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When Can Violation of a Condition of Participation Result in False Claims Act Liability? Update on Escobar’s Materiality Standard

Posted on November 17, 2016 by

In June, I published a blog article on a decision of the United States Supreme Court that appeared to change the law applicable to “false certification” in the 7th Judicial Circuit Circuit.  The Supreme Court decision in Universal Health Services v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016), (“Escobar”) opened the door to […]

Breaking News: Judge Says He Will Issue Ruling on November 22 Regarding DOL Proposed OT Rule!

Posted on November 17, 2016 by

As we reported recently, (see DOL Overtime Rule Update: Breaking News!!!!!) 21 States and multiple business groups have filed suit in the Eastern District of Texas seeking a delay in the implementation of the proposed OT rule set for December 1.   Yesterday, the judge assigned to that case advised the parties he will issue his […]

Western District of Wisconsin Ranks 3rd in Chapter 12 Farm Bankruptcy Filings

Posted on November 15, 2016 by

The harvest is plenty, but with corn at $3/bushel, soybeans at $9/bushel, and milk at $15-$16/hundred weight, the profits are few.  Did you know that in 2015 and 2016, the Western District of Wisconsin ranks 3rd (out of 94 federal judicial districts) for most Chapter 12 farm bankruptcy filings?  In 2015, the Western District of […]

Taxes Under a Trump Administration

Posted on November 11, 2016 by

Donald Trump won more than 270 votes in the Electoral College and thus on January 20, 2017 he is going to become the 45th president of the United States.  In anticipation of that event, congressional tax writers and proponents for tax overhaul are optimistically planning to move bipartisan tax legislation forward in the first part […]

False Claims Act Basics – Known Overpayment Becomes False Claim

Posted on November 7, 2016 by

The Federal False Claims Act (“FCA”) provides a very strong enforcement tool to the federal government.  The FCA also provides the opportunity for whistleblowers to bring “qui tam” cases and collect a portion of the recovery where false claims are proved against the federal government. FCA recovery was originally intended to provide a remedy against […]

Provider Self-Disclosure Decisions – Voluntary Disclosure Process

Posted on November 7, 2016 by

The decision whether or not to voluntarily disclose non-compliance to the government can be very difficult.  Not every case is clear. Clearly not every situation where there has been a billing error amounts to fraud or wrongdoing requiring use of the self-disclosure protocol.  Many overpayments that are identified through audit can be dealt with at […]

When Does An Overpayment Become Fraud? How Simple Inattention Can Expose You to Penalties for Fraudulent Activities

Posted on November 7, 2016 by

If you are involved in any way in the health care system, it should be obvious by now that the government has committed ever increasing resources to the prosecution of fraud and abuse cases. Simply put, from a governmental standpoint, prosecuting fraud and abuse is good business. Every dollar the government puts into pursuing health […]

Worker’s Compensation: Opt Out in Wisconsin?

Posted on November 4, 2016 by

In 2014 Oklahoma enacted a radical change to its workers’ compensation statute, and on September 13, 2016, the Oklahoma Supreme Court held that it violates the state constitution. The case is Dillard’s, Inc. v. Vasquez, 2016 OK 89. Some version of the Oklahoma legislative plan might be considered by the Wisconsin Legislature. This article explores […]

Recent Disability Discrimination Cases Outline Employer Responsibilities

Posted on November 3, 2016 by

Two recent decisions regarding disability discrimination have outlined an employer’s responsibilities when dealing with a potential claim of disability and need for accommodation.  These decisions offer reminders for employers of the importance of recognizing potential disability claims and addressing them promptly. In the first decision, the Eighth Circuit Court of Appeals concluded that an employee […]

Same Loan Application, Only Different

Posted on November 2, 2016 by

Last month the Bureau of Consumer Financial Protection (CFPB) quietly approved a revised and redesigned Uniform Residential Loan Application (URLA) for 2017 to allow for the collection of more information about the ethnicity and race of loan applicants. With some exceptions, Regulation B § 1002.5(b) generally prohibits a creditor from inquiring about the race, color, […]