Tag archives: DOJ

COVID-19 Update: Coronavirus Designated a Pandemic by WHO

By Yvonne Puig (US), Daphne Calderon (US) and Jeff Wurzburg (US) on March 11, 2020 Posted in Coronavirus, General

On Wednesday the World Health Organization declared COVID-19 a pandemic. WHO Director-General Tedros Adhanom Ghebreyesus stated that “In the days and weeks ahead, we expect to see the number of cases, the number of deaths and the number of affected countries climb even higher.” In a hearing before the House Oversight and Reform Committee Dr. … Continue reading

Deputy Associate Attorney General Stephen Cox Addresses DOJ’s False Claims Act Enforcement Priorities and Regulatory Reforms

By Chandra Westergaard (US), Keith M. Rosen (US) and Rachel Park (US) on February 19, 2020 Posted in Enforcement, General

On January 27, Deputy Associate Attorney General Stephen Cox delivered keynote remarks on the False Claims Act (FCA) at the 2020 Advanced Forum on False Claims and Qui Tam Enforcement. Mr. Cox’s remarks described the Department of Justice’s (“DOJ”) ongoing enforcement efforts and priorities, as well as outlined DOJ’s regulatory reform agenda and some of its … Continue reading

DOJ intervenes in FCA lawsuit against Life Spine for an illegal kickback scheme

By Savannah Wiseman (US) and Benjamin Wallfisch (US) on July 29, 2019 Posted in Enforcement

This week, the Department of Justice (DOJ) intervened in a False Claims Act (FCA) lawsuit against Life Spine and two of its executives, filed in the U.S. District Court for the Southern District of New York. The lawsuit alleges that Life Spine violated the Anti-Kickback Statute by paying more than $7 million in consulting fees, … Continue reading

DOJ issues guidance on cooperation credit in FCA investigations

By Michael Koon (US), Carol Poindexter (US) and Zach Smith (US) on May 9, 2019 Posted in Enforcement

On May 7, the Department of Justice (“DOJ”) released an update to its previous 2017 guidance (“Updated Guidance”) outlining when the government will award cooperation credit to defendants in False Claims Act (“FCA”) investigations. Under the Updated Guidance, set forth at Justice Manual Section 4-4.112, defendants can earn cooperation credit in FCA cases in three … Continue reading

DOJ announces Market Integrity and Consumer Fraud Task Force

By Yvonne Puig (US) and Jeff Wurzburg (US) on July 12, 2018 Posted in Enforcement

On July 11 the U.S. Department of Justice (DOJ) announced a new Task Force on Market Integrity and Consumer Fraud. The wide-ranging Task Force will be chaired by the Deputy Attorney General and work towards: [T]he investigation and prosecution of cases involving fraud on the government, the financial markets, and consumers, including cyber-fraud and other … Continue reading

US DOJ charges 601 individuals in nation’s largest healthcare fraud takedown

By Benjamin Wallfisch (US) on July 10, 2018 Posted in Enforcement

Last week, the U.S. Department of Justice announced charges against 601 individuals for their alleged participation in healthcare fraud schemes. According to the announcement, the alleged fraud is estimated to have resulted in more than $2 billion in losses to federal healthcare programs. This national healthcare fraud takedown is the largest in U.S. history, surpassing … Continue reading

Department of Justice will not defend ACA individual mandate

By Jeff Wurzburg (US) on June 11, 2018 Posted in News from DC

The Department of Justice (DOJ) announced on June 7, 2018 that it will no longer defend the constitutionality of section 5000A of the Affordable Care Act (ACA), a.k.a. the individual mandate. DOJ announced its policy change in a three page letter to Congress and a brief in response to the plaintiff’s motion for a preliminary … Continue reading

Budget Act codifies Stark liberalizations

By Thomas Dowdell (US) and Joseph Keillor (US) on February 20, 2018 Posted in News from DC, Regulatory

As we previously reported, on February 9, the U.S. Senate and House of Representatives approved the Bipartisan Budget Act of 2018 (the “Act”) and President Trump subsequently signed the bill into law. Section 50404 of the Act includes several amendments to the Stark Law. Specifically, Section 50404 endorses recent liberalizations of the Stark Law requirements … Continue reading

Deregulatory wave prompts renewed examination of Stark Law application

By Debbi Johnstone (US), Joseph Keillor (US) and Sarah Jean Kilker (US) on February 2, 2018 Posted in Regulatory

In another sign that the Trump administration’s penchant for regulatory flexibility may apply to the federal fraud-and-abuse regulatory regimes, CMS administrator Seema Verma announced during an AHA Town Hall webcast on January 17 that CMS is convening an interagency group to examine possible ways to minimize the regulatory barriers of fraud-and-abuse laws, including the Stark … Continue reading

Rumors of sea change in DOJ policy potentially confirmed by two recent memos

By Carol Poindexter (US) on January 31, 2018 Posted in Enforcement

Rumors of a significant shift in U.S. Department of Justice (DOJ) policy were confirmed last week when a privileged and confidential internal DOJ memo was leaked to the press. The memo outlines seven factors government attorneys should use for evaluating whether the government should seek dismissal of qui tam actions filed under the federal False Claims … Continue reading

Court applies Escobar, overturns $350M False Claims Act verdict

By on January 16, 2018 Posted in Enforcement

In Universal Health Services v. U.S. ex rel Escobar, the United States Supreme Court emphasized the importance of the materiality standard in False Claims Act cases. Since that decision, litigants have anxiously awaited further guidance on how Escobar’s instructions would be applied by lower courts. In U.S. ex rel Ruckh v. Salus Rehabilitation, LLC et … Continue reading

DOJ policy shift in qui tam litigation?

By Callan Edquist (US) on November 17, 2017 Posted in Enforcement

Last week, a senior US Department of Justice official appeared to announce a surprising, and potentially significant, shift in policy regarding qui tam litigation. Michael Granston, director of the commercial litigation branch of the fraud section in the DOJ’s civil division, said during a speech that the DOJ will be moving to dismiss False Claims … Continue reading

DOJ charges 412 individuals in largest healthcare fraud takedown in US history

By on July 17, 2017 Posted in Enforcement

On Thursday, the DOJ announced charges against 412 individuals for their alleged participation in healthcare fraud schemes involving approximately $1.3 billion in false billings. This marks the largest national healthcare fraud takedown in U.S. history—topping the DOJ’s announcement of charges against 301 individuals in June 2016. The enforcement actions spanned across 41 federal districts and … Continue reading

DOJ recovers $4.7 billion in 2016, third highest in FCA history

By Michael Koon (US) on December 15, 2016 Posted in Enforcement

The Department of Justice (“DOJ”) announced yesterday that it recovered over $4.7 billion in fiscal year 2016 in civil cases involving claims of fraud against the government under the False Claims Act (“FCA”). This is the third largest annual recovery in FCA history and one of the largest in recent years, easily surpassing last year’s … Continue reading

FTC and DOJ side with Texas-based Teladoc

By on September 19, 2016 Posted in Regulatory

The Federal Trade Commission (“FTC”), in a joint amicus brief with the Department of Justice filed on September 9, 2016, petitioned the Fifth Circuit to dismiss the Texas Medical Board (“TMB”) appeal of the district court ruling holding that TMB regulations restricting the prescribing rights of physicians providing professional services through telemedicine may be challenged … Continue reading

HHS announces near-doubling of civil penalties for numerous infractions

By on September 12, 2016 Posted in Enforcement

Last week, HHS, OIG, CMS, the Office of the Assistant Secretary for Financial Resources, and the Administration for Children and Families issued an interim final rule (the Rule) that adjusts maximum civil monetary penalties for inflation.… Continue reading

CMS investment in preventing healthcare fraud brings $42 billion return

By Savannah Wiseman (US) on July 28, 2016 Posted in Enforcement

CMS’s annual report demonstrates that the government is becoming increasingly effective at ferreting out fraud and abuse from the healthcare system. With a 12-to-1 return on investment, the government will likely continue to make fighting healthcare fraud a priority.… Continue reading

2015 CMS “Open Payments” data released

By Benjamin Wallfisch (US) on July 5, 2016 Posted in Transparency

Last week, CMS posted the 2015 Open Payments data to its website, as well as updated payment records for 2013 and 2014. Overall, manufacturers reported $7.52 billion in payments and ownership interests to 618,931 physicians and 1,116 teaching hospitals in 2015. Nearly 1,500 companies reported making payments in 2015, comprising a total 11.9 million records. … Continue reading

Legal Update: DOJ announces near doubling of FCA penalties

By on July 1, 2016 Posted in Enforcement

The DOJ has confirmed that the amount of False Claims Act civil penalties is set to nearly double following recent updates to FCA regulations. … Continue reading

DOJ charges over 300 people in largest healthcare fraud “takedown” in U.S. history

By on June 23, 2016 Posted in Enforcement

On Wednesday, the Justice Department announced that it had brought criminal and civil charges against 301 healthcare professionals as part of the largest national healthcare fraud “takedown” in history. A nationwide investigation spearheaded by the Medicare Fraud Strike Force revealed claims amounting to $900 million in the form of alleged kickbacks, money laundering, and other … Continue reading

House passes comprehensive opioid legislation in advance of negotiations with the Senate

By Yvonne Puig (US) and Mark Faccenda (US) on May 16, 2016 Posted in News from DC, Regulatory

During the week ending May 13, 2016, the U.S. House of Representatives approved a comprehensive set of 18 bills aimed at curbing the opioid epidemic. The largest of these bills, the Comprehensive Opioid Abuse Reduction Act of 2016 (H.R. 5046), passed by a 413-5 vote in the House on May 12, 2016. This bill authorizes … Continue reading

DOJ launches pilot program for FCPA cases

By Kevin J. Harnisch (US) and Paul Sumilas (US) on April 11, 2016 Posted in Enforcement

On April 5, 2016, the DOJ announced a new Foreign Corrupt Practices Act (FCPA) enforcement pilot program with the goal of motivating companies to voluntarily self-disclose FCPA-related violations, to fully cooperate with the DOJ during investigations, and to promote greater accountability for individuals and corporations who violate the FCPA and related laws. Under the program, … Continue reading

DOJ announces new regional elder justice task forces to target nursing home fraud

By on March 31, 2016 Posted in Enforcement

Yesterday, the Department of Justice launched 10 regional task forces aimed at identifying fraud at nursing homes that provide inferior care to elderly residents. Referred to as the Elder Justice Task Forces, the DOJ plans to launch the 10 regional task forces in the following districts across the country:… Continue reading

Company exec can face $18M in restitution for ignoring attorney warnings

By Carol Poindexter (US), Jim Wiehl (US) and Savannah Wiseman (US) on March 21, 2016 Posted in Enforcement

On March 3rd, the Ninth Circuit ruled that the president of Commerce Planet, Inc. could be held personally liable for violations of the Federal Trade Commission Act (FTC Act) after he ignored warnings from his in-house counsel that the company’s disclosures about the monthly fees for an online auction kit were inadequate under the FTC Act. … Continue reading