nursing homeOn June 22, 2021, the Office of the Inspector General for the U.S. Department of Health and Human Services (OIG-HHS) released a comprehensive report on the impact of COVID-19 on Medicare beneficiaries residing in nursing homes for 2020.  While the results may not be surprising, they are still disturbing.  Overall, the report paints a tragic

Price GougingIn early March 2020, at the outset of the COVID-19 pandemic, former Attorney General William Barr instructed federal prosecutors to prioritize the “detection, investigation and prosecution of all criminal conduct related to the current pandemic.”  His memos from the early days of the pandemic made it clear that COVID-19 related wrongdoing would be a top

FraudA federal district court has rejected a novel attempt to impose False Claims Act (FCA) liability for Medicare billings based on a theory that the underlying purchase of the home healthcare agency submitting those billings was allegedly tainted by fraud.  The court’s decision delimits the scope of fraud that will support an FCA claim and

Recent Developments and Emerging Risks2020 was a unique year in the world of white-collar criminal investigations and prosecutions. In this two-session presentation, Thompson Hine’s compliance and white-collar team will review the enforcement risks created by the global pandemic and discuss what we expect to happen as the new administration begins to implement its enforcement priorities. We will also identify

PillsOn December 22, 2020, the Department of Justice’s (“DOJ”) Civil Division, Consumer Protection Branch, and five U.S. Attorneys’ Offices announced a groundbreaking civil enforcement action against Walmart Inc. (“Walmart”).  The 160-page complaint alleges that the world’s largest company (by revenue) and the operator of over 5,000 in-store pharmacies contributed to the national opioid crisis by

nursing homeSeveral months into the COVID-19 pandemic that has gripped the United States, it is well established that hotbeds for spread of the disease are nursing homes and other assisted living facilities. Tight quarters holding vulnerable populations is precisely the kind of environment in which the novel coronavirus thrives. That fact is made all the worse

On September 30, 2020, the Department of Justice (“DOJ”) announced its latest health care fraud take down, which was its first since the pandemic hit in March 2020. DOJ charged 345 doctors, medical professionals, owners/operators, and others with criminal health care fraud schemes implicating more than $6 billion in total alleged loss amount. Arriving six

Department of JusticeRecoveries and settlements in False Claims Act (FCA) cases by the U.S. Department of Justice (DOJ) have accelerated in recent months and appear to be poised to rise dramatically as DOJ follows spending related to the pandemic recovery and federal stimulus efforts and bring additional resources to bear. Thus far in FY 2020 (which closes

courthouse and moneyOn September 4, 2020, the Eighth Circuit affirmed Reuben Goodwin’s conviction for his role in a Medicare/Medicaid kickback scheme. Goodwin’s conviction was supported by evidence of his knowledge of the conspiracy and willful participation in the conspiracy. The Eighth Circuit’s decision serves to remind everyone the risks a conspiracy charge pose to even a potentially

FraudOn March 20, 2020, the Attorney General ordered the Department of Justice (“DOJ”) to prioritize oversight, investigation, and prosecution of misuse of federal funds distributed in response to the COVID-19 pandemic.[1] Now, almost six months later, the DOJ continues to examine instances of “COVID-19 Fraud” for possible civil or criminal prosecution. The DOJ’s prioritization