Pietragallo partner Marc S. Raspanti will be speaking at the upcoming American Bar Association’s April 25-27, 2022 False Claims and Qui Tam Trial Institute. Marc will be participating in an AseraCare Update: Insights into Objective Falsity in Litigation and Trials Panel and a Legislative Update Panel.
This event, taking place in Coral Gables (Miami), FL, will show how experienced trial counsel try a False Claims Act jury trial to verdict. Attendees get to be a part of the experience, observe the jury deliberations and gauge how jurors respond to the themes, evidence and arguments presented at trial. It’s all the benefits of a mock jury trial exercise at a fraction of the cost!
For more information, or if you’d like to attend, please visit https://ambar.org/fct2022 to register. Read More
On Monday, January 31, 2022, Pietragallo partner Pamela Coyle Brecht will be presenting on “The Dos and Don’ts of Medicare Advantage and Medicaid Managed Care: Lessons from Recent Enforcement Activity” at the HCCA’s Managed Care Compliance Conference.
This is an annual event for individuals who manage compliance at health plan providers. Learn the latest practices, share strategies, and connect with peers and mentors who face similar challenges.
For more information and to register, visit: https://lnkd.in/gyjX4U7X Read More
Pietragallo partner Timothy Hazel has been appointed the Board Chair of the Allegheny County Board of Property Assessment Appeals and Review (BPAAR). Tim will serve as the Board Chair for a one-year term.
The BPAAR is oversees assessment appeals and certify assessment appeal decisions concerning: the valuations of real property used by taxing authorities within the County for the purpose of levying taxes, and whether real property is exempt from real property taxation based upon the applicable law. The board is composed of seven members who are all appointed for three year terms. The BPAAR hears and decides all appeal hearings pursuant to the Board’s Rules (authority under the Allegheny County Home Rule Charter Article X Section 5).
Tim’s practice is centered in the real estate, construction, housing, retail, hospitality, and oil and gas industries. For nearly two decades, he has represented lenders, borrowers, developers, contractors, design professionals, big box retailers, landlords, and tenants in a myriad of transactions including:
land acquisition and divestiture;
project financing;
zoning and land use;
construction, project and design contracting;
leasing (industrial, commercial, retail and office);
organization and equity structuring;
oil and gas contracting and acquisition at all levels (upstream, mainstream and downstream); and
franchising.
About Pietragallo Gordon Alfano Bosick & Raspanti, LLP
Pietragallo Gordon Alfano Bosick & Raspanti, LLP is a multi-disciplined business and commercial litigation firm headquartered in Pittsburgh with five offices throughout Pennsylvania, Ohio, and West Virginia from which we serve our clients in all 50 states and the District of Columbia. Read More
Part 1 of this article series, published in the November 2021 issue of Compliance Today, outlined in general the American and Italian healthcare systems. Part 2, published in the December 2021 issue, outlined America’s primary healthcare fraud laws. Part 3 of this series outlines the Italian healthcare enforcement regime, criminal law, and the Anti-Corruption Act.
Italian enforcement against fraud and corruption, including in the healthcare field, has traditionally been reserved to criminal courts, with no specific effort to coordinate or combine these actions through civil remedies. In light of the largely state-funded healthcare system in Italy, government corruption is in the foreground of efforts to detect and prevent fraud, waste, and abuse in healthcare. Egregious scandals erupted in Italian healthcare sectors, especially in the 1990s. Perhaps the most notorious case involved Dr. Duilio Poggiolini, the Ministry of Health’s general manager of the pharmaceutical department whose fortune included gold, jewels, and paintings of enormous value.[1] Poggiolini was charged and arrested for using his position for personal benefit, and his sentence of seven and a half years in prison was reduced on appeal.[2] The scandal surfaced during an investigation, called “mani pulite,” by a pool of public prosecutors operating out of the Milan criminal court. They were able to pierce the veil of silence that long protected government corruption. While its success resulted from significant cooperation and solidarity among the prosecutors, their coordination was not officially structured as an institutional team.
Italy’s criminal law
Italian criminal law always has included crimes of government corruption. The Italian Criminal Code has been amended periodically, not only to increase the sanctions (as, for example, in the latest “Spazza-Corrotti” amendments in 2019), but also with the aim of criminalizing more subtle corruption than an outright offer of cash in exchange for favorable treatment by a public official. Read More
Takeaway:
For most companies, following the SHIELD or FTC practices are sufficient to establish a reasonable security program that should protect companies from civil liability or penalty. But companies storing large amounts of personal information, or valuable proprietary information, should consider even greater controls and protections.
Robinhood, a stock trading platform, was recently sued in connection with a significant data breach. When high profile companies like Robinhood experience loss to data breach, the glare of scary headlines is only a shadow of the cost to the company. Increasingly, companies are subject to litigation risk and the corresponding damages caused by a breach.
According to a class action lawsuit filed in Federal District Court in the Eastern District of New York, over 7 million individual records were revealed in the Robinhood breach. The lawsuit alleges negligence, breach of contract, breach of fiduciary duty, and other violations of state and federal law.
Plaintiffs point out that this type of breach was reasonably foreseeable, given all the news and information on data breaches in recent years. Plaintiffs claim that Robinhood had a duty to secure their personal information. That duty – plaintiffs allege – stems from users’ relationship with the Robinhood service and is actionable based on the Federal Trade Commission Act (FTC Act), which prohibits unfair practices in or affecting commerce, and New York’s SHIELD statute.
Plaintiffs say that Robinhood failed to implement adequate policy, procedure, and technical safeguards, as recommended by the FTC and SHIELD. If those laws create an affirmative duty and obligation for implementing a reasonable security plan, then Robinhood – and others – can be found liable and assessed damages for failure to do so.
What is a “reasonable security plan”? According to Plaintiffs, a reasonable plan includes:
data encryption
employee training
technological tools to defend systems against invasion
But what’s really recommended under SHIELD and FTC, and is that guidance enough to protect companies? Read More
Part 1 of this article series, published in the November 2021 issue of Compliance Today, outlined in general the American and Italian healthcare systems. Part 2 outlines America’s primary healthcare fraud laws. Part 3 of this series, to be published in the January 2022 issue of Compliance Today, will outline Italy’s fraud and abuse laws.
In America, the enforcement landscape is ever evolving. Compliance within this thicket of criminal, civil, and administrative laws and regulations can prove especially challenging. The most used fraud and abuse prevention tools include the federal Anti-Kickback Statute (AKS), the federal False Claims Act (FCA), state false claims acts (FCAs), Stark Law, and more recently the Physician Payments Sunshine Act. In addition to these laws, there are two important industry codes of conduct that govern behavior: the PhRMA Code on Interactions with Health Care Professionals, which covers the pharmaceutical industry, and the AdvaMed Code of Ethics, which covers the medical device industry.
Anti-Kickback Statute and its growing exceptions
The AKS is a powerful federal law that seeks to prevent financial considerations from interfering with the independent medical judgment and purchasing decisions of healthcare providers.[1] In general, this law prohibits a company or individual from offering a healthcare provider, such as a doctor or hospital, incentives (referred to as “inducements”) to encourage use of its products or services.More specifically, the AKS imposes criminal penalties on any person who knowingly and willfully solicits, receives, offers, or pays any “remuneration” (including any kickback, bribe, or rebate) directly or indirectly, in cash or in kind, to any person to induce that person to either:
refer an individual to a person for the furnishing of an item or service for which payment may be made in whole or in part under a federal healthcare program, or
purchase, lease, order, or arrange for or recommend the purchasing, leasing, or ordering of any good, facility service, or item for which payment may be made in whole or in part under a federal healthcare program. Read More
On Wednesday, November 10, Pietragallo partner Michael Morse will present on Laboratory Enforcement and Compliance at the 2021 HCCA Healthcare Enforcement Compliance Conference.
His panel will review recent case studies with a discussion of what those cases tell us about risks related to medical necessity and arrangements, discuss practical solutions and best practices for mitigating risk, and give updates on the Eliminating Kickbacks in Recovery Act.
To register, visit here https://www.hcca-info.org/conferences/national/2021-healthcare-enforcement-compliance-conference. Read More
This is Part 1 of a three-part series discussing the similarities and differences between the US and Italian healthcare fraud, waste, and abuse laws. Part 2 of this series will be published in the December issue of Compliance Today, and Part 3 will be published in January 2022 issue of the magazine.
The United States of America and the Italian Republic share many common ideals. America was named after Amerigo Vespucci, an Italian explorer.[1] The American Constitution is based on the principle of government “of the people, by the people, for the people.” The Italian Constitution embodies this same principle in the ideals of sovereignty to the people: “La sovranità appartiene al popolo.” As of 2003, almost 16 million Americans claimed to have had Italian heritage.[2] With shared values, our two countries have forged an indelible alliance. These allied nations work together as world leaders in responding to a wide variety of economic, political, medical, technological, and scientific challenges that confront a rapidly changing world.
A major challenge confronting both America and Italy is providing a healthcare system that extends medical treatment that is effective, innovative, devoid of fraud, and cost efficient. While the healthcare systems in America and Italy differ in many respects, they suffer from the same obstacles: fraud, waste, and abuse. Both countries take these problems seriously. For example, in America, the federal government recovered more than $2.2 billion in 2020 alone from healthcare fraud and false claims,[3] while in Italy the National Anti-Corruption Authority (Autorità Nazionale Anticorruzione) is actively monitoring, preventing, and responding to corruption, as well as issuing anti-corruption plans.
This article highlights laws enacted in America and Italy to combat fraud, waste, and abuse, showing important similarities as well as differences between these enforcement efforts. Given the close historical and commercial ties between America and Italy, including healthcare companies that regularly operate in both countries, all stakeholders involved in healthcare (i.e., Read More
Whether it is your job, a new relationship or for any other reason, relocation is a tricky issue. Pennsylvania has a stringent relocation statute, 23 Pa.C.S.A. § 5337, which creates a protocol to follow in order to accomplish a relocation.
The first step is to determine whether the move constitutes a relocation.
A relocation is defined as change in residence of the child which significantly impairs the ability of a non-relocating party to exercise custodial rights. Obviously, a move from Pittsburgh to Seattle would have a strong likelihood of filling into this definition. However, courts have found that local moves can also fall within the definition. Consider the case of a 50/50 schedule with both parents having equal opportunity to having the child before and after school. A move from Upper St. Clair to Butler could have the effect of impairing the other party’s custody rights.
If your move is a relocation, you cannot move without permission from the other parent or the court.
You are required to give the other parent 60 days’ written notice of your move. The notice is in the form of an affidavit including information such as your new address, reason for the move, and proposed custody schedule after the move.
What if the other party objects? In that event, the court will decide. The party proposing the relocation has the burden of establishing that the relocation will serve the best interest of the child as shown under the factors.
One important factor is the integrity of the purpose of the move. If the court believes that you are moving just to be further away from the other parent, it will hurt your chances. The court will also consider (1) the impact on the child; (2) the child’s family ties where they are and at the proposed location; and (3) the well-reasoned preference of the child given their level of maturity. Read More
Takeaway:
The Department of Justice will use the False Claims Act as the basis for exacting civil penalties against companies who’ve fraudulently procured federal dollars while knowingly choosing to permit business practices with unacceptable cybersecurity risk.
The Department of Justice (DOJ) is getting aggressive with cyber fraud. Lisa O. Monaco, the DOJ’s Deputy Attorney General over the Department’s Civil Cyber-Fraud Initiative (Initiative), announced recently that the DOJ will actively pursue companies who receive federal funds through federal government contracts, when they fail to follow cybersecurity practices. This type of fraud is all-too-common throughout the federal government’s supply chain. Civil penalties resulting from the DOJ’s new Initiative should be a deterrent for bad actors/contractors who refuse to invest in cybersecurity planning and risk management.
The DOJ will use the False Claims Act (FCA) as the basis for exacting civil penalties against companies who’ve fraudulently procured federal dollars while knowingly choosing to permit business practices with unacceptable cybersecurity risk.
Under the FCA, companies can be held liable if they knowingly cause a false claim to be submitted. The standard for knowing is defined as:
Actual knowledge,
Deliberate ignorance of the truth or falsity of the information, or
Reckless disregard of the truth or falsity of the information.
Notably, , whistleblowers who come forward and provide information about a violation are protected under the FCA, and even allows for the whistleblower to participate in the reward following recovery of a claim.
The purpose of the Initiative appears to be two pronged:
Encourage companies and individuals to disclose cybersecurity incidents and breaches.
Recover federal funds from contractors who are not following certain cybersecurity standards.
Those two prongs were emphasized in President Biden’s May 2020 Executive Order (EO) on cybersecurity. The EO promises to “bring to bear the full scope of its authorities and resources” to protect the Country’s cyber infrastructure and assets. Read More
