NY Doctor Indicted for Medicare Fraud Related to Genetic Testing and Equipment

The government is continuing to take a close look at laboratory testing in the wake of the COVID-19 pandemic. On February 21, 2024, a federal grand jury in New Jersey issued a superseding indictment against a New York physician. The indictment claims the physician committed healthcare fraud and conspired to defraud the United States by …

6 Key Steps to Respond to a Health Care Investigation (and Related Issues)

Originally published in Healthcare Michigan, Volume 41,  No. 2 The United States Department of Justice (“DOJ”) and state law enforcement agencies have robust teams investigating and prosecuting health care fraud. Law enforcement often uses advanced data analytics and algorithmic methods to identify newly emerging health care fraud schemes. DOJ also employs nine regional strike forces located …

False Claims Act “Knowledge” Is a Subjective Standard

The Federal False Claims Act (“FCA”) allows private parties to bring lawsuits in the name of the federal government against defendants who allegedly “knowingly” present a false claim to the government for payment.  The question for courts has been what standard should be applied to evaluate a defendant’s “knowledge.”  The US Supreme Court recently clarified …

Supreme Court Issues Ruling on the Requisite Intent for False Claims Act Defendants

Originally published in Healthcare Michigan, Volume 40,  No. 7 A recent decision by the Supreme Court clarified the required intent for a defendant to be held liable under the False Claims Act.  According to the Court, the FCA’s scienter requirement refers to a defendant’s knowledge and subjective beliefs – not what an objectively reasonable person might have known …

Sixth Circuit Defines False Claims Standards

The Federal False Claims Act (“FCA”) imposes civil liability for presenting a false claim to the government for payment. The Federal Anti-Kickback Statue (“AKS”) prohibits medical providers from making referrals in return for “remuneration.”  In a recent decision by the Sixth Court of Appeals, the Court found that a hospital’s decision not to hire an …

U.S. Marketing Materials Can and Will Be Used Against You in a Canadian Court

Health Canada determined that Texas-based LE-VEL BRANDS, LLC (“Le-Vel”), broke the law by selling its weight loss products to Canadians without seeking product licenses for their natural health products. The products had been distributed in Canada for some time, and Health Canada had flagged no health concerns. In deciding to issue a stop-sale order, Health Canada relied upon …

Court Strikes Down Portions of Federal Regulations Concerning No Surprises Act

Last month, we published an article summarizing new surprise billing laws that prohibit nonparticipating providers from balance billing patients when the patient’s insurance company pays less than the provider’s usual and customary charge.  The Michigan law, known as the Surprise Medical Billing Law, has been in effect since last year.  The Federal law, known as …

DICKINSON WRIGHT’S HEALTH CARE PRACTICE GROUP ANNOUNCES CREATION OF ITS HEALTH CARE LITIGATION TASK FORCE

Dickinson Wright’s Health Care Practice group announces the creation of its Health Care Litigation Task Force. Our Health Care Practice Group is diverse in its representation of clients operating in the health care industry. While a traditional litigation attorney can handle routine matters, when facing complex health care litigation matters you need an attorney who …

Sixth Circuit Court of Appeals Rules that Retiree Health Benefits May be Terminated Based on Ordinary Contract Principles

In its latest case addressing retiree health benefits, the Sixth Circuit Court of Appeals has held that a collective bargaining agreement’s general durational clause controls when retiree healthcare benefits end. Zino v. Whirlpool Corp., 2019 BL 50961, 6th Cir. (2019). This is a new data point indicating that the Sixth Circuit has moved away from …

Ohio Expands Telemedicine to Include Teledentistry

Telemedicine is a relatively new concept that allows healthcare providers to treat patients via the Internet through varying technology platforms, such as FaceTime or Skype. While the practice initially started as a means for healthcare providers to treat patients in rural or remote areas who were far away from local health facilities or in areas …