Category Archives: Litigation

Subscribe to Litigation RSS Feed

SEC Turns Up the Heat on Issuer Officials

New York Office of the Medicaid Inspector General Releases 2014-2015 Work Plan
Two recent SEC enforcement actions demonstrate that the Securities and Exchange Commission remains intently focused on the municipal market and, in particular, on officials participating in financings that fail to accurately and completely disclose material information. In an action arising from defaulted bonds sold by a Michigan city to develop a soundstage, the SEC successfully brought … Continue reading this entry

Eleventh Circuit Affirms Dismissal of Relator’s Complaint Under Amended Public Disclosure Bar

In United States of America ex rel. Marc Osheroff v. Humana, Inc. et al., No. 13-15278 (11th Cir., Jan. 16, 2015), the Eleventh Circuit affirmed dismissal of a relator’s complaint under the public disclosure bar of the False Claims Act (FCA). The Court addressed several notable issues and provided insight as to how courts may … Continue reading this entry

Roadmap to Prison: Lessons Learned from the Criminal Prosecution of Alpha Ambulance’s Leaders

CMS Releases Medicare Part B Supplier Billing and Payment Data
No one running an ambulance company ever planned to go to prison for doing his or her job. But that is a real possibility if the government knocks on the door, and the owner or manager is dishonest in his or her response to the inquiry. CMS contractors are increasing the number of audits they are performing … Continue reading this entry

Happy Holidays!

Thank you for reading, subscribing and being a part of our blog community in 2014. We hope you have a happy holiday season and a wonderful new year! – The Health Care Law Today Team We will be back with new posts the week of January 5.… Continue reading this entry

Federal Prosecutors Charge NECC Employees with Second Degree Murder: A Shot Across the Bow to Healthcare Companies Navigating Uncertain Regulatory Environments

Research
Federal prosecutors charged the head pharmacist and the president of New England Compounding Center (NECC), a now-bankrupt Massachusetts compounding pharmacy, with second-degree murder and racketeering in the U.S. District Court District of Massachusetts on Tuesday, December 16. The charges relate to NECC’s 2012 distribution of contaminated steroid injection vials in twenty states. The contaminated vial … Continue reading this entry

OIG Releases Fiscal 2014 Report to Congress

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS) released its Semiannual Report to Congress (Report) last week summarizing health care fraud investigation activities for the second half of fiscal year 2014 and the full year’s achievements. OIG reported expected recoveries of over $4.9 billion for fiscal year … Continue reading this entry

Happy Thanksgiving!

The Health Care Law Today team is thankful for you, our readers and subscribers. Thank you all for reading, contributing to, and sharing our blog. We hope you have a safe and happy holiday. Have a great weekend!… Continue reading this entry

For Single-Enterprise Immunity, the Bottom Line May Be Having One Bottom Line

CMS Releases Medicare Part B Supplier Billing and Payment Data
A federal court in Ohio has provided some of the clearest guidance to date on the application of the single-enterprise immunity doctrine to healthcare organizations. The single-enterprise immunity doctrine is critically important in the healthcare industry, because firms that qualify for single-enterprise immunity are free to engage with each other in joint contracting, joint strategic … Continue reading this entry

CMS Says: Let's Make a Deal

In the hours before everyone began enjoying Labor Day Weekend, the Centers for Medicare & Medicaid Services (CMS) issued an important inpatient hospital review update. To expedite the appeals process and reduce the volume of inpatient status claims currently pending, “CMS is now offering an administrative agreement to any hospital willing to withdraw their pending … Continue reading this entry

Eighth Circuit Dismisses Whistleblower's Suit Finding Facts Were Already Publicly Disclosed

CMS Releases Medicare Part B Supplier Billing and Payment Data
In an August 7, 2014 opinion, the Eighth Circuit upheld the dismissal of a whistleblower’s suit alleging that a number of pain pump device makers had violated the False Claims Act (FCA) by marketing their pain pumps for harmful off-label uses. United States ex rel. Paulos v. Stryker Corp. et al., 8th Cir., No. 13-2509, 8/7/14. The … Continue reading this entry

Appellate Courts Split on Validity of Key ACA Regulation

CMS Releases Medicare Part B Supplier Billing and Payment Data
In two important decisions issued July 22, 2014, both addressing the validity of a key regulation promulgated under the Patient Protection and Affordable Care Act (ACA), two federal appeals courts reached opposite conclusions, possibly setting the stage for another ACA showdown in the Supreme Court. The two cases, Halbig v. Burwell (formerly Halbig v. Sebelius) … Continue reading this entry

Hospitals Urging SCOTUS to Limit False Claims Act Penalties

CMS Releases Medicare Part B Supplier Billing and Payment Data
What do a moving company and a hospital association have in common? The False Claims Act (FCA).  The American Hospital Association along with the United States Chamber of Commerce and the Pharmaceutical Research and Manufacturers of America recently submitted an amici curiae brief in support of petitioners, Gosselin World Wide Moving, urging the Supreme Court … Continue reading this entry

FTC Uses its "Unfair Acts" Power to Go After PHI Security Breach

As if HIPAA Weren’t Enough… The Federal Trade Commission (FTC) is moving forward with an administrative action against a small medical laboratory that suffered two data security breaches, resulting in its patients’ protected health information falling into the hands of identity thieves. The facts of this case are unremarkable: a small facility suffered a data … Continue reading this entry

Recent Decision Underscores Need for Involvement of Counsel in Internal Investigations

A recent federal court decision raises concerns about the ability of companies to maintain privilege over materials generated in connection with internal investigations. The case, United States ex rel. Barko v. Halliburton Company et al., No. 1:05-CV-1276 (D.D.C. Mar. 6, 2014), involved allegations by a qui tam relator that his employer committed abuses in connection … Continue reading this entry

CMS Releases Medicare Part B Supplier Billing and Payment Data

Potential for Increase in Whistleblower Litigation On 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 scanning easy. Within 48 … Continue reading this entry

Florida's False Claims Act - Did You Know It Changed Last Year?

In June 2013, Florida’s legislature significantly amended Florida’s False Claims Act, Fla. Stat. §§ 68.081-68.092 (“FFCA”), effective July 1, 2013. Although these amendments have not received much publicity or commentary, they considerably expanded the FFCA’s scope, among other important changes. Persons potentially subject to the FFCA, including those who seek and receive payments from the … Continue reading this entry