The Brand Memo: Establishing “Reasonable and Necessary” In The Face Of DOJ’s New Mandate Prohibiting Reliance On Agency Guidance Documents
On January 25, 2018, the U.S. Department of Justice (DOJ) issued a memorandum that further limits its ability to rely on sub-regulatory guidance to establish legal requirements for health care providers. The memorandum prohibits DOJ from using the type of guidance it has historically relied upon to attempt to establish falsity in False Claims Act (FCA) cases involving issues of medical necessity. This memorandum, along with recent federal court decisions, supports the argument that the FCA is an inappropriate means by which to prosecute medical necessity cases, which require the application of the “reasonable and necessary” standard – a standard that is only defined in sub-regulatory guidance.
Circular Economy update: A short summary of the EU Commission’s 16 January 2018 Circular Economy package
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