The question of when U.S. federal attorneys can dismiss a whistleblower suit filed under the False Claims Act (FCA) has roiled the courts for several years, but the Supreme Court has laid many of those questions to rest in an 8-1 ruling which said that the government can dismiss a whistleblower FCA case only after federal attorneys have intervened.
U.S. federal authorities continue to wrap up cases in connection with COVID fraud, the latest of which yielded a $30 million fine for a single defendant accused of fraud and money laundering.
Most enforcement activities in the U.S. related to physician participation in fraud deal with activities that run to six figures at most, but the U.S. Department of Justice (DOJ) reported recently that it has snared a much bigger fish.
The U.S. Department of Justice announced that a judgment of more than $487 million has been lodged against Cameron-Ehlen Group Inc., of Bloomington, Minn., for alleged violations of the False Claims Act (FCA) in connection with the company’s distribution of products used in cataract surgeries. That final amount is more than 10 times the amount alleged to have been billed illicitly to federal health programs, a clear signal that inducement of this sort will be met with severe penalties.
Four U.S. government agencies have issued an advisory regarding bias in the use of artificial intelligence (AI) and other automated systems, the scope of which includes software products that “make decisions.” The four agencies have pledged to use their enforcement powers to “protect individuals’ rights regardless of whether legal violations occur through traditional means or advanced technologies,” all of which sends a signal to developers of medical software that the FDA is not the only federal government agency that will be looking over their shoulder to evaluate the risk of bias in those algorithms.
Mergers and acquisitions in the U.S. have been under tremendous regulatory pressure over the past two years, a trend that seems likely to continue for the foreseeable future. However, Lina Khan, chairwoman of the U.S. Federal Trade Commission (FTC), said in a March 27 public forum that the agency will not wait for airtight cases to pursue legal remedies in part because the perfect case does not always arise, but also because the courts can be provoked into validating a novel legal theory even if the court does not ultimately side with the FTC.
Manufacturers of contact lenses may or may not want prescribers to be agnostic as to brand, but the U.S. Federal Trade Commission’s (FTC) contact lens rule requires that prescribers give the prescription to the customer when the eye exam is complete.
The U.S. Department of Justice (DOJ) reported the withdrawal of three legacy enforcement policies related to health care, including a 1996 policy that allowed hospitals to share the cost of capital equipment such as MRI systems. The announcement would seem to jeopardize the ability of smaller hospitals and other health care clinical sites to share the cost of these and other examples of costly, high-end equipment, but the damage may not stop there, thanks to the elimination of policies regarding medical information sharing that could impede medical research.
Fraud perpetrated on U.S. federal health care programs is the stuff of nightmares among U.S. enforcement agencies, and yet another pair of fraudsters have been rounded up by the Department of Justice (DOJ).
The U.S. Department of Justice (DOJ) reported an indictment of three men alleged to have filed more than $100 million in genetic testing false claims directly or indirectly with the Medicare program. Two of the three defendants face as many as 65 years of incarceration if convicted, a clear sign that federal government agencies in the U.S. are more intent than ever on cracking down on fraud and abuse of federal health programs.
