Teva and DOJ May Reach Settlement in Closely Watched AKS Lawsuit -
On June 16, Teva Pharmaceuticals filed a request with the First Circuit Court of Appeals seeking to hold in abeyance its interlocutory appeal concerning...more
6/24/2024
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Fraud ,
Interlocutory Appeals ,
Kickbacks ,
Money Laundering ,
Sentencing ,
Settlement ,
Teva Pharmaceuticals ,
Vaccinations ,
Wire Fraud
Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme -
The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more
6/17/2024
/ Chronic Care Managment (CCM) ,
Coronavirus/COVID-19 ,
Damages ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
TRICARE ,
Uninsured Patients
DOJ Secures Plea in $50 Million Medicare Fraud and Kickback Scheme -
On April 26, the US Department of Justice (DOJ) announced that Manishkumar Patel pleaded guilty to charges related to a $50 million health care fraud and...more
5/6/2024
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Guilty Pleas ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Medicare Fraud ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Retaliation ,
Telemarketing ,
Whistleblowers ,
Wire Fraud
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
2/19/2024
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
False Billing ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Insurance Fraud ,
Mail Fraud ,
Medical Equipment ,
Medicare ,
Paycheck Protection Program (PPP) ,
Scams ,
Sentencing ,
TRICARE ,
Wire Fraud
Three Individuals Sentenced for $3.5 Million COVID-19 Relief Fraud Scheme-
On February 6, three individuals were sentenced for fraudulently obtaining and misusing Paycheck Protection Program (PPP) loans that the US Small...more
Home Health Care Owner Sentenced to Nine Years in Prison for Medicare Fraud Scheme -
This week, the owner of a home health company was sentenced to nine years in prison for orchestrating a nearly $2.8 million scheme...more
2/5/2024
/ CARES Act ,
Coronavirus/COVID-19 ,
Email ,
Fraud ,
Healthcare Fraud ,
Home Health Care ,
Identity Theft ,
Income Taxes ,
IRS ,
Medicare Fraud ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Sentencing ,
Social Security ,
Tax Fraud ,
Wire Fraud ,
Witness Tampering
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
12/18/2023
/ Coronavirus/COVID-19 ,
Criminal Conspiracy ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Food and Drug Administration (FDA) ,
Fraud ,
Indictments ,
Medicaid ,
Medicare ,
Money Laundering ,
Securities Fraud ,
Wire Fraud
DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence -
Mark Schena, the former president of Arrayit Corporation, a Silicon Valley-based medical technology company, was...more
10/23/2023
/ Conspiracies ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Emergency Use Authorization (EUA) ,
False Claims Act (FCA) ,
False Statements ,
Food and Drug Administration (FDA) ,
Healthcare Fraud ,
Investors ,
Kickbacks ,
Medicaid ,
Medical Technology Companies ,
Medicare Fraud ,
Restitution ,
Securities Fraud ,
Sentencing ,
Settlement ,
TRICARE ,
Wire Fraud
Co-Founder of Fraudulent Cryptocurrency Sentenced to 20 Years in Prison -
Karl Sebastian Greenwood, a citizen of Sweden and the United Kingdom and co-founder of the cryptocurrency OneCoin, was sentenced to 20 years in...more
9/18/2023
/ Blockchain ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Embezzlement ,
Fraud ,
Identity Theft ,
Misrepresentation ,
MLM Industry ,
Nonprofits ,
Sentencing
DOJ Announced Results of Nationwide COVID-19 Fraud Enforcement -
On Wednesday, August 23, 2023, the US Department of Justice (DOJ) announced the results of a coordinated, nationwide enforcement action to combat COVID-19...more
8/28/2023
/ Beneficiaries ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Enforcement ,
Fraud ,
Kickbacks ,
Medicare Fraud ,
Money Laundering ,
OIG ,
Public Health Emergency ,
Sanction Violations
Walgreens Medicaid Fraud Case Kicked Back to Trial Court -
On August 15, 2023, the US Court of Appeals for the Fourth Circuit issued an opinion reversing a district judge’s dismissal of False Claims Act (FCA) claims...more
8/21/2023
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicaid Act ,
Medicare ,
Money Laundering ,
Reimbursements ,
Trial Court Orders ,
Virus Testing ,
Walgreens
Former NBA Player Sentenced to 10 Years in Prison for Health Care Fraud -
Terrence Williams, a former NBA player, was sentenced to 10 years in prison for his participation in a scheme to defraud the NBA’s Health and...more
8/14/2023
/ Bitcoin ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
False Advertising ,
Federal Trade Commission (FTC) ,
Healthcare Fraud ,
Kickbacks ,
Misleading Statements ,
Money Laundering ,
NBA ,
Penalties ,
Reimbursements ,
Sentencing ,
Theft ,
Unfair or Deceptive Trade Practices
Government Brings FCA Action Against Laboratory Companies -
On July 18, 2023, the US Department of Justice (DOJ) announced it has filed a complaint against multiple laboratory companies and their owner, Patrick...more
7/24/2023
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Electronic Protected Health Information (ePHI) ,
False Claims Act (FCA) ,
Health Care Providers ,
Kickbacks ,
Laboratories ,
Medicare ,
Medicare Fraud ,
Virus Testing
$140 Million Healthcare Fraud Case to Be Retried -
On June 27, a Houston federal district court judge indicated that a $140 million healthcare fraud case, which ended in mistrial in December 2022 due to allegations of...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
5/30/2023
/ Blue Cross ,
Blue Shield ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Investors ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Wire Fraud
Two Men Sentenced for $1.6 Million COVID-19 Fraud Scheme -
On Monday, April 10, two brothers were sentenced for their participation in a COVID-19 fraud scheme. The scheme involved fraudulent applications for $1.6 million...more
Top Reasons for 2022’s Downward Trend in False Claims Act Recoveries -
Following the US Department of Justice’s (DOJ) release of statistics regarding FCA settlements and judgments for the 2022 fiscal year, Law360 spoke...more
2/20/2023
/ CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fees ,
Fraud and Abuse ,
Healthcare ,
Kickbacks ,
Medicare Advantage ,
Opioid ,
Private Equity ,
Proposed Amendments ,
Qui Tam ,
Settlement ,
Stark Law ,
Telehealth ,
Whistleblowers
$31 Million Medicare Fraud Scheme Results in Two Convictions -
On January 30, 2023, a federal jury found two Florida physicians guilty for their involvement in a scheme to defraud Medicare of over $31 million. The two...more
2/6/2023
/ CARES Act ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Customs and Border Protection ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Kickbacks ,
Medicare ,
Medicare Fraud ,
Paycheck Protection Program (PPP) ,
Settlement
Guilty Plea in $250 Million Federal Child Nutrition Fund Fraud Scheme -
A man from Brooklyn Park, Minneapolis, Minnesota, pled guilty for his involvement in a $250 million fraud scheme that exploited a federally-funded...more
1/30/2023
/ CARES Act ,
Coronavirus/COVID-19 ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
Forgery ,
Fraud ,
Guilty Pleas ,
IRS ,
Nursing Homes ,
Paycheck Protection Program (PPP) ,
Settlement
Medical Device Company to Pay Over $700,000 To Resolve Criminal Allegations -
On January 4, 2023, a criminal information was filed in the Southern District of Illinois, in which Jet Medical Inc. (Jet), a medical device...more
1/6/2023
/ Civil Monetary Penalty ,
Coronavirus/COVID-19 ,
Criminal Penalties ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Food and Drug Administration (FDA) ,
Fraud ,
Healthcare Fraud ,
Medical Billing Codes ,
Medical Devices ,
Medicare ,
Paycheck Protection Program (PPP) ,
SBA ,
Settlement ,
Tax Evasion
Pharmacy Owners Plead Guilty to COVID Fraud and Money Laundering Scheme -
Two New York men pled guilty for their alleged involvement in a complex money laundering conspiracy to launder proceeds from a fraudulent health...more
Modernizing Medicine to Pay $45 Million to Settle False Claims Act Allegations -
Modernizing Medicine Inc. (ModMed), a Florida-based electronic health record (EHR) technology vendor, has agreed to pay $45 million to...more
11/4/2022
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
Economic Injury Disaster Loans ,
Electronic Medical Records ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Settlement
Headlines that Matter for Companies and Executives in Regulated Industries-
Amici Seek Dismissal of Qui Tam Suit From High Court -
Various medical, business and legal organizations are asking the US Supreme Court to...more
10/28/2022
/ Amicus Briefs ,
Anti-Money Laundering ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Indictments ,
Motion to Dismiss ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Whistleblowers ,
Wire Fraud
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
10/10/2022
/ Anti-Competitive ,
Anti-Kickback Statute ,
Bid Rigging ,
Bribery ,
Caltrans ,
Contractors ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Discounts ,
Drug Pricing ,
Economic Injury Disaster Loans ,
False Statements ,
Fraud and Abuse ,
Healthcare Fraud ,
IRS ,
Medicare ,
Medicare Part D ,
OIG ,
Sanctions ,
Tyson Foods ,
Wire Fraud
COVID-19 Fraud Update: DOJ Prosecutes More than 150 Defendants, 95 Criminal Cases -
Since the inception of the CARES Act, DOJ’s Fraud Section has prosecuted over 150 defendants in over 95 criminal cases. The Fraud Section...more
9/30/2022
/ CARES Act ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Genetic Testing ,
IRS ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Payroll Expenses