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Practice Reminder: Research Misconduct Can Be A Source Of False Claims Act Liability
The October issue of the journal Science features a series of short articles highlighting a database containing a list of more than 18,000 scientific papers and conference abstracts that have been...
United States
13 Dec 2018
Seventh Circuit Reevaluates And Adopts More Stringent FCA Causation Standard
On October 23, 2017, the US Court of Appeals for the Seventh Circuit reversed itself by determining that proximate cause—and not the "but-for" causation test that the court adopted 25 years ago— ...
United States
14 Nov 2017
Ninth Circuit Remands False Claims Act Case Against Tribal College For Determination Of Sovereign Status
On July 10, 2017, US Circuit Court of Appeals for the Ninth Circuit reversed a December 3, 2014, district court dismissal of False Claims Act (FCA) claims against Salish Kootenai College (College)...
United States
2 Aug 2017
OIG Reports More Than $731 Million In Inappropriate Medicare Meaningful Use Payments
The EHR Incentive Program run by CMS and Medicaid Services garnered attention again last week following the release of a report by the OIG of the US Department of Health and Human Services...
United States
28 Jun 2017
Recent $2.5 Million OCR Settlement Is A Warning To Wireless Health Service Providers
On April 24, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a Health Insurance Portability and Accountability Act of 1996 (HIPAA) settlement...
United States
10 May 2017
District Court Finds Oregon University Immune To FCA Suit Brought By Federal Government
On April 11, 2017, the US District Court for the District of Oregon sided with the Oregon Health and Sciences University (OHSU), finding that as an arm of the state...
United States
3 May 2017
Federal Health Care Fraud And Abuse Enforcement Made A Strong Showing In FY 2016
According to a report released last week, the Health Care Fraud and Abuse Control Program (HCFAC) returned over $3.3 billion to the federal government or private individuals as a result of its health care enforcement efforts in fiscal year (FY) 2016, its 20th year in operation.
United States
8 Feb 2017
OCR Guidance Underscores Importance Of Authentication Under HIPAA
In its tenth OCR Cyber Awareness Newsletter of the year, the OCR reminded HIPAA-covered entities and business associates of the importance of selecting an appropriate authentication method to protect ePHI.
United States
22 Nov 2016
CMS Reissues Stark Rules Restricting Certain Unit-based Rental Rate Arrangements And Issues Two Stark Updates
As part of its 2017 Medicare Physician Fee Schedule update, the Center for Medicare and Medicaid Services reissued its prohibition on certain unit-based rental arrangements with referring physicians.
United States
21 Nov 2016
Fifth Circuit Upholds Omnicare Decision For Lack Of Supporting Evidence Of Kickback Violation
In an unpublished opinion, the Fifth Circuit Court of Appeals affirmed the decision of the US District Court for the Southern District of Texas that granted summary judgment to Omnicare...
United States
14 Nov 2016
OCR Explains How Information Blocking Violates HIPAA
The HHS OCR posted guidance clarifying that a business associate generally may not block or terminate access by a covered entity customer to PHI maintained by the vendor on behalf of the customer.
United States
27 Oct 2016
Ninth Circuit Court Overturns District Court On Sufficiency Of Pleading Under Rule 9(B), Remands For Amendment
However, Rule 9(b) continues to set a demanding standard that should be enforced by courts to guard against frivolous claims.
United States
22 Aug 2016
Roundtable Discussion Results In Senate Committee White Paper On Stark Law Reform
On June 30, 2016, the US Senate Committee on Finance released a white paper titled Why Stark, Why Now? Suggestions to Improve the Stark Law to Encourage Innovative Payment Models.
United States
14 Jul 2016
District Court Dismisses FCA Claims Based On Fraudulent Off-Label Promotion For Lack Of Particularity
The district court held that Witkin failed to plead his claims with sufficient particularity pursuant to Fed. R. Civ. P. 9(b).
United States
8 Jun 2016
Fifth Circuit Affirms Summary Judgment Where Whistleblower Offered No Evidence Of The Requisite Scienter
On March 7, the U.S. Court of Appeals for the Fifth Circuit affirmed a grant of summary judgment by the U.S. District Court for the Northern District of Texas in favor of Kaner Medical Group and its owner, David Kaner.
United States
23 Mar 2016
RehabCare Settles False Claims Act Allegations For $125 Million
RehabCare, the nation's largest provider of nursing home rehabilitation services, agreed to pay $125 million on January 12 to settle claims under the False Claims Act.
United States
8 Feb 2016
CMS Finalizes Stark Law Amendments
On November 16, 2015, the Centers for Medicare and Medicaid Services (CMS) published the 2016 Medicare Physician Fee Schedule final rule with comment period in the Federal Register at 80 Fed. Reg. 70,886
United States
25 Nov 2015
DOJ Pursues Both Sides Of An Alleged Kickback Arrangement Under The FCA
As many health lawyers know, the government usually only pursues the person or entity that offers or pays allegedly improper remuneration, even though the federal Anti-Kickback Statute also applies to those to solicit or receive it.
United States
20 Oct 2015
Overview Of Recent Stark Law Developments
There has been a flurry of judicial and administrative activity regarding the Stark Law in recent weeks...
United States
4 Aug 2015
CMS Proposes Stark Law Amendments, Requests Comments On Whether Stark Law Is Barrier To Health Care Reform
The Centers for Medicare & Medicaid Services (CMS) recently published a notice of proposed rulemaking to amend its regulations implementing and interpreting the Stark Law.
United States
22 Jul 2015
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