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U.S. Justice Department Takes Tough Stance on MA Medicare Fraud in the Cases Against Kaiser Permanente

DOJ recently joined forces with numerous private plaintiffs against healthcare giant Kaiser Permanente. The original whistleblower lawsuit, filed under the qui tam provisions of the False Claims…

The Inspector General’s Strategic Plan for 2020-2025

In addition to fighting fraud, HHS-OIG performs a myriad of other functions that are worth mentioning. In its Strategic Plan for 2025, it articulated a…

OIG Is the Fulcrum in the Fight Against HSS Program Fraud

The U.S. Department of Health and Human Services (HSS) provides over $1 trillion in health and human services to the American people. Every day, more…

Paying Physicians to Draw Blood and Process Samples Can Be an Illegal Kickback – U.S. V. Mallory

In U.S. v. Mallory, the 4th Circuit Court of Appeals issued a recent opinion regarding violations of the Federal Anti-Kickback Statute and involving Medicare Fraud. …

What Does “Materiality” and “Scienter” Have to Do With the False Claims Act?

A Falsehood Must be Material to be Actionable If a falsehood did not have any impact on whether the government decided to pay a benefit,…

Healthcare Fraud Risk Framework

Healthcare Fraud can take multiple forms.  The quintessential Healthcare Fraud schemes include fraudulent billing for services not provided, billing for services provided but were not…

FDA APPROVES FIRST DRUG TO TREAT ALZHEIMER’S IN 17 YEARS

On June 7th, 2021, the FDA approved Biogen’s Aduhelm (aducanumab) for the treatment of Alzheimer’s disease, the first drug approved to treat Alzheimer’s in 17…

What is the Daubert Standard as it Relates to Expert Testimony?

Why Do We Sometimes Need Expert Witnesses to Resolve Legal Disputes? The standard legal reason that judges typically give to juries as to why an…

When is Expert Testimony Considered “Rebuttal” Testimony?

United States ex rel. Montcrieff v. Peripheral Vascular Associates – Part II In this blog post, we review one of the issues in Montcrieff: the…

Published Articles

Nolan Auerbach lawyers serve as respected leaders and expert sources for Medicare fraud and other healthcare qui tam lawsuits. Published articles written by our attorneys include:

Our Firm In the News

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When should patients be admitted to a hospital through the ER?

NPR Marketplace

On October 20, 2022, Ken Nolan commented on National Public Radio concerning the balance between comprehensive but reasonable and necessary care, versus overutilization, in the context of hospital admissions from EDs.

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HCA faces over-admission allegations that have gotten other Nashville hospital systems in trouble

WPLN News Nashville

On October 11, 2022, Ken Nolan was quoted generally about overutilization, in a piece on National Public Radio concerning allegations of FCA violations against Hospital Corporation of America.

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$168 Million Payout to Johnson & Johnson Whistleblowers

CNN Money

The $2.2 billion settlement between Johnson & Johnson and authorities means a record payout for whistleblowers. Joe Strom, a former employee of Johnson & Johnson subsidiary, Scios, will receive the entire $28 million awarded in California. He first brought suit against J&J in 2005 and ultimately helped government…

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Nurse Pleads Guilty to Taking Kickbacks From Drug Maker

The New York Times

A Connecticut nurse has pleaded guilty to federal charges of accepting $83,000 in kickbacks from Insys Therapeutics, an Arizona drug manufacturer that sells the powerful painkiller Subsys. According to federal prosecutors, the nurse worked in a pain clinic and was a top prescriber of Sybsys to Medicare patients…

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High Court Ruling on FCA Limitations Period, Bar on Filings Gives Providers Mixed Result

Bloomberg BNA

On May 26, 2015 a unanimous decision was announced by the U.S. Supreme Court that said a strict six-year limitations period applies to civil actions brought by whistle-blowers under the False Claims Act.

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What Happened After She Helped Nurse at Catholic Healthcare Blow Whistle on her Employer?

Law.com

A settlement agreement between Dignity Health and the Justice Deparment was announced on October 30, 2014 for $36.7 million. The whistleblower in this case, Kathleen Hawkins, a registered nurse who worked as a director of medical management at Catholic Healthcare

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