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Cadwalader Client & Friends Memo: A 'Hat Trick' of Heightened False Claims Act Risks for Health Care Providers

Introduction At the risk of stating the obvious, fighting and prosecuting health care fraud are top priorities for the Federal Government, and the False Claims Act ("FCA") is its weapon of choice in the battle. In a speech in June, Stuart Delery, the Acting Assistant Attorney General for...

DLA Piper: Government Turns Up the Heat With the False Claims Act – 5 Action Steps for Healthcare Providers

By Savaria B. Harris and Mitka T. Baker Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. Just last month, the Health...

Cadwalader: Federal Court Upholds Provider Mandate to Report and Return Medicare and Medicaid Overpayments in 60 Days

Introduction | The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed care organizations that were overpaid...

DLA Piper LLP: Federal Court Sides With Government In First Interpretation Of ACA’s 60-day False Claims Act Rule

By Adam J. Rogers , Bradley M. Smyer and Karen Nelson | In a significant development for healthcare providers, a federal court in New York has adopted the government’s interpretation of the 2010 Patient Protection and Affordable Care Act’s (ACA’s) so-called 60-day rule, which governs...

Barnes & Thornburg: DOJ Secures Big Win in First Court Interpretation of FCA’s 60-Day Overpayment Rule

By Jessica Talati On August 3, Judge Edgardo Ramos of the Southern District of New York denied hospital defendants’ motions to dismiss in United States ex rel. Kane v. Healthfirst, Inc., et al . , No. 11 CIV 2325 (S.D.N.Y. Aug. 3, 2015), keeping alive a much-followed whistleblower case accusing...

Williams Mullen: The Definition of Identify: The 60-Day Rule

By Ruth Levy & Patrick C. Devine, Jr. | The Patient Protection and Affordable Care Act (“PPACA”) established that any person who receives an overpayment from the Medicare or Medicaid programs and who does not report and return the overpayment within 60 days after it is identified will...