Tag Archives: Fraud

Scientific Research Misconduct vs. Fraud: How to Tell the Difference

digital health
The following article was originally published in May 2018 Compliance Today and is reprinted with permission. For years, misconduct in scientific research was policed primarily by the Office of Research Integrity (ORI) at the U.S. Department of Health and Human Services.1 After a lengthy and confidential review, an institution suspected of producing false or fraudulent … Continue reading this entry

FCA's "First to File" Bar Retains Some Teeth

Granston Memo
Health care providers are under constant threat of lawsuits brought by whistleblowers under the federal civil False Claims Act, 31 U.S.C. §§ 3729, et seq. (FCA), the statute under which the government obtains most judgements against providers. These qui tam lawsuits can be costly even where they lack any merit, and counsel for providers are … Continue reading this entry

DOJ and OIG Focus on Opioid Abuse: Medical Professionals Who Overprescribe May Be Targets

controlled substances
Two recent announcements reflect that the U.S. Government is taking aggressive steps to address opioid abuse by identifying and targeting the involvement of medical professionals in facilitating opioid abuse involving Federal health care program beneficiaries.  The U.S. Department of Justice announced on July 13, 2017 fraud charges involving 412 defendants in 41 federal districts across … Continue reading this entry

OIG Rings in the New Year With New Anti-Kickback Statute Safe Harbors

Just in time for the New Year, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued final regulations (Final Regulations) that revised two existing Anti-Kickback Statute safe harbors, added two regulatory safe harbors to complement existing statutory safe harbors, and created an entirely new safe harbor regarding local … Continue reading this entry

Ransomware Reporting Requirements & New HHS Guidance

New York Office of the Medicaid Inspector General Releases 2014-2015 Work Plan
Ransomware is malicious software that denies access to data, usually by encrypting the data with a private encryption key that is only provided once a ransom is paid. Sometimes the ransomware will actually destroy, steal, or export data from information systems. Ransomware has become a significant threat to all U.S. businesses and individuals, and a … Continue reading this entry