Whistleblower’s Claim Survives Dismissal and Death

The Energizer Bunny has nothing on the whistleblower claim of Robert Cunningham.  Here’s what’s happened since Robert files his qui tam action against Millennium Labs back in 2009: the government declined to intervene; seven more whistleblowers filed related actions against Millennium; the government …

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Another Blow to Medicare “Self-Disallowance” Rule

You can tell by its name that you won’t like the Medicare “self-disallowance” rule.   The federal district court for D.C. didn’t like it, either, and gave a group of Banner Health hospitals summary judgment that the rule was invalid as applied to the group’s appeal. Medicare pays hospitals under the …

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Anti-Kickback Regs Near Approval, After Only 19 Years

The White House is reviewing proposed regulations to ease restrictions on certain financial arrangements between hospitals and physicians and on certain transactions between providers and patients.  The proposed regulations, received by the Office of Management & Budget on August 16, are certainly welcome to …

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The Law Doesn’t Forbid Submitting False Claims

An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims.   That made all the difference in an appeal of summary judgment in favor of a physician group that, according to the relator, failed to comply with …

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HHS Proposes 340B Dispute Resolution Process

From its inception the 340B program has been the subject of disputes between drug manufacturers and their safety-net hospital customers.  On August 12 HHS proposed an administrative process for resolving those disputes. Established in 1992, the 340B program requires manufacturers to enter into pharmaceutical …

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Policy for Employee Theft Including Forgery Doesn’t Cover Employee Forgery

A seller extends $90 million in credit to a customer, secured by letters of credit.  When the debtor can’t pay, the seller discovers the instruments are fakes, forged by its own employee.  Can the seller recover under a policy that covers employee theft, including forgery? Tesoro refinery sold fuel on …

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