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Department of Justice

Reimagining Skilled Nursing Compliance Programs: Five Key Areas of Focus from the DOJ


Posted on June 9, 2020 in Long-Term Care, Home Health & Hospice

Published by: Hall Render

Skilled nursing facilities (“SNFs”) are facing many challenges as their residents and staff encounter COVID-19 diagnosis, care and testing. During the COVID-19 pandemic, CMS and state departments of health have issued and revised interim final regulations, waivers, quality care directives, orders and multiple guidance memos. In early June 2020, the U.S. Department of Justice... READ MORE

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DOJ Announces $100 Million Criminal Antitrust Penalty for Florida Oncology Provider


Posted on May 13, 2020 in COVID-19 Daily Updates, Health Law News

Published by: Hall Render

On April 30, 2020, the Antitrust Division of the U.S. Department of Justice (the “DOJ”) announced its first criminal felony charge in an ongoing probe of the Florida cancer treatment industry. The DOJ alleged that from 1999 to 2016, Florida Cancer Specialists & Research Institute, LLC (“FCS”) and unnamed co-conspirators conspired to allocate the... READ MORE

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Webinar Preview: Analyzing 2018 Anti-Kickback Compliance Settlements Involving Real Estate Arrangements


Posted on September 18, 2019 in Health Law News

Published by: Hall Render

The Office of the Inspector General (“OIG”) and Department of Justice (“DOJ”) often release information about compliance settlements under the Anti-Kickback Statute (“AKS”), including both the settlement value and the subject arrangement. The most recent data from 2018 shows several of these settlements arose from real estate arrangements and some involved millions of dollars... READ MORE

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Department of Justice Updates Compliance Program Guidance


Posted on May 13, 2019 in Compliance, Health Law News

Published by: Hall Render

On April 30, 2019, the U.S. Department of Justice (“DOJ”) released an updated version of is guidance known as “The Evaluation of Corporate Compliance Programs” (“2019 Guidance Document”). This document provides actionable guidance for health care providers seeking to assess and enhance their compliance programs. The DOJ’s updates emphasize the government’s view that not... READ MORE

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


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


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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Massive Penalty Spike Darkens the FCA Landscape


Posted on June 30, 2016 in False Claims Act Defense

Written by: David B. Honig

In November 2015, the Bipartisan Budget Act of 2015 went into effect. One aspect of that act was the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. The new law required that the Program Fraud Civil Remedies Act and the False Claims Act (“FCA”) penalties be “corrected” to adjust for inflation since... READ MORE

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


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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Qui Tam Complaints to Be Reviewed by Criminal Division


Posted on October 1, 2014 in False Claims Act Defense

Written by: David B. Honig

Leslie R. Caldwell, Assistant Attorney General for the Criminal Division, announced recently that all new qui tam complaints would be “shared by the Civil Division with the Criminal Division as soon as the cases are filed.” Fraud prosecutors will now review all qui tam complaints to determine whether to open a parallel criminal investigation. READ MORE

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Hospice Owner Indicted for $14.3 Million in False Claims


Posted on October 14, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On October 12, 2011, the U.S. Department of Justice unsealed an indictment charging Matthew Kolodesh a/k/a Matvei Kolodech, with conspiracy to defraud Medicare of more than $14 million.  According to the indictment, Kolodesh’s business, Home Care Hospice, Inc. (HCH), located in Philadelphia, PA, submitted Medicare claims for approximately $14.3 million dollars for patients who... READ MORE

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