In a March 3, 2020, speech by Attorney General Bill Barr, the Department of Justice (DOJ) announced a new nursing home enforcement initiative targeting “grossly-substandard” care of Medicare and Medicaid beneficiaries in nursing homes nationwide. The DOJ, in partnership with the U.S. Department of Health and Human Services, will also seek to enhance enforcement of
If the CFPB is Unconstitutional, Can Its Prior Actions be Unwound?
There are widespread expectations that the Supreme Court, following an oral argument last week, may rule that part of the law that created the CFPB is unconstitutional. As a result, many business executives, in particular, have been asking their lawyers about the likely impact of such a ruling. These questions have included ones like: Could
Value-Based Purchasing and the False Claims Act: Tenth Circuit Finds Falsified Quality Data Immaterial Under Escobar
Last month, the Tenth Circuit upheld a grant of summary judgment in U.S. ex rel. Janssen v. Lawrence Memorial Hospital, 2020 WL 594508 (10th Cir. Feb. 7, 2020), applying the “rigorous” and “demanding” standard of materiality for False Claims Act (“FCA”) cases established by the Supreme Court in Escobar. In Janssen, the relator alleged that
3rd Circuit Case of First Impression Clarifies Lower Threshold for FCA Actions
Government contractors should take note of a March 4, 2020, ruling by the 3rd U.S. Circuit Court of Appeals (Court) that lowers the jurisdictional threshold for establishing a claim under the False Claims Act (FCA).
The 3rd Circuit’s decision in Druding v. Care Alternatives revived an FCA claim that the U.S. District Court for the District of
Fintech Company Avoids Murky Regulatory Landscape by being the First U.S. Fintech Company to Acquire a Regulated Bank
For the first time, a U.S. fintech company is acquiring a regulated U.S. bank, which will give it access to a stable and cheaper source of funding – as well as a national bank charter.
On February 18th, LendingClub, one of the largest providers of personal loans in the U.S., announced that it will pay
Federal Court Upholds CMS’ Use of Extrapolation to Claw-Back Improper Payments
A recent federal court decision should serve as an important reminder to providers that the Centers for Medicare and Medicaid Services (“CMS”) and its contractors have substantial authority to audit provider Medicare claims and to broadly apply extrapolation to calculate overpayments. In Palm Valley Health Care, Inc. v. Azar, No. 18-41067, 2020 BL 14097 (5th
FINRA 2.0: FINRA Releases Its 2020 Risk Monitoring and Examination Priorities
FINRA’s examination program has undergone its most significant reorganization in decades. As stated in a press release, Oct. 1, 2018, FINRA’s goal for the reorganization was to “consolidate its Examination and Risk Monitoring Programs, integrating three separate programs into a single, unified program to drive more effective oversight and greater consistency, eliminate duplication and
SEC 2020 National Exam Program Examination Priorities
On January 7, 2020, the Securities and Exchange Commission’s Office of Compliance Inspections and Examinations (OCIE) released its 2020 examination priorities. OCIE is prioritizing practices, products, and services that it believes present heightened risks to investors or market integrity. The examination priorities are organized around seven themes, many of which build on OCIE’s priorities
SEC Continues Compensation Disclosure Focus With FAQs and Enforcement
On Oct. 18, 2019, the Securities and Exchange Commission (SEC) Division of Investment Management staff published Frequently Asked Questions Regarding Disclosure of Certain Financial Conflicts Related to Investment Adviser Compensation (FAQs). Many in the industry view the FAQs as overdue SEC guidance in an area that has been a focus of the SEC Division of
OIG Redesigned Hotline Webpage
The Office of Inspector General (“OIG”) recently launched a new, redesigned hotline webpage to better guide the public through the tip and complaint reporting process. The OIG hotline operations accepts tips and complaints from all sources regarding potential fraud, waste, abuse, and mismanagement in the U.S. Department of Health and Human Services’ (“HHS”) programs. The