Articles and Blogs

NATIONAL 5 PE moves ASC leaders are eyeing Academic health systems benefitting from for-profit selling spree Amazon’s top 10 healthcare moves in ’24 Amazon One Medical faces lawsuit over telehealth patient death Bipartisan bills in Congress would force insurance companies, PBMs to sell pharmacies CMS rolls out 5-year plan to ‘optimize’ care delivery CMS... READ MORE

NATIONAL Amazon’s push into telehealth knocks shares of Hims & Hers America’s Rural Hospital Crisis Has Been Looming for Decades AMA lawsuit targets collusion in health care pricing CMS Unveils Major Changes for Nursing Home Surveys for 2025 DEA, HHS issue another extension for telehealth controlled substance prescribing Donald Trump taps TV personality Dr.... READ MORE

The government lawsuit against defendants Precision Lens and its founder Paul Ehlen, United States ex rel. Fesenmaier v. Cameron-Ehlen Group, Inc. (“Fesenmaier”), has garnered substantial media attention. This is due in part to juicy facts (kickbacks to physicians in such forms as fancy meals and exclusive vacations for which physicians were invoiced at below... READ MORE

On February 22, 2024, the Department of Justice (“DOJ”) announced that it recovered over $2.68 billion in False Claims Act (“FCA”) settlements and judgments during the 2023 federal fiscal year. Notably, this amount stems from the highest number of settlements and judgments in a single year, including 543 settlements and judgments during this last... READ MORE

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. The case, brought under the anti-retaliation provision of the False Claims Act (“FCA”), is available here. Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C. § 3730(h)(1)), has provided... READ MORE

The government’s dilatory investigation of a sealed False Claims Act (“FCA”) complaint was so egregious that its $32M award after a nine-week jury trial will be cut nearly in half. The Fifth Circuit Court of Appeals refused the defendants’ request to overturn the entire verdict but enforced the consequences of the government’s prejudicial delay... READ MORE

The Ninth Circuit recently held in Hendrix ex rel. United States v. J-M Manufacturing Company, Inc. that in False Claims Act (“FCA”) cases, one penalty per project or FCA violation is proper, rather than one penalty per line item contained within the project or violation. Background In this case, the plaintiff brought suit against the... READ MORE

The Fourth Circuit recently held that providers may not defend a False Claims Act (“FCA”) lawsuit by arguing that eligibility requirements violate the Medicaid Act. Rather, liability under the FCA may still be established if any misrepresentations made by a provider influenced decision-makers and resulted in the submission of false claims to the government.... READ MORE

Recently, Simon et al, v. Healthsouth of Sarasota Limited Partnership, et al, the Eleventh Circuit held that for a plaintiff to qualify as engaging in “protected activity,” the plaintiff must demonstrate that they had both a subjectively reasonable belief of fraud and an objectively reasonable belief of fraud. Background The plaintiff in this action... READ MORE

The Eleventh Circuit Court of Appeals recently affirmed that a qui tam relator’s original complaint, rather than any amended complaints subsequently filed in the action, is the “proper point of reference” for analysis under the False Claims Act’s (“FCA’s”) first-to-file rule. Cho on behalf of States v. Surgery Partners, Inc., No. 20-14109 WL 982126... READ MORE