Podcasts about False Claims Act

In this episode, Scott Becker talks with McGuireWoods partner David Pivnick about a major constitutional challenge to the False Claims Act, the potential impact on whistleblower lawsuits, and what it could mean for healthcare litigation and government recoveries.

In this episode, Scott Becker talks with McGuireWoods partner David Pivnick about a major constitutional challenge to the False Claims Act, the potential impact on whistleblower lawsuits, and what it could mean for healthcare litigation and government recoveries.

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In a move that feels ripped from a dystopian satire, the Justice Department is now using the False Claims Act (yes, the one meant to catch fraud) to go after universities and institutions with diversity programs. Because under the Trump administration, fighting racism is now considered racist, and DEI efforts are somehow the real threat to America. Let's be clear, this isn't about fraud. It's about targeting institutions Trump sees as too liberal, too inclusive, or just too inconvenient. It's red meat for the base and a direct attack on the communities already fighting for visibility and opportunity. Don breaks it all down...the legal tactics, the political theater, and what this crackdown on DEI means for the future of equity in education and beyond. This episode is brought to you by Zbiotics. Go to https://zbiotics.com/LEMON and use LEMON at checkout for 15% off any first time orders of ZBiotics probiotics. This episode is brought to you by Shopify. Sign up for your one-dollar-per-month trial and start selling today at SHOPIFY. COM/lemon This episode of The Don Lemon Show is sponsored by 120 Life. Go to https://120life.com and use the code, “D-O-N ” to save 20% This episode is sponsored by MSI Choices. Every woman deserves a choice. Rush your donation today to MSIUNITEDSTATES.ORG, or text "LEMON" to 511 511. Text Fees may apply. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Crowell's hosts Agustin Orozco and Jason Crawford speak with Crowell attorneys Simeon Yerokun and Katherine Quinn about DOJ's plan to aggressively use the FCA against illegal foreign trade practices. This episode includes discussion of common areas of FCA enforcement in cases involving allegations of customs fraud, and the hosts address steps that importers can take to mitigate risks. "Let's Talk FCA" is Crowell & Moring's podcast covering the latest developments with the False Claims Act.

On the surface, it was the perfect scam: kickbacks to docs in exchange for public speaking engagements, in order to induce them to prescribe drugs.That's apparently what Gilead Sciences thought.But a whistleblower blew the whistle, and Gilead admitted to paying hundreds of thousands of dollars to high prescribers of their HIV drugs to serve as speakers at programs at luxury restaurants.Famed whistleblower attorney Mary Inman, partner at Whistleblowers Partners, LLP, will report the savory details during the new live edition of Monitor Mondays, coming up at 10 a.m. EST on Monday, May 12.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Folan Houston, assistant general counsel for Zelis, will report on the news at the intersection of healthcare and congressional action.• Field Report: Dr. Drew Updike continues his reporting on recent efforts by the Trump Administration to prevent providers from undertaking gender-affirming treatments for America's LGBTQ+ population.

The False Claims Act is the government's primary tool for redressing fraud against the United States. A party violates the Act when they knowingly submit a false claim for payment to the government. If a party is found to have violated the False Claims Act, they could be liable for significant treble damages and civil fines. Needless to say, government contractors, who regularly submit claims for payment to the government, must keep up with False Claims Act trends. In this episode of Bona Fide Needs, Tirzah Lollar and Christian Sheehan of Arnold & Porter examine recent False Claims Act developments. They discuss how the Trump Administration has impacted False Claims Act enforcement, a recent constitutional challenge to the Act's qui tam provision, and they provide an update on the Department of Justice's Civil Cyber Fraud Initiative.

As political forces target Diversity, Equity, and Inclusion programs, companies reassessing their DEI strategies must tread carefully—because while the rhetoric has shifted, the law largely hasn't.Joining us on the Emerging Litigation Podcast is employment attorney Patice L. Holland of Woods Rogers, a Principal in the firm's, Roanoke, Va., offices, where she is co-chair of the Government & Special Investigations Practice. Patice unpacks what companies need to know as they reassess their Diversity, Equity, and Inclusion (DEI) initiatives in light of recent executive orders and rising political pressure. Patice explains that while the administration has moved to eliminate disparate impact liability and deprioritize federal enforcement, core legal protections under Title VII and state laws like Virginia's Values Act remain fully intact. Employers—especially federal contractors—face complex new certification requirements and exposure to potential False Claims Act liability, while private businesses must weigh operational risk, employee morale, and public perception in their decisions. We also examine the ripple effects across corporate America—from Costco and Apple, which continue to invest in DEI, to Target and Amazon, which scaled back initiatives and faced backlash. Patice offers a practical roadmap for compliance, emphasizing clear communication, leadership buy-in, and smart risk assessment. Listen in as we explore what executive orders really change about DEI law, how obligations differ for government contractors and private companies, the legal and strategic risks of altering DEI policies, and the real-world business consequences of staying the course—or stepping back.

When Your Life Sciences Are on the Line: False Claims Act by Morrison & Foerster LLP (MoFo)

Community Health Network, Inc. of Indiana (CHN) entered into an agreement with the Department of Justice (DOJ) in December 2023 to settle alleged violations of the False Claims Act. The settlement amount of $345 million was the largest settlement of its kind in history. Dave Hesselink, Managing Principal, SullivanCotter, A.J. Orille, Consulting Principal, SullivanCotter, and Mark Ryberg, Practice Leader, Physician Workforce, SullivanCotter, discuss the particulars of the 2023 CHN settlement with DOJ, with a focus on the valuation components. They also share some practical takeaways for health care organizations looking to maintain their physician compensation compliance programs. Sponsored by SullivanCotter.AHLA's Health Law Daily Podcast Is Here! AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Premium members. Get all your health law news from the major media outlets on this new podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.

Send us a textIn Fiscal Year 2024, the federal government collected $2.9 billion in False Claims Act settlements (FCA). In this episode, Captain Integrity Bob Wade explains what happened. Hear how the qui tam bar is still active, why Stark Law and Fair Market Value issues (FMV) are still very big issues for compliance, how the Department of Justice (DOJ) gives you credit for cooperation & self-reporting, a deep dive into the numbers from 2024, and some fun facts about the settlements. Learn more at CaptainIntegrity.com 

Andrew Bab, Partner & Co-Chair of the Healthcare Group at Debevoise & Plimpton LLP In this episode of M&A Science, Andrew Bab joins Kison Patel live in New York to dive into the fast-changing legal landscape facing private equity deals in healthcare. From emerging state-level regulations and reverse CFIUS to FDA policy shifts and CVR litigation, Andrew offers a masterclass in legal diligence and deal structuring. They also explore how political scrutiny and increasing regulatory complexity are driving the need for more proactive, buyer-led approaches in healthcare M&A. Things you will learn: How state-level regulation is changing the game for healthcare deals What private equity needs to know about DEI rollbacks and False Claims Act liability Impacts of recent Delaware case law and why some firms are leaving the state When to use CVRs in pharma M&A and the litigation risks they carry How new HSR rules and antitrust dynamics are shifting auction timelines _______________ What is the Buyer-Led M&A™ Virtual Summit This isn't just another webinar—it's an interactive experience designed to give you the tools and strategies to lead your M&A deals with confidence. This half-day event brings together corporate development leaders and M&A experts to explore Buyer-Led M&A™, showing how you can take control of every stage of the deal. Register Now: DealRoom.net/Summit ________ Episode Timestamps:  [00:01:30] Andrew's background and overview of Debevoise & Plimpton's healthcare practice [00:03:00] Regulatory updates: DEI rollbacks, reverse CFIUS, foreign direct investment [00:05:30] National security laws expanding into tech, steel, and social media [00:06:00] Antitrust enforcement differences between Trump and Biden administrations [00:09:00] Delaware case law: MFW, Molus, Crispo and corporate governance implications [00:15:00] State-level regulation of healthcare deals (e.g., CA OHCA, MA law) [00:18:30] FDA's AI guidance and post-Chevron court deference [00:21:00] CVRs in pharma: structuring, litigation risk, and buyer incentives [00:29:00] Put/call deal structures for PE–strategic healthcare partnerships [00:32:30] HSR form overhaul and implications for auction vs. proprietary deals [00:34:30] Increased scrutiny of PE under False Claims Act and integration risk [00:44:00] Political scrutiny of PE in healthcare and rising public pressure [00:47:00] “Craziest M&A moment” – Mercury in the House of Orion delays closing

No matter the approach one might take for debridement, wound care continues to be an attractive source for audits – they inevitably arise and fester. Case in point: Wachler and Associates, a prestigious law firm in Michigan, currently is representing clients in some 18 wound care audit cases.That is why RACmonitor, producers of Monitor Mondays, has invited Andrew “Drew” Wachler, founder of Wachler & Associates, to be the special guest during the next live edition of the venerable weekly Internet broadcast.The long-running broadcast will also include these instantly recognizable features:• Breaking News: Famed whistleblower attorney Mary Inman, partner at Whistleblower Law, will report about a False Claims Act (FCA) settlement involving a Medicare Advantage provider.• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Cate Brantley, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

President Trump's executive orders against diversity, equity, and inclusion (DEI) are back in effect after the U.S. Court of Appeals for the Fourth Circuit stayed a nationwide injunction, posing new compliance challenges for federal contractors. In this week's episode, Epstein Becker Green attorneys Nathaniel M. Glasser and Frank C. Morris, Jr., outline the implications for employers, focusing on the False Claims Act, whistleblower risks, and the need for certification of compliance with anti-discrimination laws. Tune in to learn what steps your organization can take to mitigate potential penalties and retaliation claims. Visit our site for this week's Other Highlights and links: https://www.ebglaw.com/eltw383 Subscribe to #WorkforceWednesday: https://www.ebglaw.com/subscribe/ Visit http://www.EmploymentLawThisWeek.com This podcast is presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

On this Ropes & Gray podcast, partners Greg Demers, Amy Kossak, Dan O'Connor, and associate Kendall Dacey provide updates on the SEC's whistleblower program, False Claims Act enforcement, and recent federal laws supporting survivors of workplace harassment. They also discuss significant Supreme Court decisions impacting whistleblower and discrimination claims, offering a comprehensive overview of what to expect in the months and years ahead.

Legal Team, we're finally back to Bravo — and it feels SO good! This week, we're tackling two wildly different legal sagas. First up, we're breaking down Mauricio Umansky's ongoing legal drama, where his past Sweetwater Malibu property lawsuit is now tangled in new PPP loan controversy. Then, we're diving into Karen Huger's (AKA The Grand Dame) fourth DUI case — from courtroom strategies to her sentencing and probation terms. Sit down and get cozy, there's plenty to unpack!    What's on the docket?  The Agency's PPP loan controversy explained  How the Sweetwater Malibu Property ties into the current case  What the False Claims Act means and how it applies  Key details of the lawsuit against The Agency — what's being demanded and its current status  Karen Huger's background and DUI history  Understanding negligent driving and failure to control speed  Highlights from Karen's trial  Karen's 2-year suspended sentence explained  Key differences between jail and prison    Access additional content and our Patreon here: https://zez.am/thebravodocket  The Bravo Docket podcast, the statements we make whether in our own media or elsewhere, and any content we post are for entertainment purposes only and do not provide legal advice. Any party consuming our information should consult a lawyer for legal advice. The podcast, our opinions, and our posts, are our own and are not associated with our employers, Bravo TV, or any other television network. Cesie is admitted to the State Bars of California and New York. Angela is admitted to the State Bars of Texas, Kansas, and Missouri.  Thank you to our incredible sponsors! OneSkin: For a limited time, you can try OneSkin with 15% off using code BRAVODOCKET at oneskin.co.   Rula: Connect with quality therapists and mental health experts who specialize in you at https://www.rula.com/bravodocket #rulapod   Skims: The Fits Everybody collection is available in sizes XXS to 4X. You can shop now at SKIMS.com and SKIMS stores. After you place your order, be sure to let them know we sent you! Select "podcast" in the survey and be sure to select our show in the dropdown menu that follows.   AquaTru: Go to Aquatruwater.com and enter code “DOCKET” “ at checkout for 20% off any AquaTru purifier!   Quince: Go to quince.com/docket for 365-day returns, plus free shipping on your order!   Pretty Litter: Go to prettylitter.com/bravodocket to save 20% on your first order and get a free cat toy.   Factor: Get started at factormeals.com/FACTORPODCAST and use code FACTORPODCAST to get 50% off your first box plus free shipping. Learn more about your ad choices. Visit megaphone.fm/adchoices

A clinical documentation integrity (CDI) professional who “knowingly … acts in reckless disregard of the truth or falsity of the information” may ultimately run into issues related to the federal False Claims Act (FCA).The Medicare Fee-for-Service (FFS) Compliance Program on the Centers for Medicare & Medicaid Service (CMS).gov website lists several CMS compliance programs designed to educate and support Medicare providers in “understanding and applying” FFS policies. If the hospital compliance department is not monitoring these resources, it would be prudent for CDI leadership to do so, according to CDI expert Cheryl Ericson, who will be the special guest during the next live edition of the long-running Monitor Mondays Internet broadcast.The venerable weekly Internet broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on the latest news concerning healthcare legislation.

In the realm of False Claims Act (FCA) enforcement, state attorneys general (AGs) are increasingly collaborating with federal authorities and fellow state AGs to address allegedly fraudulent activities. Companies operating across multiple states are under heightened scrutiny, particularly in the healthcare sector, where compliance with regulations is critical. The United States Department of Justice (DOJ) highlighted this collaboration with state AGs in its announcement of FCA recoveries last year, noting that DOJ is working closely with state AGs to recover funds for both federal and state Medicaid programs. There also has been increased coordination targeting third-party investors, such as private equity and venture capital firms, to ensure that they conduct thorough due diligence and maintain robust compliance programs when investing in healthcare companies. This increased coordination aims to hold all parties accountable, from healthcare providers to their financial backers, in preventing and addressing alleged fraud. In the latest episode of MoForecast, Morrison Foerster partners Carrie H. Cohen, global co-chair of the Investigations + White Collar Defense Group and State + Local Government Enforcement team, and Adam Braverman, a partner in the Investigations + White Collar Defense Group, examine the current dynamics of state AG enforcement under the FCA. They explore the implications of multijurisdictional investigations and the growing involvement of third-party investors in healthcare fraud cases. Their discussion provides valuable insights for companies navigating these complex legal challenges, highlighting the importance of proactive compliance measures and strategic responses to enforcement actions. Tune in to the podcast to gain a deeper understanding of the future of state AG enforcement in the FCA arena. MoForecast is a podcast series discussing enforcement and policy trends we can expect from the new presidential administration. This episode continues our focus on state AGs, which aims to provide valuable insights for in-house counsel, compliance professionals, and defense lawyers navigating the evolving landscape of state AG enforcement.

It's time for a critical reappraisal of President Carter. Joining me this week is Jim Barger, Jr., coauthor of the new book Jimmy Carter: River & Dreams, Rods, Reels, and Peace Deals, Plus the One that Got Away. Jim knew the late President and spoke about Jimmy Carter the angler, the environmentalist, and why he deserves another look. We also talk about Rosalynn, their relationship, and how fishing played into Carter's life in the White House and beyond. This is the conversation about a man sorely needed in the world right now.About the book:For more than half a century, and from Plains to Patagonia, Dr. Carlton Hicks fished with Jimmy and Rosalynn Carter, their group of loyal guides, and a merry band of best friends and anglers. In 12 stories set in 12 locations around the globe, Jim Barger Jr. and Hicks recount how President Carter and his lifelong friends changed the course of world history, all while casting flies and pursuing the perfect strike.About our guest:Jim Barger, Jr. is a nationally recognized trial lawyer who handles complex government investigations, particularly qui tam whistleblower litigation under the False Claims Act.  Straight out of law school, Jim won a ground-breaking $2 million settlement against a major health insurance company employing a then-novel legal theory under the tort of outrage; two years later, he set the record for the largest qui tam case in Alabama history, winning $24.5 million from Southerncare.  Jim holds the records for the largest home health fraud case in U.S. history, securing $150 million from Amedisys in 2014, and the largest hospice fraud case in U.S. history, securing $75 million from Vitas in 2017.  Jim has served as lead trial counsel in more than 100 qui tam whistleblower cases across the country, has testified as a healthcare fraud expert in federal court, and regularly consults with companies on healthcare compliance issues.  He has been quoted by The New York Times, The Washington Post, The Wall Street Journal, USA Today, NPR, and CNN.

In this episode of From Lawyer to Employer, Shipman attorneys Dan Schwartz and Emily McDonough Souza discuss the first 45 days of the Trump administration and its impact on labor and employment law. They dive into the latest executive orders on DEI programs, the implications of the False Claims Act for federal contractors, and recent legal challenges affecting workplace policies. The conversation also covers immigration enforcement, ICE workplace audits, and the latest developments from the NLRB and EEOC. Tune in for insights into what these changes mean for employers.

In this episode of Compliance Conversations, host CJ Wolfsits down with returning guest Sean McKenna, a Partner at Nelson Mullins and former Federal Prosecutor, to explore the critical issues at the intersection of healthcare law and compliance. From the challenges posed by the False Claims Act to the innovative use of data analytics in enforcement, Sean offers firsthand insights drawn from years of legal practice. Whether you're managing a compliance program or navigating regulatory challenges, this episode delivers actionable strategies and expert predictions for the future. What You'll Learn: - How evolving legal standards impact healthcare providers - The role of whistleblower initiatives in driving compliance - Data analytics as a game-changer in regulatory enforcement - Strategies to build and maintain effective compliance programs - Predictions for upcoming changes in healthcare law and regulation

Welcome back to another powerhouse episode of the GovCon Giants Podcast! Today, I sit down with Cara Wulf, a government contracts attorney at McCarter & English LLP, to tackle the critical legal issues surrounding subcontracting. Whether you're navigating subcontract percentages, compliance requirements, or the latest contractual updates, this episode is packed with insights that could save your business from costly penalties—or worse, legal trouble. We break down the False Claims Act, key subcontract templates, and the latest restrictions, including the ban on TikTok in federal contracts. If you're a small business or a seasoned contractor, understanding these legal nuances is the key to scaling successfully in government contracting. Cara shares insider strategies from both the government and private sector, helping you avoid common pitfalls and protect your bottom line. Stay tuned until the end—you won't want to miss these expert tips that could make or break your next contract! Linkedin: https://www.linkedin.com/in/cara-wulf-a9b7a518/  Company Linkedin: https://www.linkedin.com/company/mccarter-&-english-llp/  Website: https://www.mccarter.com/ 

In the unanimous decision of Wisconsin Bell, Inc. v. United States ex rel. Heath, the U.S. Supreme Court addressed the applicability of the False Claims Act (FCA) to reimbursement requests made under the E-Rate program, a federal initiative subsidizing internet and telecommunications services for schools and libraries. Justice Kagan delivered the opinion of the Court, holding that such reimbursement requests qualify as "claims" under the FCA because the government provides a portion of the funds disbursed by the program.

On this edition of the Security Weekly News: False Claims Act, Google Cloud PQC, Salt Typhoon, AI in SOC, Ivanti Flaws, ICS, DeFi and more! Visit https://www.securityweekly.com/swn for all the latest episodes! Show Notes: https://securityweekly.com/swn-453

On this edition of the Security Weekly News: False Claims Act, Google Cloud PQC, Salt Typhoon, AI in SOC, Ivanti Flaws, ICS, DeFi and more! Show Notes: https://securityweekly.com/swn-453

On this edition of the Security Weekly News: False Claims Act, Google Cloud PQC, Salt Typhoon, AI in SOC, Ivanti Flaws, ICS, DeFi and more! Visit https://www.securityweekly.com/swn for all the latest episodes! Show Notes: https://securityweekly.com/swn-453

On this edition of the Security Weekly News: False Claims Act, Google Cloud PQC, Salt Typhoon, AI in SOC, Ivanti Flaws, ICS, DeFi and more! Show Notes: https://securityweekly.com/swn-453

Based on AHLA's annual Health Law Connections article, this special series brings together thought leaders from across the health law field to discuss the top ten issues of 2025. In the third episode, Joe Wolfe, Attorney, Hall Render Killian Heath & Lyman PC, speaks with Ilene Albala, Partner, Goodwin Procter LLP, about how the new administration could reshape the health care fraud and abuse landscape. They discuss potential impacts on fraud and abuse enforcement and the False Claims Act in particular, possible challenges to the constitutionality of the False Claims Act, and the Anti-Kickback and Stark regulatory outlook. From AHLA's Fraud and Abuse Practice Group.Watch the conversation here.AHLA's Health Law Daily Podcast Is Here! AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Premium members. Get all your health law news from the major media outlets on this new podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.

In this episode, hosts Jason Crawford, Agustin Orozco, and Yuan Zhou discuss the evolving disclosure landscape and the various risks and rewards that contractors must weigh when deciding what to disclose, when to disclose, and where to direct the disclosure. "Let's Talk FCA" is Crowell & Moring's podcast covering the latest developments with the False Claims Act.

The award-winning Compliance into the Weeds is the only weekly podcast that takes a deep dive into a compliance-related topic, literally going into the weeds to explore a subject more fully. Are you looking for some hard-hitting insights on compliance? Look no further than Compliance into the Weeds! In this Compliance into the Weeds episode, Tom Fox and Matt Kelly explore the Trump Administration's summary of the Friday night firing of 17 US Inspector Generals. They explore the background and illegality of these firings, highlighting the critical role Inspector Generals play in the federal government by investigating fraud, mismanagement, and abuse. Furthermore, they discuss the implications for compliance professionals, comparing this situation to what would be deemed unacceptable in corporate settings. The conversation also touches on potential consequences, such as increased False Claims Act lawsuits and the problematic precedent set for the rule of law within federal agencies. Key highlights: The Friday Night Massacre: What Happened? Role and Importance of Inspectors General Comparisons to Corporate Governance Potential Consequences and Future Outlook Resources: Matt in Radical Compliance Tom Instagram Facebook YouTube Twitter LinkedIn Learn more about your ad choices. Visit megaphone.fm/adchoices

This week on Off the Shelf  Alex Canizares, partner at Perkins Coie, shares his thoughts regarding False Claims Act landscape for 2025, including the anticipated priorities of the Department of Justice in 2025.  Canizares also discusses the recent status of the legal challenge to theconstitutionality of the FCA's qui tam provisions.  He also addresses recent cybersecurity policy developments, including CMMC and CUI. Finally, Alex shares his thoughts and insights regarding the major governmentcontract policy trends and case law developments.  Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This week on Off the Shelf  Alex Canizares, partner at Perkins Coie, shares his thoughts regarding False Claims Act landscape for 2025, including the anticipated priorities of the Department of Justice in 2025.  Canizares also discusses the recent status of the legal challenge to the constitutionality of the FCA's qui tam provisions.  He also addresses recent cybersecurity policy developments, including CMMC and CUI.  Finally, Alex shares his thoughts and insights regarding the major government contract policy trends and case law developments.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Send us a textWhen is the violation of the Anti-Kickback Statute a False Claims Act liability? In this episode, Captain Integrity Bob Wade explains the scenario given a recent district court decision. Hear how the “But For” Causation Standard works under the False Claims Act (FCA) and Anti-Kickback Statute (AKS), how the language has changed under the Anti-Kickback Statute, why the issues brought forward were bifurcated, how sales reps played into the decision, and an analogy involving roller coasters & Cedar Point. Learn more at CaptainIntegrity.com 

New York health insurer Independent Health and its former executive reached a settlement that will amount to up to $100 million with the U.S. Department of Justice (DOJ) and a whistleblower over False Claims Act allegations that they made Medicare members appear sicker than they really were to get more money from the government, a practice known as risk adjustment fraud.Betsy Gaffney, former CEO of now-defunct vendor DxID, agreed to pay $2 million to resolve allegations she helped DxID mine patients' medical records for diagnoses that risk-adjust, nudging doctors to approve them up to a year after the patient visits, all while pocketing up to 20 percent of the additional revenue generated for Independent Health by these unsupported diagnoses.Reporting the lead story during the next live edition of Monitor Mondays will be famed whistleblower attorney Mary Inman, partner in the law firm Whistleblower Partners.More than four weeks since its last news broadcast, Monitor Mondays will return this coming Monday with a cadre of the smartest minds in healthcare auditing. You'll hear auditing news you won't find anywhere else – except here and in RACmonitor.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Cate Brantley, senior government affairs liaison for Zelis, will report on current healthcare legislation.Register now to listen to this exclusive news edition of Monitor Mondays; all this and more will be coming up at 10 a.m. EST on Jan. 13, 2024.

Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICDCM. Thanks to all of you for making this a Top 15 Podcast for 4 Years: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://blog.feedspot.com/medical_billing_and_coding_podcasts/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Sonal's 13th Season starts up and Episode 14 features a BONUS episode featuring #ComplianceCapers with Betty Hovey. It debuted on May 24, 2024 with a lively discussion on an Integrity Agreement involving a pharmacy and its pharmacist violating the False Claims Act. May 2024 episodes on Corporate Integrity Agreements were specially curated in advance and featured on Sonal's LinkedIn Live Events and Sonal's YouTube Channel. Sonal's LinkedIn Live event: ⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/events/compliancecapers-episode20-cias7198729622824394753/theater/ Sonal's YouTube Channel: ⁠⁠⁠⁠⁠⁠https://www.youtube.com/watch?v=yeyXMs7esXA&list=PLD5lAnNOMPGYjPJuU2nAq4ootNIdgGgwW&index=6&t=2s Thanks to HCPro®: Website: https://hcpro.com/ If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠PaintTheMedicalPicturePodcast@gmail.com⁠⁠ --- Support this podcast: https://podcasters.spotify.com/pod/show/sonal-patel5/support

In this episode, Jason Crawford, Agustin Orozco, and Will Tucker discuss U.S. ex. rel. Zafirov v. Florida Medical Associates LLC, the recent decision in which a court found the qui tam provisions of the False Claims Act to be unconstitutional. The hosts analyze the court's reasoning and consider its potential impact on FCA cases.   "Let's Talk FCA" is Crowell & Moring's podcast covering the latest developments with the False Claims Act.  

$23 million: that's the amount that the University of Colorado Health, also known as UCHealth, has agreed to pay to resolve False Claims Act allegations related to its seeking and receiving payment from federal healthcare programs for visits to its emergency departments.The university, headquartered in Aurora, was accused of falsely coding certain Evaluation & Management (E&M) claims submitted to the Medicare and TRICARE programs.Reporting the lede story during the next live edition of Monitor Mondays will be famed whistleblower attorney Mary Inman, partner in the law firm of Whistleblower Partners.Broadcast segments will also include these instantly recognizable features:• Monday Rounds: Dr. Ronald Hirsch, vice president of R1-RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Matthew Albright, chief legislative analyst for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Two government contractors agree to pay a total of $4.3 million to settle allegations that they violated the False Claims Act and forced the Army to overpay for IT hardware. The Justice Department says Dell Technologies and Iron Bow will each pay more than $2 million to resolve a Qui Tam lawsuit. DoJ says Dell and Iron Bow allegedly conspired to collude on solicitations under the Army's AMDC-3 contract. Justice says from 2020 to 2024 Dell operated a deal registration program, whereby it gave advantageous pricing to Iron Bow to sell certain Dell computer hardware products and then also submitted their own direct bids on the same solicitations that were more costly. Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Two government contractors agree to pay a total of $4.3 million to settle allegations that they violated the False Claims Act and forced the Army to overpay for IT hardware. The Justice Department says Dell Technologies and Iron Bow will each pay more than $2 million to resolve a Qui Tam lawsuit. DoJ says Dell and Iron Bow allegedly conspired to collude on solicitations under the Army's AMDC-3 contract. Justice says from 2020 to 2024 Dell operated a deal registration program, whereby it gave advantageous pricing to Iron Bow to sell certain Dell computer hardware products and then also submitted their own direct bids on the same solicitations that were more costly. Learn more about your ad choices. Visit podcastchoices.com/adchoices

What happens when a major defense contractor faces scrutiny for ethics and compliance violations? In this episode of Corruption, Crime, and Compliance, Michael Volkov dives into the high-stakes world of corporate accountability, exploring Raytheon's recent $428 million settlement with the U.S. Department of Justice. From fraudulent pricing to bribery and compliance lapses, we uncover the impact of these violations and the tough questions they raise about corporate governance, oversight, and ethical responsibility in high-stakes industries.Hear Michael talk about:Raytheon Company (Raytheon) -- a subsidiary of defense contractor, RTX (formerly known as Raytheon Technologies Corporation) — agreed to pay over $950 million to resolve the Justice Department's investigations into three areas of violation. The settlement addresses three main issues:A major government fraud scheme involving defective pricing on certain government contractsViolations of the Foreign Corrupt Practices Act (FCPA) the Arms Export Control Act (AECA) and its implementing regulations, the International Traffic in Arms Regulations (ITAR)As part of the settlement, Raytheon entered into a three-year deferred prosecution agreement (DPA) and agreed to the filing of criminal information in the District of Massachusetts charging Raytheon with two counts of major fraud against the United States. Raytheon admitted to engaging in two separate schemes to defraud the Department of Defense (DOD) relating to the provision of defense articles and services, including PATRIOT missile systems and a radar system. Separately, Raytheon entered into a three-year DPA in connection with a criminal information in the Eastern District of New York charging Raytheon with two counts: conspiracy to violate the anti-bribery provision of the FCPA for a scheme to bribe a government official in Qatar and conspiracy to violate the AECA for willfully failing to disclose the bribes in export licensing applications with the Department of State as required by part 130 of ITAR.The Justice Department's FCPA and ITAR resolution is coordinated with the Securities and Exchange Commission (SEC). Both DPAs require that Raytheon retain an independent compliance monitor for three years, enhance its internal compliance program, report evidence of additional misconduct to the Justice Department, and cooperate in any ongoing or future criminal investigations. Raytheon also reached a separate False Claims Act settlement with the Justice Department relating to the defective pricing schemes.ResourcesMichael Volkov on LinkedIn | X (Twitter)The Volkov Law Group

Send us a textUse the data early & often. In this episode, Captain Integrity Bob Wade explores the intersection of data analytics & the False Claims Act (FCA) with Mandy Asgeirsson, Director at BRG (Berkeley Research Group). Hear why it's really helpful to understand the data available in an FCA investigation, how to be creative in how you use the data to understand the case or allegations against you, why you should use the data proactively instead of just reactively, how data helps to tell the story, and a case where the data analytics shocked Mandy. Learn more at CaptainIntegrity.com

After processing the election and thinking through what it means for the future of the Supreme Court, Kate and Leah dig into a Voting Rights Act case newly added to SCOTUS's docket. They also tackle this week's cases on the False Claims Act, compensation for hospitals that treat low-income people, the Fair Labor Standards Act, and federal securities law. Follow us on Instagram, Twitter, Threads, and Bluesky

Each month, a panel of constitutional experts convenes to discuss the Court's upcoming docket sitting by sitting. The cases covered in this preview are listed below. Wisconsin Bell v. U.S., (November 4) – Telecommunications; Whether reimbursement requests submitted to the Federal Communications Commission’s E-rate program are “claims” under the False Claims Act. Advocate Christ Medical […]

A case in which the Court will decide whether reimbursement requests submitted to the Federal Communications Commission's E-rate program are “claims” under the False Claims Act.

Civil Procedure: Are reimbursement requests submitted to the E-rate program "claims" under the False Claims Act? - Argued: Mon, 04 Nov 2024 16:21:57 EDT

Each month, a panel of constitutional experts convenes to discuss the Court’s upcoming docket sitting by sitting. The cases covered in this preview are listed below.Wisconsin Bell v. U.S., (November 4) - Telecommunications; Whether reimbursement requests submitted to the Federal Communications Commission's E-rate program are “claims” under the False Claims Act.Advocate Christ Medical Center v. Becerra, (November 5) - Medicare; Whether the phrase “entitled ... to benefits,” used twice in the same sentence of the Medicare Act, means the same thing for Medicare part A and Supplemental Social Security benefits, such that it includes all who meet basic program eligibility criteria, whether or not benefits are actually received.E.M.D. Sales v. Carrera, (November 5) - Labor & Employment; Whether the burden of proof that employers must satisfy to demonstrate the applicability of a Fair Labor Standards Act exemption is a mere preponderance of the evidence or clear and convincing evidence.Facebook v. Amalgamated Bank, (November 6) - Corporations; Whether risk disclosures are false or misleading when they do not disclose that a risk has materialized in the past, even if that past event presents no known risk of ongoing or future business harm.Velazquez v. Garland, (November 12) - International and National Security; Whether, when a noncitizen's voluntary-departure period ends on a weekend or public holiday, a motion to reopen filed the next business day is sufficient to avoid the penalties for failure to depart under 8 U.S.C. § 1229c(d)(1).Delligatti v. U.S., (November 12) - Criminal Law & Procedure; Issue(s): Whether a crime that requires proof of bodily injury or death, but can be committed by failing to take action, has as an element the use, attempted use, or threatened use of physical force.NVIDIA Corp. v. E. Ohman J:or Fonder AB, (November 13) - Securities; (1) Whether plaintiffs seeking to allege scienter under the Private Securities Litigation Reform Act based on allegations about internal company documents must plead with particularity the contents of those documents; and (2) whether plaintiffs can satisfy the Act's falsity requirement by relying on an expert opinion to substitute for particularized allegations of fact.Featuring:Tyler S. Badgley, Senior Counsel, U.S. Chamber Litigation CenterKaren Harned, President, Harned Strategies LLCRobert S. Peck, President, Center for Constitutional LitigationCollin White, Of Counsel, Kellogg Hansen(Moderator) Sarah Child, Attorney, Jackson Lewis

Summary Eric Rubenstein and Ron Chapman join The Compliance Guy to discuss the implications of a recent dismissal of a False Claims Act case based on the appointment clause. The guys explore the historical context of key tam cases, the role of relators, and the complexities surrounding the appointment clause. The conversation delves into the differences between dismissals with and without prejudice, the potential for Supreme Court involvement, and the impact of venue shopping on key tam cases. The episode concludes with a discussion on judicial appointments and their political implications. Takeaways Qui Tams are a significant part of healthcare fraud enforcement. The appointment clause raises questions about the authority of relators. Dismissals with prejudice are nearly final and limit future actions. The Supreme Court may be interested in conflicting rulings on key tam cases. Venue shopping can dilute the strength of a case. Judges may make decisions that align with their career interests. The appointment of special counsels has constitutional implications. Relators can receive a larger share if the government does not intervene. Resource limitations often lead to the government declining key tam cases. Judicial decisions can reflect broader political agendas. 00:00 Introduction to Key Tam Cases and the Appointment Clause 07:03 Exploring the Appointment Clause and Its Implications 14:03 Dismissal with Prejudice vs. Without Prejudice 16:19 The Future of Key Tam Cases in the Supreme Court 24:13 The Impact of Venue Shopping on Key Tam Cases 30:29 Judicial Appointments and Political Implications

In this episode, Scott Becker interviews David Pivnick, Partner at McGuireWoods LLP, as they discuss the heightened activity at the Department of Justice and the Federal Trade Commission. David shares his perspective on government enforcement trends, the impact of the opioid crisis on False Claims Act cases, and what the legal landscape might look like […]

Summary In this conversation, Sean and his guests discuss various pressing issues in healthcare, focusing on the implications of HIPAA violations, the challenges of patient privacy, and the recent controversies surrounding the Epic EMR system. They delve into the complexities of unauthorized access to patient information, the role of AI in healthcare compliance, and the legal ramifications of the recent overturning of the Chevron deference. The discussion highlights the importance of statistical sampling in overpayment estimations and the evolving landscape of healthcare legislation, particularly in light of the False Claims Act. Takeaways Epic EMR's interoperability issues have led to legal challenges. HIPAA compliance is critical in protecting patient information. Unauthorized access to medical records is a growing concern. AI tools in healthcare require careful human oversight. Zero paid claims must be considered in overpayment estimations. The Chevron deference ruling will impact regulatory interpretations. The False Claims Act's provisions are under legal scrutiny. Veterans' support is crucial, especially in times of need. Healthcare professionals must prioritize patient privacy and compliance. The Epic EMR Controversy Explained The Future of the False Claims Act "Epic has not particularly been a company that plays well in the sandbox." "You can't just think that signing a waiver will protect you." Chapters Introduction and Context Setting 02:54 The Epic EMR Controversy 07:53 HIPAA Violations and Patient Privacy 14:59 Unauthorized Access and Compliance Challenges 20:02 The Impact of AI on Healthcare Compliance 24:56 Statistical Sampling and Overpayment Estimation 30:07 The Future of Healthcare Regulations 36:09 Closing Thoughts and Call to Action

They're baaaaaack! The Supreme Court's October term starts this week, and the howler monkey wing is ready to FSU. Down in Florida, Trump appointee Judge Kathryn Mizelle is doing her best Aileen Cannon impersonation. That story has an old school deep dive from Andrew into 13th century Saxony and beyond. And, for subscribers, we'll unpack an amazing grift in Oklahoma.   Links:   ABA Letter rating Mizelle “Not Qualified” https://www.americanbar.org/content/dam/aba/administrative/government_affairs_office/2020-09-08chair-rating-letter-to-graham-and-feinstein-re-nomination-of-kathryn-kimball-mizelle.pdf?logActivity=true False Claims Act, 31 U.S.C. Subchapter III https://www.law.cornell.edu/uscode/text/31/subtitle-III/chapter-37/subchapter-III US ex rel Clarissa Zafirov v. Florida Medical Associates https://storage.courtlistener.com/recap/gov.uscourts.flmd.364103/gov.uscourts.flmd.364103.346.0.pdf 2007 OLC Memo re Relators https://www.justice.gov/file/494641/dl?inline OKLAHOMA TRUMP BIBLES https://www.lawdork.com/p/oklahoma-ryan-walters-bible-inhalers OKLAHOMA RFP https://sde.ok.gov/ev00000555   Show Links: https://www.lawandchaospod.com/ BlueSky: @LawAndChaosPod Threads: @LawAndChaosPod Twitter: @LawAndChaosPod Patreon: patreon.com/LawAndChaosPod