Category: Healthcare

Recent False Claims Act Settlement Should Put Treatment Centers on Notice

Late last month, the federal government announced a False Claims Act settlement with Summit BHC New Jersey, LLC, d/b/a Seabrook (“Seabrook”), a prominent New Jersey Drug & Alcohol Rehabilitation facility. The joint settlement with the New Jersey Attorney General’s Office, in the amount of $19,751,762.69, covered claims submitted by Seabrook under the Medicaid program and Department of Veterans Affairs benefit programs.

States Follow Federal Lawmakers in Bipartisan Focus on Private Equity

For at least five years, under both Republican and Democrat administrations, there has been a focus on private equity actors in the healthcare space. Since at least 2020, the Department of Justice (DOJ) has focused on private equity in enforcement efforts. In 2023, during the Biden administration, the Senate conducted a bipartisan investigation of the effect that private equity could have on the healthcare industry.

Whistleblowers – A Powerful Antidote to Private Equity Abuses in Healthcare?

Senate testimony focusing on the impact of the rising presence of private equity (PE) firms’ control of major healthcare providers touched on the “substantial overlap between the risks associated with private equity ownership of healthcare companies and the activities targeted by the False Claims Act (FCA), a federal law that establishes liability for individuals or companies that defraud governmental programs.” See O’Grady Statement.pdf (senate.gov).

Kaiser Scores First-to-File Dismissal in Medicare Advantage Fraud Suit

Medicare Advantage Organizations have come under increased fire as their parent companies continue to acquire more healthcare practices across the country.  Experts suggest that this vertical integration has led to inflated Medicare spending, with providers facing new pressure to diagnosis chronic conditions that fetch more money for Medicare Advantage plans.

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