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DOJ

The DOJ Is Not Backing Down: FCA Cases Recover More Than $2.8 Billion in 2018

[01/09/19]

Posted on January 9, 2019 in Health Law News

Published by: Hall Render

The Department of Justice (“DOJ”) reported it collected more than $2.8 billion in False Claims Act (“FCA”) settlements and verdicts in 2018.¹ This is significantly down from the record $5.69 billion recovered in 2014 and from the $3.6 billion – $4.7 billion in 2015 through 2017. This can primarily be explained by the absence... READ MORE

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The Granston Memo’s Effect: The DOJ Is Dismissing Meritless and Frivolous Actions

[12/27/18]

Posted on December 27, 2018 in False Claims Act Defense

Published by: Hall Render

The DOJ plans to dismiss 11 FCA lawsuits involving the new theory that patient assistance services supplied by drugmakers are unlawful kickbacks.¹ These lawsuits were brought by shell company whistleblowers backed by the National Healthcare Analysis Group (“NHCA”), a company that specializes in generating FCA cases. The 11 cases were essentially the same complaints with a different... READ MORE

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Department of Justice Announces Important Updates to Yates Memo Requirements

[12/07/18]

Posted on December 7, 2018 in Health Law News

Published by: Hall Render

On November 29, 2018, Deputy Attorney General Rod Rosenstein announced some significant changes to the Department of Justice’s (“DOJ’s”) policies on investigating corporate wrongdoing. These changes pull back some of the guidance that was first announced in a public memorandum issued by former Deputy Attorney General Sally Quillian Yates (“Yates Memo”) in 2015, especially... READ MORE

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DOJ Approves Merger Between Cigna and Express Scripts, Paving the Way for Increased Vertical Integration Between Payers and PBMs

[10/04/18]

Posted on October 4, 2018 in Health Law News

Published by: Hall Render

On September 17, 2018, the U.S. Department of Justice (“DOJ”) approved the $52 billion vertical merger between health insurer Cigna Corp. (“Cigna”) and pharmacy benefit manager (“PBM”) Express Scripts. The Cigna-Express Scripts merger is just one in a string of recent health insurer/PBM acquisitions. For more on these transactions, click here. As the largest unaffiliated... READ MORE

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OIG Final Rule Significantly Expands Exclusion Authority

[01/19/17]

Posted on January 19, 2017 in Health Law News

Published by: Hall Render

On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE

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DOJ Seeks to Nearly Double Health Care Fraud Litigation Budget for 2016

[02/04/15]

Posted on February 4, 2015 in False Claims Act Defense

Written by: Drew B. Howk

Just three months ago, the Department of Justice announced a record year for False Claims Act recoveries totaling more than $5 billion, including $2.3 billion from health care defendants alone. Helping to contribute to these recoveries was another record: over 700 whistleblower cases filed in 2014. READ MORE

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DOJ Intervenes in Retained Overpayment Suit

[06/30/14]

Posted on June 30, 2014 in False Claims Act Defense

Written by: Drew B. Howk

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

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