Tagged: false claims act

Episode 52 — The False Claims Act and Healthcare Fraud

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19 Aug, 2018

Episode 52 — The False Claims Act and Healthcare Fraud

The federal government continues to push aggressive False Claims Act enforcement cases against healthcare companies, including hospitals, skilled nursing facilities, hospices and other healthcare providers. The Justice Department has employed the False Claims Act to target companies in the opioid industry as a response to the opioid crisis in our country. Healthcare companies have to implement effective ethics and compliance controls to protect against fraud...

Federal Enforcement and the Opioid Epidemic (Part IV of IV)

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16 Aug, 2018

Federal Enforcement and the Opioid Epidemic (Part IV of IV)

The scope of our country’s opioid epidemic is devastating. From 1999 to 2017, more than 700,000 people have died from a drug overdose. Two-thirds of these deaths involved an opioid. On average, 195 Americans dies every day from an opioid overdose. These numbers are tragic and mind-boggling. In response, federal enforcement efforts have primarily focused on criminal prosecutions, but there have also been significant civil...

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

General

15 Aug, 2018

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

Despite the controversial impact of the Supreme Court’s Escobar decision, the Justice Department’s False Claims Act prosecutions and settlements are continuing at a consistent rate – heading towards another multi-billion dollar year of FCA recoveries. Some examples of these prosecutions and settlements will demonstrate my overall point – FCA risks are significant and healthcare providers, especially hospitals, have to devote time and attention to oversight...

General

13 Aug, 2018

The Supreme Court’s Escobar Decision and the Impact on False Claims Act Cases (Part I of IV)

This week I am running a series of posts on healthcare fraud enforcement and the False Claims Act. With all the controversy swirling around the Mueller investigation and prosecutions, the Justice Department continues its aggressive pursuit of healthcare fraud. The Justice Department’s machinery and resources are producing a steady stream of False Claims Act cases and settlements. Just like other enforcement areas, companies in the...

Webinar: Healthcare Providers — The Need to Enhance Your Ethics and Compliance Program

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28 Mar, 2018

Webinar: Healthcare Providers — The Need to Enhance Your Ethics and Compliance Program

Webinar: Healthcare Providers — The Need to Enhance Your Ethics and Compliance Program Tuesday, April 10, 2018, 12 Noon EST Sign Up Here Healthcare providers continue to face significant enforcement risks. Federal and state regulation of healthcare providers creates numerous risks, including the possibility of criminal fraud prosecutions. False Claims Act prosecutions continue to threaten healthcare providers with potential parallel criminal and civil proceedings. In...

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31 Jul, 2017

Double Whammy for United Healthcare: Two False Claims Act Cases in Two Weeks

The False Claims Act is the government’s weapon of choice in fighting healthcare fraud. In the beginning of the Obama Administration, Congress amended the False Claims Act and enacted a wish list from DOJ prosecutors. Healthcare companies have no choice but to negotiate settlements since they risk exclusion from federal healthcare programs, the equivalent of a death sentence for healthcare businesses. United Healthcare is...

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11 Feb, 2017

Webinar: Update on Healthcare Enforcement and Compliance Strategies

March 1, 2017, 12 Noon EST Sign up HERE The Justice Department continues to reap great benefits from its aggressive False Claims Act — civil and criminal — enforcement program. 2016 was another multi-billion dollar year for False Claims Act recoveries, especially against healthcare providers, hospitals, skilled nursing and hospice facilities. The Supreme Court also delivered an important decision on False Claims Act implied certification...

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24 Oct, 2016

Tenet Healthcare Settles Fraud Case for $514 Million

If you work in compliance in the healthcare industry, you have a tough job. The number and variety of risks that healthcare providers face is daunting. The False Claims Act is a mighty weapon in the hands of federal prosecutors. Hospitals are under the enforcement microscope given the significant role they play in the delivery of healthcare. Tenet Healthcare Corporation, a national hospital chain, recently...

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30 Aug, 2016

Healthcare Compliance: Juggling Risk Mitigation Strategies

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk assessment, healthcare organizations are often juggling among competing risks and responding to enforcement threats. The design and implementation of an effective healthcare compliance program is extremely difficult and requires dedication, resources,...

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23 Mar, 2016

The Telltale Sign of Corporate Culture: Treatment of Whistleblowers

There are many important predictors of corporate culture. Everyone laments the difficult in measuring a company’s culture. There are a few issues, however, that may be inconvertible as a predictor of a corporate culture. How does a company react to a whistleblower? I am sure everyone is saying to themselves – well, we do not have that problem, we are committed to fair treatment of...