The Department of Justice (“DOJ” or the “Government”) and Bartell Drug, Inc. (“Bartell”), a Washington State pharmacy chain of approximately 70 pharmacies, recently reached a civil settlement in which Bartell agreed to pay a fine... Read More
A criminal conviction relating to health care will result in an exclusion from Medicare and related health care programs. The length of the exclusion imposed depends on a variety of factors. Thinking about how to mitigate the impact of an exclusion... Read More
You may have heard the phrase "CMS investigation." Unlike a CMS audit, which is administrative in nature, a CMS investigation usually connotes a federal criminal investigation of suspected health care fraud. A CMS investigation will likely be... Read More
Healthcare providers across the nation have been battered by audits from the CMS and private payors alike. The CMS, however, has many different types of audits, each with their own wrinkles and potential risks to providers. To understand the risks... Read More
The Federal Government has taken the position in two recent civil False Claims Act (FCA) matters that copayment assistance (in the form of both deductibles and co-pays) resulting from pharmaceutical manufacturers’ funding of charitable... Read More
Earlier this year in a criminal case in the federal District of New Jersey, a physician was indicted for conspiracy to distribute controlled substances, and the indictment also included a count for violation of 18 U.S.C.§ 1519, "Destruction,... Read More
Inspections are not uncommon in the world of healthcare and life sciences. State licensing boards, DEA, and other oversight agencies at times assert a right to inspect a medical practice or pharmacy. They usually show up unscheduled and at an... Read More
As a first in the nation, criminal complaints were filed recently in Federal Court in Rhode Island for fraud related to the seeking of more than a half million dollars in loans pursuant to the Coronavirus, Aid, Relief, and Economic Security... Read More
Criminal complaints in two separate cases involving personal protective equipment (PPE) were recently filed in Federal Court in Brooklyn (Eastern District of New York). In the first matter, Donald Allen and Manuel Revolorio, two California... Read More
In response to the COVID-19 emergency, on March 13, the secretary of the US Department of Health and Human Services identified certain areas of law under Medicare, Medicaid and Children’s Health Insurance Program that may be waived during the... Read More
