Qui Tam/False Claims Act

Fraud and Compliance Forum

2017/10/04

Marc Stephen Raspanti will be speaking at the Fraud and Compliance Forum. His topic for presentation is on Medical Necessity and The False Claims Act. His co-presenters include John-David H. Thomas, J. Reginald Hill, and Jessica Sievert. The name of the presentation is titled, “Medical Necessity and the False Claims Act – Lions and Tigers and… Read more »

PBMs – Goliaths of Healthcare Operating in the Shadows

July 7, 2017

The Pharmacy Benefit Management (PBM) industry is the Goliath of healthcare. PBMs have a huge impact on prescription healthcare that is little understood outside of the pharmacy industry. According to a November 2016 report, PBMs in the United States have revenues of $423 billion, they experienced 11-16% growth between 2011 and 2016, and they employ… Read more »

Whistleblowers’ Should Seek Counsel – Not Line the Pockets of Short Sellers

June 29, 2017

A recent news article in the New York Times, “The Bounty Hunter of Wall Street,” featured Andrew Left, an “activist” short seller who receives leaked documents and other intelligence about publicly-traded companies from confidential sources. Armed with this information, short sellers leak negative information to the press. When the information negatively impacts the target company’s… Read more »

Strategic Perspectives: Government Rekindles Concerns about CMS’ MAO Overpayments

May 22, 2017

CMS estimated improper payments to Medicare Advantage Organizations (MAOs) to be 9.5 percent or $14.1 billion based on a national audit that reviewed 2013 payments. Of those improper payments, CMS estimated that 73 percent were the result of insufficient medical documentation submitted to support the diagnoses the MAOs submitted, according to an April 2016 Government… Read more »

Current Trends in False Claims Act/Qui Tam Whistleblower Litigation CLE

May 12, 2017

Marc Stephen Raspanti and Pamela Coyle Brecht will speak at the “Current Trends in False Claims Act/Qui Tam Whistleblower Litigation,” CLE presented by the SC Bar CLE Division, SC Federal Bar Association Qui Tam Section, and the Charleston School of Law. Marc will discuss, “Ten Practice Tips for Relators- Doing Your Best to File a Winning Qui Tam… Read more »

2016 False Claims Act Review: A Truly Extraordinary Year

April 1, 2017

As we head into the second quarter of an already turbulent 2017, it is worth reflecting on the truly extraordinary events of 2016. Of course, there was the hotly-contested, historic election in November, which may usher in sweeping changes to our nation’s healthcare system. Although the potential impact of these future changes remains to be… Read more »

A Practitioner’s Primer on History and Use of the Federal Anti-Kickback Statute

March 28, 2017

When Congress discovered that Great Depression-era employers were scheming to circumvent wage provisions in federal contracts, it enacted the first anti-kickback law, the Copeland Act, in 1931. The statute, which is still good law, prohibits federal building contractors and subcontractors from inducing their workers to “kick back” or return any part of the compensation to… Read more »

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