Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Opting Out of Medicare: When and How to Do It
Medical Device Legal News with Sam Bernstein: Episode 11
Show Me the Money: New Study Confirms Hospice Saves Money for Medicare
An Unwanted Spotlight: DOJ Announces Hospice Fraud Is Top Priority
The Chartwell Chronicles: Medicare & Medicaid
Navigating EMTALA Rules
Heed Caution: Takeaways From the OIG's Advance Care Planning Report
Podcast: The End of the Public Health Emergency – What's to Come? – Diagnosing Health Care
Patient Steering and Charting
Telehealth Risk Report: What the Government Found
Do You Have a Backup? Building Redundancies Into Your Written Certification Process
Former NBA player Glen “Big Baby” Davis was sentenced to 40 months in prison after being convicted for his role in a scheme to defraud the NBA healthcare plan. Davis’ sentence comes almost a year after the scheme’s...more
Big Baby’s Big Foul: Former NBA Star Glen 'Big Baby' Davis Sentenced to 40 Months for Healthcare Fraud Scheme - On May 9, former Boston Celtics forward Glen “Big Baby” Davis was sentenced to 40 months in prison following...more
Cooperation Spares Former NBA Shooting Guard From Prison - Former National Basketball Association (NBA) shooting guard, Antoine Wright, was sentenced to time served after he pled guilty to conspiracy and aggravated...more
Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme - Steven Dorfman, the former chief executive officer and owner of the Florida-based healthcare company Simple Health, and John Sand, a former...more
Health Care Network Settles False Claims Act Allegations for $345 Million - Community Health Network Inc. (CHN) has agreed to pay $345,000,000 to settle allegations that it violated the False Claims Act (FCA) for knowingly...more
Two Individuals Indicted for Operating $25 Million Crypto-Fraud - On December 11, a federal court in California unsealed a superseding indictment, which charged two men with operating a $25 million cryptocurrency fraud...more
Hospital Executive and Three Physicians to Pay More Than $880,000 to Resolve Kickback Allegations - On Monday, December 4, 2023, a Lexington, Texas, hospital executive and three health care providers agreed to pay more...more
Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims - On September 27, 2023, Chief Judge Dennis Saylor of the US District Court for the District of Massachusetts ruled that...more
The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more
Recent Filings Shed Light on DOJ’s View of Supreme Court’s Recent FCA Ruling - On June 1, 2023, the US Supreme Court explained that an assessment of a defendant’s subjective beliefs — rather than what an objectively...more
Court Unseals Charges Alleging Nearly $15 Million in Fraudulent PPP Loans - Earlier this week, federal prosecutors in the Southern District of New York announced the unsealing of a criminal complaint charging six...more
Surgeon To Pay Up to $43 Million for FCA Fraud - A Michigan vascular surgeon, Vasso Godiali, was sentenced to 80 months in prison for defrauding health care programs in connection with his submission of false claims for...more
OIG Warns That Proposed Drug Discounts May Warrant Sanctions - On October 5, the US Department of Health and Human Services’ Office of Inspector General (OIG) issued an advisory opinion assessing a proposal that involved...more
The U.S. Department of Justice recently announced that a federal grand jury has charged two pharmacy owners, a mother-daughter duo from South Florida, with healthcare fraud, wire fraud, and payment of kickbacks in exchange...more
Medical Technology Company President Convicted for Participation in $77 Million COVID-19 and Allergy Testing Scheme - On September 1, 2022, the president of Arrayit Corporation, a medical technology company in Silicon...more
If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually...more
Jury Orders Eli Lilly To Pay $61 Million - A federal jury in Illinois found that, beginning around 2004, drug manufacturer Eli Lilly deliberately underpaid rebates to Medicare programs by excluding retroactive drug prices...more
The DOJ announced charges against 21 people across nine federal districts for their alleged role in pandemic-related fraud schemes resulting in over $149 million in false billings to federal programs. This is the largest...more
Florida Surgeon Who Saved Rapper 50 Cent’s Life Is Sentenced to Seven Years Imprisonment for Fraudulent Insurance Billing - In 2000, a Florida doctor, Moses deGraft-Johnson, was one of the surgeons who operated on 50 Cent...more
Texas Man Sentenced to More Than Nine Years in Prison for COVID-19 Fraud Scheme - After pleading guilty to two charges of wire fraud and money laundering, a Texas man was sentenced to 110 months in prison for his scheme to...more
CEO of Defunct Medical Testing Lab to Pay $1.1 Million to Settle FCA and AKS Case - Jae Lee, the former CEO of defunct Northwest Physicians Laboratory (NWPL), agreed to pay $1.1 million to resolve allegations that he...more
A Florida owner of telemedicine companies is charged with orchestrating a health care fraud and illegal kickback scheme that involved the submission of over $784 million in false Medicare claims. DOJ Charges Telemedicine...more
Urgent Care Provider and Management Company to pay $22.5 Million to End FCA Claims - South Carolina urgent care providers agreed to pay $22.5 million to resolve False Claims Act claims filed by two former employees. The...more
Judge Rules Against Seizure of $330 Million Allegedly Connected to 1MDB Fraud Scheme - On March 9, California District Court Judge Dale S. Fischer ruled that the government could not seize about $330 million in assets...more
Deutsche Bank to Pay Over $130 Million to Resolve Foreign Corrupt Practices Act and Fraud Allegations - Deutsche Bank Aktiengesellschaft (Deutsche Bank) has agreed to pay more than $130 million to resolve the government’s...more