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HHS OIG Issues Open Letter On Changes In OIG Civil Fraud Settlement Policies and Practices

Client Alert | 1 min read | 11.21.01

On November 20, 2001, DHHS Inspector General Janet Rehnquist issued an open letter to health care providers announcing changes to certain Office of Inspector General ("OIG") civil settlement policies and practices in response to concerns expressed by providers.

One change is the development of eight criteria to be considered by OIG staff in determining whether, in a given case, it would be appropriate for the OIG to forego administrative exclusion without imposing a corporate integrity agreement or, if a corporate integrity agreement is deemed appropriate, what the substance of the agreement should be. A second change is the modification of the claims review process mandated in future and, where appropriate, existing corporate integrity agreements to require the use of full statistically valid random samples only in cases where an initial claims review has identified an unacceptably high error rate.
The letter also promises that the OIG will explore ways to increase reliance on providers' internal audit capabilities, and will be more flexible in other integrity agreement requirements, such as employee training.

The letter included two attachments further detailing the new claims review procedures: (1) a summary of the procedures; and (2) a list of frequently asked questions regarding the new procedures.

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Client Alert | 3 min read | 03.28.24

UK Government Seeks to Loosen Third Party Litigation Funding Regulation

On 19 March 2024, the Government followed through on a promise from the Ministry of Justice to introduce draft legislation to reverse the effect of  R (on the application of PACCAR Inc & Ors) v Competition Appeal Tribunal & Ors [2023] UKSC 28.  The effect of this ruling was discussed in our prior alert and follow on commentary discussing its effect on group competition litigation and initial government reform proposals. Should the bill pass, agreements to provide third party funding to litigation or advocacy services in England will no longer be required to comply with the Damages-Based Agreements Regulations 2013 (“DBA Regulations”) to be enforceable....