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PharMerica Settlements Highlight Potential for Dual False Claims Act and Controlled Substances Act Liability for Invalid Prescriptions

In the July/August 2015 issue of Rx Ipsa Loquitur, the newsletter publication of the American Society for Pharmacy Law (ASPL), Internal Investigations & White Collar Defense Principal Barbara Rowland, and Principal Matthew T. Newcomer, examine potential dual False Claims Act and Controlled Substances Act liability for Medicare Part D and Medicaid providers.

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FERC Administrative Law Judge Finds Market Manipulation in "Cross-Over"Case

An August 13, 2015 decision of a FERC Administrative Law Judge held that BP America Inc.engaged in market manipulation during a two and a half month period in violation of the Natural Gas Act and FERC regulations. The initial decision, which is subject to Commission review and eventual court appeal, marks another “case of physical for financial benefits" the sort of "cross-over" case involving both physical and financial energy markets that has been at the heart of questions over FERC's jurisdiction, which traditionally extends only to physical trading.

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HHS's Data Security Problem: Lessons for the Private Sector

Recently, the House of Representatives Committee on Energy and Commerce cataloged a series of potentially-serious data security failures at the Department of Health and Human Services (HHS). The Committee's report reveals, among other things, that HHS division systems have been hacked five times in the past three years, and traces the root of the problem to HHS's treatment of data security as subordinate to operational priorities.

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Heightened False Claims Exposure: 60-Day Period to Repay Begins When Overpayment is Suspected Rather Than Confirmed

In a significant decision this week affecting Medicaid and potentially Medicare healthcare providers, a U.S. District Court for the Southern District of New York held that federal False Claims Act (FCA) liability applies to providers that do not repay “identified overpayments” within 60 days of “when a provider is put on notice of a potential overpayment, rather than the moment when an overpayment is conclusively ascertained.”

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New Jersey Non-Profit Hospital Stripped of Tax Exemption Based on Ruling that Modern Non-Profit Hospitals Essentially Function as For-Profit Businesses

A recent court ruling has called into question some basic assumptions regarding the ability of not-for-profit entities to obtain certain tax exemptions. In AHS Hospital Corp. v. Town of Morristown, the Tax Court for the State of New Jersey recently ruled that Atlantic Health System Hospital Corporation, the parent company of Morristown Medical Center (collectively, Atlantic or the Hospital, was ineligible for exemption from state property tax. This ruling, if upheld, could cost the Hospital millions of dollars each year.

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Keeping Government Environmental Investigations Civil

In the lead article for the July 2015 issue of Business Crimes Bulletin, Internal Investigations & White Collar Defense Chair Ronald H. Levine, and Environmental Principal Michael C. Gross, review recent environmental prosecutions and offer best practice tips for responding to civil investigations and avoiding criminal prosecution.

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The Appointment of SEC Administrative Law Judges: Constitutional Questions and Consequences for Enforcement Actions

In a June 2015 article for Bloomberg BNA's Securities Regulation & Law Report, Principal Peter D. Hardy, and Associates Abraham J. Rein and Carolyn H.Kendall examine recent constitutional challenges to the Securities & Exchange Commission's (SEC) administrative proceedings and the administrative law judges (ALJ) that adjudicate them.

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Market Manipulation: Staying a Step Ahead

The article, in the April 2015 issue of Public Utilities Fortnightly, examines U.S. Federal Energy Regulatory Commission's (FERC) policing of fraud and market manipulation in energy markets, and notes that, "between 2007 and the end of 2014...FERC assessed civil penalties of $602 million and ordered disgorgement totaling almost $300 million."

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