C&M Health Law

C&M Health Law

Analysis, commentary, and the latest developments in health care law and policy

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GAO Finds HHS Exceeded Authority in Implementation of Transitional Reinsurance Program

Posted in Exchanges, Health Care Reform & ACA, Uncategorized
The Government Accountability Office (GAO), in a letter to members of Congress, found that the implementation of the Transitional Reinsurance Program by the U.S. Department of Health and Human Services (HHS) violates the Affordable Care Act. The Transitional Reinsurance Program is one of three premium stabilization programs authorized by the Affordable Care Act (ACA), commonly… Continue Reading

Negating Elements for Kickbacks: District Court in the Fifth Circuit Grants Defendant’s Partial Summary Judgment Motion

Posted in Uncategorized
In a December 10 decision, the United States District Court for the Southern District of Texas granted partial summary judgment in favor of a pharmaceutical company in a qui tam action – holding that the Relators’ discovery responses demonstrated that they could not prevail at trial on certain FCA claims. Among other things, Relators alleged… Continue Reading

Subscribe to the New Blog Whistleblower Watch for False Claims Act Developments

Posted in Uncategorized
Over 40 percent of money recovered by the Department of Justice from False Claims Act (FCA) suits involve fraud against federal health care programs. More importantly, nearly 89 percent of all new FCA matters in 2014 originated qui tam lawsuits brought by whistleblowers. Developments in FCA jurisprudence have innumerable consequences for the health care industry,… Continue Reading