DOJ Intervenes in Whistleblower Suits Against Kaiser Permanente
Six complaints allege submission of inaccurate diagnosis codes. The Department of Justice (DOJ) intervened in multiple whistleblower complaints alleging that…
DOJ Reports Sentencing of Two Physicians to Prison for Prescription Fraud
The United States Department of Justice (DOJ) announced that two Arkansas physicians were sentenced to a combined 12 and a…
Criminal Charges Related to COVID-19 Pandemic Brought Against Defendants Across the Country
Telemedicine Executive, Physician, Marketers, and Medical Business Owners Charged in Fraud Schemes Involving $143 Million in Losses. The Department of…
Subjects Sentenced in $150 Million Hospice Fraud Case
3 Categories of Hospice Fraud The three major categories of hospice fraud are: (1) false claims for unnecessary, improperly delivered,…
DOJ Fraud Section Issues 2020 Report
The Fraud Section of the United States Department of Justice (DOJ) issued its 2020 Year in Review report. It notes that…
Compliance Root Cause Analysis
DOJ Guidelines encourage seeking independent evidence of root cause identification and remediation. The Department of Justice (DOJ) has indicated that…
Compliance Investigations
The Department of Justice (DOJ) and Department of Health and Human Services Office of the Inspector General (OIG) stress the…
DOJ Compliance Guidance Regarding Compliance Culture
Key Points: Compliance culture repeatedly used in the DOJ Guidance. “How often and how does the company measure its culture…
$50 Million Anti-Kickback and Stark Law Settlement
Key Points: Physician Arrangements continue to be the highest enforcement priority for the DOJ and OIG “Whistleblower” to receive $10,000,000…
2020 DOJ Compliance Guidance Policy Questions: Suggested Actions
There can be no doubt about the value that the Department of Justice (DOJ) places on the development, implementation, and…
OIG 2019 Report on Fraud Actions and Recoveries
Key Points: $3.6 billion recovered 528 DOJ criminal convictions 747 OIG criminal actions 2,640 new exclusions In June 2020, the…
2020 DOJ Compliance Guidance: Organizations must conduct periodic compliance program reviews
Key Takeaways The DOJ stresses how critical it is to evidence program effectiveness Regular, rigorous, and consistent independent reviews is…