Articles and Blogs

On January 1, 2025, the Centers for Medicare and Medicaid Services’ (“CMS”) new 60-Day Rule became effective. The 60-Day Rule states several changes, with some changes significantly impacting False Claims Act (“FCA”) liability. Background CMS’s 60-Day Rule is a regulation under the Affordable Care Act (“ACA”) that requires health care providers and suppliers to... READ MORE

Nearly a decade has passed since the U.S. Congress enacted the Patient Protection and Affordable Care Act (the “ACA”). Since March 2010, we have seen federal court rulings on numerous challenges to the ACA itself and the executive branch’s efforts to enforce the ACA. One such challenge resulted on September 7, 2018 in the... READ MORE

Most health care providers caring for federal health care program beneficiaries are familiar with the False Claims Act[1] (“FCA”) and its qui tam provision,[2] which grants private citizens the right to sue health care providers on behalf of the federal government. The seemingly routine 6+ figure FCA settlements garner much-deserved attention. After all, providers... READ MORE

With the passing of the Affordable Care Act (“ACA”), False Claims Act (“FCA”) observers noted the imminent filing of cases alleging violations of the ACA’s amendments to the FCA or “reverse” false claims. Such claims are per se false claims under the FCA and arise when a government contractor or health care provider becomes aware... READ MORE