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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Download the Healthcare Fraud & Abuse Review 2017, authored by Bass, Berry & Sims

The Healthcare Fraud & Abuse Review 2017 details all healthcare-related False Claims Act settlements from last year, organized by particular sectors of the healthcare industry. In addition to reviewing all healthcare fraud-related settlements, the Review includes updates on enforcement-related litigation involving the Stark Law and Anti-Kickback Statute, and looks at the continued implications from the government's focus on enforcement efforts involving individual actors in connection with civil and criminal healthcare fraud investigations.

Click here to download the Review.

Richard Arnholt and Kaitlin Harvie Author Article on Implied-Certification Theory

Westlaw Journal Government Contracts


January 11, 2016

Bass, Berry & Sims attorneys Richard Arnholt and Kaitlin Harvie authored an article for Thomson Reuters' Westlaw Journals 2015 U.S. Supreme Court Report, discussing the implied-certification theory at issue in Triple Canopy, Inc. v. United States ex rel. Badr, a case involving allegedly false claims submitted by a defense contractor for security services in Iraq. In the article, Richard and Kaitlin explore the ambiguity of the implied-certification theory and how the pending decision on the Triple Canopy petition for certiorari may help clarify the theory's viability and scope, particularly in light of the Supreme Court's recent grant of certiorari in the Universal Health Services v. United States ex rel. Escobar case, which addresses the same issues in the healthcare context. In Triple Canopy, the Fourth Circuit Court of Appeals adopted the implied-certification theory, relying on "common sense" and ignoring the express terms of the underlying contract to conclude that false presentment claims had been adequately pleaded against the contractor, even though payment was not conditioned on the provision allegedly violated. To complicate matters, other courts have rejected the theory, such as the Seventh Circuit in United States v. Sanford-Brown Ltd.

The full article, "Implied Certification in the Crosshairs: 7th Circuit Ruling Increases Likelihood of Supreme Court Review of False Claims Act Case," was published January 4, 2016, in Westlaw Journal Government Contracts and is available in the PDF below. Additionally, the article was published in more than 30 legal publications distributed by the publisher.

Download Document - Westlaw Journal Government Contracts (January 4, 2016)

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