DOJ-HHS FCA Working Group Revived

By Health Capital Consultants, LLC

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On July 2, 2025, the Department of Justice (DOJ) and Department of Health & Human Services (HHS) announced during the American Health Law Association (AHLA) Annual Meeting that the agencies have reestablished a Working Group to “strengthen” their ongoing collaboration, specifically as relates to the False Claims Act (FCA).

This Health Capital Topics article discusses the Working Group’s priorities and the implications for providers. (Read more…)

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DOJ Intervenes in Fraud & Abuse Case Against Tennessee Hospital

By Health Capital Consultants, LLC

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On July 26, 2024, the U.S. Department of Justice (DOJ) filed a complaint in intervention against Murphy Medical Center, doing business as Erlanger Western Carolina Hospital, and Chattanooga-Hamilton County Hospital Authority, doing business as the Erlanger Health System and Erlanger Medical Center. The government’s complaint, filed in the U.S. District Court for the Western District of North Carolina, alleges that Erlanger violated the Stark Law, and subsequently submitted false claims to the Medicare program in violation of the False Claims Act (FCA).

CITE: https://www.r2library.com/Resource

This Health Capital Topics article reviews the allegations underlying the case. (Read more...) 

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UPMC: Settles Stark Law Case

By Health Capital Consultants, LLC

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On May 9th, 2024, the University of Pittsburgh Medical Center (UPMC), a large nonprofit healthcare system that owns a number of hospitals, medical practices, and other subsidiaries, announced that they would pay $38 million to settle a longstanding Stark Law case which had triggered a violation of the False Claims Act (FCA). The lawsuit claimed that several of UPMC’s surgeons ordered complex and unnecessary procedures to increase their earnings. 

CITE: https://www.r2library.com/Resource

This Health Capital Topics article will discuss the UPMC settlement and the allegations underlying the case. (Read more…) 

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DAILY UPDATE: ChristianaCare Settles FCA Lawsuit as Stock Markets Celebrate 2023 but Start Off Rocky in 2024

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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ChristianaCare agreed to pay $47.1 million to resolve illegal kickback allegations flagged by its former chief compliance officer.

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Markets: The stock market was closed yesterday to give investors time to celebrate New Year’s Day 2024. As the just passed old year, 2023, provided plenty of reasons to pop bottles and celebrate:

For example, global stock markets had their best year since 2019, and all three major US indexes finished the year higher than they started it, with tech company gains pushing the NASDAQ up the most. Even among tech giants, Nvidia was a standout, boosted by A.I. suddenly being everywhere.

But, all major markets are down as of this posting time, today.

CITE: https://www.r2library.com/Resource

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Refer a Colleague: MarcinkoAdvisors@msn.com

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Gifts that Violate the FCA Anti-kickback Statute

THE EIGHT [8] GIFTS

By Staff Reporters

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Much like the False Claims Act, the Anti-Kickback Statute (AKS) remains a frequent tool used by the Department of Justice to investigate the healthcare industry. Unlike the False Claims Act, the AKS imposes criminal penalties on violators.

FCA: https://medicalexecutivepost.com/2022/03/28/doj-recoveries-for-false-claims-act-cases-doubled-in-2021/

CITE: https://www.r2library.com/Resource

The leaders of a physicians’ practice may be held liable for what others in the practice do, even if the leader did not know precisely what was going on. It has been called the “crime of doing nothing.”

1. Providing free dinners or lunches to physicians

2. Travel expenses paid to physicians

3. Entering into consulting or research agreements with physicians under which payments are made but minimal (or zero) work is done in return

4. Other gifts, such as electronics or tickets to sporting events 

5. Laboratory pays a specimen processing fee to physicians above the fair value for those fees

6. Physician retention or recruitment agreements, when those agreements provide for payments above fair market value or are made with the intent to induce Medicare referrals

7. Agreements for speaking or teaching where the payments are above fair market value or made with the intent to induce referrals

8. Discount schemes that do not meet the safe harbor requirements

Source: Sara Kropf and Logan Lutton, Physicans Practice

STARK LAWS: https://medicalexecutivepost.com/2023/04/18/podcast-the-anti-kickback-and-stark-laws-for-doctors-and-hospitals-explained/

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ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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Hospital Settles False Claims Act Allegations for $18.2 Million

BY HEALTH CAPITAL CONSULTANTS, LLC

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Hospital Settles False Claims Act Allegations for $18.2 Million


On December 2, 2021, the U.S. Department of Justice (DOJ) announced that it had entered into an $18.2 million settlement with Flower Mound Hospital, a 91-bed hospital located northwest of Dallas, to resolve claims that the hospital had violated the Stark Law, the Anti-Kickback Statute (AKS), and the False Claims Act (FCA) by making improper inducements to referring physicians. This Health Capital Topics article will review the facts underlying the settlement. (Read more…)

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PODCAST: https://medicalexecutivepost.com/2021/08/28/podcast-stark-and-aks-final-rules/

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