Bass, Berry & Sims attorneys Matt Curley and Lisa Rivera shared insights for an article in Law360 Healthcare Authority outlining the use of the False Claims Act to target fraud among pharmacies. The article discusses this topic and other findings – such as uncertainty with the new presidential administration and certain court challenges to FCA provisions – from the firm’s 13th Annual Healthcare Fraud & Abuse Review.
“DOJ [Department of Justice] has made fighting the opioid epidemic a key enforcement priority in recent years, and with good reason,” Matt told Law360. “We have increasingly seen DOJ working up the distribution and supply chain to target pharmacies, hospitals and other healthcare providers.”
These “cases signal the government’s endorsement of this sort of FCA theory of liability,” Lisa added. “DOJ and whistleblowers undoubtedly will pursue CSA [Controlled Substances Act]-based FCA cases as potential high-dollar opportunities for recovery.”
Speaking about the likelihood that healthcare fraud will remain a priority for FCA enforcement, Matt stated, “Within the healthcare industry, we have continued to see DOJ and whistleblowers devote their efforts, in significant part, to False Claims Act lawsuits alleging underlying violations of the Anti-Kickback Statute, including concerns about physician compensation and improper referral income.”
The full article, “Feds Turn to FCA as Enforcement Weapon in Opioid Crisis,” was published by Law360 Healthcare Authority on March 11 and is available online (subscription required).
To access a copy of the Bass, Berry & Sims 13th Annual Healthcare Fraud & Abuse Review released in early March 2025, please click here. As a companion to this year’s Review, the firm will host a complimentary webinar on Thursday, March 20. The webinar will take a deeper dive into key focus areas covered throughout the Review. Click here to register.