The New Administrative False Claims Act Enhances Federal Agencies’ Power to Combat Fraud

The Administrative False Claims Act (“AFCA”), previously known as the Program Fraud Civil Remedies Act of 1986 (“PFCRA”) is an infrequently used, but related counterpart to the more well-known False Claims Act (“FCA”). The FCA is a widely used tool by the Department of Justice (“DOJ”) to prosecute false claims and statements in federal courts,…

Are you Checking the PMP Before Prescribing? Pharmacy Board Audits of PMP Data

The Arizona Controlled Substances Prescription Monitoring Program (“PMP”) was established in 2007 and provides the State of Arizona with a central database to track the dispensing of controlled substances.  The PMP is designed to assist providers in making better-informed decisions and help “prevent the diversion and misuse of controlled substances at the provider, pharmacy, and…

Emergency Rulemaking Expands AHCCCS’ Exclusion Authority

AHCCCS has broad authority to exclude participating providers from its program.  For example, AHCCCS may terminate a provider’s AHCCCS participation agreement if the provider fails to comply with their provider participation agreement, or with federal and state laws, rules, or regulations.  AHCCCS must also suspend payments pending an investigation of a “credible allegation of fraud”…