Publications

HCFAC Report 2014: After Consecutive Record Years, Recoveries and Prosecutions Take a Dip:  “The Health Care Fraud and Abuse Control Program (“HCFAC”) … prepares detailed yearly reports that are sometimes viewed to be a barometer of fraud and abuse enforcement efforts … (read the full article)
OIG Updates its Special Advisory Bulletin on ExclusionsThe Office of Inspector General continued to focus on issues related to exclusion screening with its update to the Special Advisory on the Effect of Exclusions from Participation in Federal Health Care Programs… (read the full article)
Nursing Home Litigation: Failure of Care (an excerpt from the “Inside the Mind” of Leading Lawyer Series published by Aspatore Books): The prosecution of U.S. v Borne … marked the first time the federal criminal health care fraud statute … was used to prosecute adequate care to nursing home residents. The multiyear investigation … eventually lead to a ninety-one count indictment charging a broad health care fraud scheme … (read an abridged version of the chapter)
Allison Engine: A “less friendly” environment for qui tam plaintiffs – But how much so?  When the Supreme Court handed down its opinion in Allison Engine Co. v. United States ex rel. Sanders, 128 S. Ct. 2123 (2008), last year, it addressed … the meaning of the “presentment” requirement … and examined … the making of a “false record or statement” … (read full article)
Five Things You Should Know About the Fraud Enforcement and Recover Act of 2009All health care providers need to be aware of how recently enacted changes to the federal False Claims Act (FCA) may affect them, particularly in the areas of refunding overpayments to the government and filing claims with Medicare and Medicaid managed care plans … (read full article)
What Providers Need to Know About Exclusion Screening: Healthcare providers … are required to screen their employees, vendors, and contractors monthly to ensure that none have been excluded … (read the full article)