment Data|
Michael P. Matthews, Lawrence W. Vernaglia; Foley & Lardner LLP;
April 16, 2014, previously published on April 14, 2014On April 8, 2014, The Centers for Medicare & Medicaid Services (CMS) released, with tremendous fanfare, hundreds of thousands of points of billing data regarding Medicare suppliers including some 880,000 physicians for 2012. These data are presented in an Excel format that makes searching and...
|Incentivizing Integrity: False Claims Act (FCA) Enforcement On The Rise|
Latour "LT" Lafferty; Fowler White Boggs P.A.;
December 10, 2013, previously published on December 2013If your company does business with the State or Federal government it has potential FCA exposure. While historical FCA enforcement actions were limited to healthcare and defense procurement industries, organizations in other industries are routinely finding themselves to be subjects of FCA...
|Admissions of Wrongdoing: The Final Frontier|
Heidi A. Wendel; Jones Day;
November 15, 2013, previously published on November 2013Admissions of wrongdoing are the final frontier in civil fraud settlements—that elusive element that purportedly makes the payment of even large settlement amounts more than "just a cost of doing business" for the defendant companies. Federal law enforcement agencies have repeatedly...
|$237,454,195 Judgment against Tuomey Healthcare System under False Claims Act|
October 29, 2013, previously published on October 17, 2013On September 30, 2013, the United States District Court for the District of South Carolina (the "District Court") ordered entry of judgment on a jury verdict against Tuomey Healthcare System ("Tuomey") in the amount of $237,454,195 in treble damages and civil money penalties...
|Physician Sunshine Act: Transparency Could Be Costly|
Michael A. Kaplan, Robert J. Kipnees, Michael T. G. Long, Maureen A. Ruane; Lowenstein Sandler LLP;
September 23, 2013, previously published on September 2013In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act (“ACA”). Buried within the 900 plus pages is a largely still unknown, and certainly underappreciated, provision known as the “Physician Payments Sunshine Act.” The Sunshine Act...
|Massachusetts Launches New Program to Combat Provider Fraud|
Kimberly J. Gold, Stephanie D. Willis; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
September 13, 2013, previously published on September 12, 2013Last week, the Massachusetts’ Secretary of Health and Human Services, John Polanowicz, announced the launch of a new $5 million program designed to detect and prevent provider fraud, waste, and abuse in MassHealth, the Commonwealth’s Medicaid program. Under the MassHealth anti-fraud...