In the MA space, historical enforcement actions taken by both OIG, under their administrative authorities, and DOJ, under the False Claims Act (“FCA”), have related to alleged MA risk adjustment payment inflation schemes. See, e.g., DaVita, Sutter Health, Beaver Medical, Martin’s Point,...
Health Care Reform: Legislation Expands False Claims Act, Whistleblower Cases Expected to IncreasePeter M. Schutzel
A complete overview of the Federal false claims act (FCA) - the secret weapon of of the Govt. used to combat fraud and incentivize whistleblowers. See the important parts of this litigation tool explained simply.
The False Claims Act (FCA) serves as an important tool to address the potential for criminal activity in both individuals and businesses. Central to this Act is thequi tamprovision, which allows private citizens to file lawsuits on behalf of the government against entities committing fraud, effect...
[4]SeePress Release, U.S. Atty’s Office for the Dist. of Vt., Electronic Health Records Vendor NextGen Healthcare, Inc. to Pay $31 Million to Settle False Claims Act Allegations (July 14, 2023),https://www.justice.gov/usao-vt/pr/electronic-health-records-vendor-nextgen-healthcare-inc...
The Council therefore finds that the city of New York should enact legislation modeled on the federal false claims act, to enhance the city’s ability to recover monetary damages from parties who file fraudulent claims for payment of city funds and to recover the substantial costs that are incur...
On June 29, 2016, the Department of Justice ("DOJ") issued an interim rule—the Civil Monetary Penalties Inflation Adjustment, 81 Fed. Reg. 42,491 (June 30, 2016)—that will nearly double civil penalties for False Claims Act ("FCA") violations. The rule impl...
the authorreviewsthe businesslobbying effortsthatderailed Californialegislationto amendthestate’sFalse ClaimsActby permittingtaxclaims.Hearguesthat oppositiontothebillwasbasedonfalseor misleadingclaims,andthatthoseefforts effectivelyhelpedconcealtaxfraud.Ventryalso connectsthecampaignagainstprivate enforcementoftaxlaws...
country. As part of that review, the federal government determined that Georgia's Medicaid False Claims Act was not as aggressive as the revised federal False Claims Act, and that Georgia would no longer be eligible for the enhanced recovery unless it strengthened its own false c...
“[t]he Justice Department is not, and cannot be, the judge, jury, and executioner of a relator’s claim.”[51]Senator Grassley asserted that he is “working with a cadre of bipartisan Senate colleagues to draft legislation that will further strengthen and improve the False Claims Act.”[...