BC Advantage - 2019 Issue 3
Welcome to 2019 Sessions Granston and Brand Memos with Insight to the Justice Manual
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Article Overview
This article explains recent Department of Justice policy developments and how they relate to the Justice Manual, agency guidance, and healthcare fraud enforcement. It is aimed at readers who follow compliance, fraud and abuse enforcement, and False Claims Act litigation involving healthcare providers and suppliers. The discussion covers DOJ’s treatment of guidance documents, litigation use of agency materials, and broader implications for federal enforcement activity and related healthcare compliance issues.
Why This Topic Matters
It helps healthcare compliance and legal professionals understand how DOJ policy shifts may affect enforcement theories, litigation posture, and the handling of agency guidance in civil and criminal fraud matters.
Article Sections
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Justice Manual and Sessions Memorandum
Introduces the DOJ policy shift and the revised Justice Manual framework for agency guidance documents. It also places the Sessions memorandum in the context of broader federal enforcement and rulemaking practices.
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Brand Memorandum
Summarizes the Brand memorandum and its relationship to DOJ reliance on agency guidance in enforcement matters. The section focuses on how federal guidance materials are treated in civil and criminal cases.
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Impact of the DOJ’s Position in Civil and Criminal Healthcare Fraud Cases
Discusses the relevance of these DOJ policy changes to healthcare fraud investigations and litigation. It frames the significance for providers, suppliers, and compliance-focused organizations.
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Justice Manual, § 1-19.000 – Limitation on Issuance of Guidance Documents
Reviews the Justice Manual provisions addressing how DOJ components issue non-binding guidance. The section describes the types of materials that fall within or outside the article’s discussion of guidance documents.
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Justice Manual § 1-20.000 – Limitation on Use of Guidance Documents in Litigation
Covers the Justice Manual provisions concerning the use of agency guidance in DOJ litigation. It includes discussion of healthcare-related agency materials and their role in enforcement contexts.
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Conclusion
Summarizes the practical implications of the DOJ policy changes and related CMS activity. The section closes with broader observations about healthcare compliance and future enforcement trends.
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Granston Memorandum
Explains the Granston memorandum and its role in DOJ False Claims Act dismissal policy. It discusses the memorandum in the context of qui tam litigation and government enforcement strategy.
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Post-Escobar Materiality and Qui Tam Litigation
Addresses materiality issues in False Claims Act litigation after Escobar and related case law. The section connects those themes to government dismissal considerations and relator risk.
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Current Circuit Approaches and an Idaho Dismissal Example
Compares differing appellate approaches to DOJ dismissal authority and references a specific district court dismissal example. This section illustrates how those standards may affect qui tam cases going forward.
What You Will Learn
- How DOJ policy memoranda relate to the Justice Manual
- How agency guidance is treated in enforcement and litigation contexts
- Why these developments matter in healthcare fraud and False Claims Act matters
- How DOJ dismissal authority may affect qui tam litigation
- How post-Escobar materiality issues are discussed in the article
- How the article frames compliance implications for healthcare providers and suppliers
Who Should Read This
- Healthcare compliance professionals
- Healthcare attorneys
- False Claims Act practitioners
- Fraud and abuse investigators
- Healthcare providers and suppliers
- Medicare and Medicaid compliance staff
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