Seventh Circuit Reverses AKS Conviction Involving Allegations of Illegal Marketing and Advertising -
On April 14, the US Court of Appeals for the Seventh Circuit reversed the criminal conviction of Mark Sorensen after a...more
4/21/2025
/ Anti-Kickback Statute ,
Appeals ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Department of Veterans Affairs ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Healthcare Fraud ,
Medical Devices ,
Medicare ,
Money Laundering ,
Pharmacies ,
Physicians ,
Wire Fraud
FCA Complaint Filed Against One of Nation’s Largest Specialty Wound Care Providers -
On April 4, the government filed a complaint against Vohra Wound Physicians Management LLC, its founder, Dr. Ameet Vohra, and VHS...more
4/14/2025
/ Department of Justice (DOJ) ,
Enforcement Actions ,
Exports ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Investigations ,
Medicare ,
Money Laundering ,
Nursing Homes ,
Physicians ,
Price-Fixing ,
Russia
Jury Acquitted Lab Owners in Nearly $40 Million COVID-19 Fraud Case -
On March 27, a Florida jury acquitted two testing lab co-owners of conspiracy, health care fraud, and wire fraud charges. Innovative Genomics, LLC...more
4/7/2025
/ Bribery ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Healthcare ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Motion to Dismiss ,
Wire Fraud
Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses -
On March 26, the US Department of Justice (DOJ) announced that a California-based medical group and related parties...more
3/31/2025
/ California ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Imports ,
Medicare Advantage ,
Physicians ,
Settlement ,
Whistleblowers
Long Island Businessman Arrested in $22 Million Medicare Fraud Scheme -
A Long Island, New York, businessman was arrested on conspiracy, kickback, and money laundering charges stemming from an alleged scheme to defraud...more
Following a whistleblower complaint filed by Andrew Hersh in 2020, a Florida businessman, Patrick Walsh, and 10 companies he owned or operated entered into a civil settlement for over $20 million to resolve False Claims Act...more
With 2025 underway, the ArentFox Schiff White Collar team highlights the US Department of Justice’s (DOJ) new enforcement priorities and two cases pending before the US Supreme Court that could have sweeping implications for...more
3/12/2025
/ Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement ,
Enforcement Actions ,
Foreign Agents Registration Act (FARA) ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Money Laundering ,
National Security ,
SCOTUS ,
White Collar Crimes
Welcome to the Winter 2025 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and...more
Jury Clears SuperValu of Liability in Whistleblower FCA Prescription Pricing Case -
A federal jury in Illinois recently found SuperValu not liable in a whistleblower lawsuit that accused the company of overcharging the...more
3/10/2025
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Medicare Fraud ,
Prescription Drugs ,
SCOTUS ,
Settlement ,
Whistleblowers
Home Health Care Company to Pay $3 Million to Resolve FCA Allegations -
The US Department of Justice (DOJ) announced that Saad Enterprises Incorporated, operating as Saad Healthcare, agreed to pay $3 million to resolve...more
3/3/2025
/ Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Home Health Care ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Settlement ,
Skilled Nursing Facility ,
Whistleblowers
First Circuit Joins Sixth and Eighth Circuits in Adopting Heightened, But-For Causation Standard for AKS-Based FCA Claims -
On February 18, the US Court of Appeals for the First Circuit became the latest court to agree...more
2/24/2025
/ Anti-Kickback Statute ,
But For Causation ,
Causation ,
Compliance ,
Cybersecurity ,
DCIS ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare ,
Overpayment ,
Paycheck Protection Program (PPP) ,
Pharmaceutical Industry ,
SBA ,
Settlement ,
TRICARE
President Trump Puts a “Pause” on FCPA Enforcement -
On Monday, President Donald Trump signed an executive order (EO) pausing the enforcement of the Foreign Corrupt Practices Act (FCPA). According to the EO, the pause will...more
2/17/2025
/ Bribery ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Executive Orders ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicare Fraud ,
Securities and Exchange Commission (SEC) ,
Significant Transnational Criminal Organization ,
Trump Administration ,
White Collar Crimes
Ninth Circuit Reverses Dismissal of FCA Suit -
On Tuesday, the Ninth Circuit reversed the district court’s grant of Express Scripts’ motion to dismiss a whistleblower’s lawsuit accusing Express Scripts of defrauding the US...more
2/10/2025
/ Appeals ,
Ciminelli v US ,
Department of Defense (DOD) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Litigation Strategies ,
SCOTUS ,
Stays ,
Whistleblowers
Pfizer Settles Its Subsidiary’s Kickback Allegations for Nearly $60 Million -
Pfizer Inc. agreed to pay over $59,746,277 to resolve allegations that its wholly owned subsidiary, Biohaven Pharmaceutical Holding Company...more
2/3/2025
/ Acquisitions ,
Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare Part D ,
Mergers ,
Pharmaceutical Industry ,
Purdue Pharma ,
Sentencing ,
Settlement ,
Whistleblowers
Massachusetts District Court Judge Applies Heightened Causation Standard in FCA Case -
On January 6, a District Court of Massachusetts judge granted summary judgment for defendants on allegations of violating the...more
1/27/2025
/ Anti-Kickback Statute ,
Causation ,
Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Medicare Advantage ,
Opioid ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
SCOTUS ,
Settlement ,
Skilled Nursing Facility ,
Whistleblowers
DOJ Reports Nearly $3 Billion in FCA Settlements, Judgments for FY 2024 -
On January 15, the US Department of Justice (DOJ) reported that settlements and judgments under the False Claims Act (FCA) totaled more than $2.9...more
1/20/2025
/ Criminal Prosecution ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Investment Fraud ,
Medicare ,
Medicare Advantage ,
Pharmaceutical Industry ,
Pharmacies ,
Settlement ,
Whistleblowers ,
Wire Fraud
Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions -
In a brief filed earlier this week, the US federal government has urged the Eleventh Circuit Court of Appeals to uphold the...more
1/13/2025
/ Anti-Kickback Statute ,
Appeals ,
Appointments Clause ,
Article III ,
Constitutional Challenges ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
Misrepresentation ,
National Institute of Health (NIH) ,
Pharmaceutical Industry ,
Qui Tam ,
SCOTUS ,
Settlement ,
Stark Law ,
Unconstitutional Condition ,
Whistleblowers
Second Circuit Partially Affirms Novartis’ Motion to Dismiss AKS Claims -
Last week, the Second Circuit Court of Appeals affirmed the district court’s ruling that dismissed allegations from a whistleblower who claimed that...more
1/6/2025
/ Anti-Kickback Statute ,
Appeals ,
Department of Justice (DOJ) ,
Digital Assets ,
False Claims Act (FCA) ,
False Statements ,
Foreign Agents Registration Act (FARA) ,
Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Misleading Statements ,
Motion to Dismiss ,
New Regulations ,
Non-Fungible Tokens (NFTs) ,
Popular
California Doctor to Pay $3 Million for Insider Trading -
On December 18, a California oncologist agreed to pay the US Securities and Exchange Commission (SEC) $3 million to resolve allegations of insider trading. The SEC...more
12/23/2024
/ Bribery ,
California ,
Civil Monetary Penalty ,
Foreign Agents Registration Act (FARA) ,
Foreign Nationals ,
Insider Trading ,
Motion to Dismiss ,
Quid Pro Quo ,
SDN List ,
Securities and Exchange Commission (SEC) ,
Securities Exchange Act of 1934
Florida Telemarketer Sentenced to 15 Years in Prison for $67 Million Medicare Fraud Scheme -
On December 6, Jose Goyos was sentenced to 15 years in prison for his role in managing a deceptive telemarketing scheme to...more
12/16/2024
/ Beneficiaries ,
Department of Justice (DOJ) ,
Florida ,
Food and Drug Administration (FDA) ,
Insider Trading ,
Investors ,
Medicare Fraud ,
Money Laundering ,
Securities Fraud ,
Sentencing ,
Telemarketing ,
Wire Fraud
Welcome to the Fall 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and compliance...more
12/10/2024
/ Advisory Opinions ,
Anti-Kickback Statute ,
Artificial Intelligence ,
Compliance ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Florida ,
Fraud ,
Health Technology ,
Healthcare ,
Manufacturers ,
Medicare Part D ,
OIG ,
Qui Tam ,
Risk Assessment ,
Settlement ,
Whistleblowers ,
White Collar Crimes
Seventh Circuit Considers When Legal Marketing Transforms Into Illegal Kickbacks -
On December 4, the US Court of Appeals for the Seventh Circuit heard oral arguments regarding whether the January 2023 jury conviction of...more
12/9/2024
/ Anti-Kickback Statute ,
Appeals ,
Bribery ,
Department of Justice (DOJ) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Marketing ,
Medicare Fraud ,
Sentencing ,
TRICARE
Owner, Operator of Texas Lab Charged for $79 Million Medical Testing Fraud Scheme -
On November 20, Osman Syed, the owner and operator of a laboratory in Texas, was charged with three counts of health care fraud,...more
11/25/2024
/ Conspiracies ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Bank Accounts ,
Fraud ,
Healthcare Fraud ,
Home Health Care ,
Kickbacks ,
Medicaid ,
Medical Testing ,
Medicare ,
Money Laundering ,
Sentencing ,
Settlement ,
Texas
UCHealth Settles FCA Violations for $23 Million -
On November 12, the US Department of Justice (DOJ) announced that University of Colorado Health (UCHealth) agreed to resolve allegations that it violated the False Claims...more
11/18/2024
/ Criminal Conspiracy ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Insurance Fraud ,
Investment Fraud ,
Medicare ,
Money Laundering ,
Pharmacist ,
Settlement ,
TRICARE ,
Wire Fraud
Judge Orders Government to Pay Relators a Cut of FCA Settlement -
On November 4, a federal judge from the US District Court for the District of Massachusetts ordered the government to pay the relators’ share of a...more
11/11/2024
/ Conflicts of Interest ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
IRS ,
Kickbacks ,
Medicaid ,
Paycheck Protection Program (PPP) ,
Settlement