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…
$145 Million Settlement With Practice Fusion In Kickback Scheme Aimed At Boosting Opioid Prescriptions
Key Points Practice Fusion allegedly took $1 million in kickbacks from a major pharmaceutical company in exchange for its software…
Multi-Agency Enforcement Action Against 35 Individuals Involved in Fraudulent Genetic Testing Scheme
The Department of Justice (DOJ) recently announced a multi-agency and multi-state coordinated law enforcement action against 35 individuals involved in…
CMS Proposes Changes to the Stark Law Regulations
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule to reduce the regulatory impact and burden…
How Kickbacks Result in Civil False Claims Fraud Actions
Overview A continual enforcement priority for both the Department of Health and Human Services Office of Inspector General (OIG) and…
DOJ Announces Formation of Newark/Philadelphia Medicare Fraud Strike Force
The Department of Justice (DOJ) Criminal Division recently announced the formation of the Newark, New Jersey/Philadelphia, Pennsylvania Regional Medicare Fraud…
New OCR Guidelines on Software Vulnerabilities and Patching
Computer processors sold in the past 10 years are vulnerable to malware. The Department of Health and Human Services Office…