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
12/27/2023
/ Compensation ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Insurance Fraud ,
Medicare ,
Money Laundering ,
OIG ,
Securities Fraud ,
Sentencing ,
Special Purpose Acquisition Companies (SPACs) ,
Wire Fraud
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
12/11/2023
/ Clinical Laboratory Testing ,
Conspiracies ,
Controlled Substances ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Facilities ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Settlement ,
TRICARE ,
Wire Fraud
Nevada Man Sentenced to 51 Months Imprisonment for Prize-Notification Fraud Scheme -
Earlier this week, a Nevada man was sentenced to 51 months in prison for perpetrating a prize-notification scheme that defrauded...more
Medical Marketer Convicted of $55 Million Fraud Scheme -
Late last week, a federal jury in the Northern District of Texas convicted Quintan Cockerell for his role in a $55 million fraud conspiracy involving TRICARE, a...more
11/6/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Fraud ,
Kickbacks ,
Medicaid ,
Medicaid Drug Rebate Program ,
Reimbursements ,
Settlement ,
TRICARE
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
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
10/9/2023
/ Anti-Kickback Statute ,
But For Causation ,
Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Home Health Care ,
Medicare ,
Medicare Fraud ,
Money Laundering ,
Settlement ,
Summary Judgment ,
Unjust Enrichment ,
Wire Fraud
Engineering Company Agrees to Pay $4.4 Million to Settle FCA -
On Friday, September 15, 2023, the US Department of Justice (DOJ) announced a settlement agreement with Navmar Applied Sciences Corporation, a...more
9/25/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Acquisition Regulations (FAR) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Identity Theft ,
Kickbacks ,
Settlement ,
U.S. Navy ,
Whistleblowers
Arkansas Men Convicted in $18 Million Global Investment Fraud Conspiracy -
A federal jury in the Western District of Arkansas convicted four men of conspiracy to commit wire fraud, wire fraud, and conspiracy to commit money...more
9/11/2023
/ Compliance ,
Conspiracies ,
Criminal Convictions ,
Cybersecurity ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Documentation ,
Financial Institutions ,
Fraud ,
General Services Administration (GSA) ,
Independent Investigations ,
Investment ,
IRS ,
Money Laundering ,
Penalties ,
Popular ,
Restitution ,
Settlement ,
Tax Fraud ,
Tax Returns ,
Verizon ,
Wire Fraud
Medical Supplier Agrees to Pay $29 Million for FCA Violations -
Earlier this month, the US Department of Justice (DOJ) and medical supplier Lincare Holdings Inc. reached an agreement to settle claims that Lincare violated...more
9/5/2023
/ Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Kickbacks ,
Medical Supplies ,
Medicare ,
OIG ,
Reimbursements ,
Settlement Agreements ,
Suppliers ,
Universal Health Services Inc v United States ex rel Escobar
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
Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment -
Defunct BestCare Laboratory Services LLC and its founder will pay $5.7 million to settle an outstanding 2018 False Claims Act...more
8/7/2023
/ Beneficiaries ,
Blue Cross ,
Blue Shield ,
DEA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare ,
Mileage Reimbursement ,
Nursing Homes ,
Pharmacies ,
Restitution ,
Settlement
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
New FCA Filings Point to Future Path Forward For Companies -
The US Supreme Court recently ruled in United States ex rel. Proctor v. Safeway Inc. and United States ex rel. Schutte, et al. v. SuperValu Inc. et al. that...more
Supreme Court Justices Signal Skepticism of Qui Tam Constitutionality -
On Friday, June 16, the US Supreme Court ruled that the US Department of Justice (DOJ) has the authority to dismiss qui tam suits brought under the...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
6/19/2023
/ Chief Compliance Officers ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
IRS ,
Medicare ,
Opioid ,
Pharmacies ,
Pharmacist ,
Scienter ,
SCOTUS ,
Tax Fraud ,
Wire Fraud
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
6/12/2023
/ Criminal Conspiracy ,
False Claims Act (FCA) ,
Falsified Documents ,
Financial Institutions ,
Fraud ,
IRS ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
SCOTUS ,
Sentencing ,
Tax Returns ,
US ex rel Tracy Schutte et al v SuperValu Inc et al ,
Wire Fraud
Supreme Court FCA Scienter Ruling Revives Fraud Lawsuits Against Safeway and SuperValu On Thursday, the US Supreme Court issued its highly anticipated ruling regarding the threshold of liability under the False Claims Act...more
6/5/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Oral Argument ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Reasonable Interpretations ,
Safeco ,
Safeco Insurance Co of America v Burr ,
Scienter ,
SCOTUS ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
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
Federal Judge Affirms $487 Million Judgment Against Medical Device Distributor for FCA Violations -
On May 12, 2023, US District Judge Wilhelmina M. Wright of the District of Minnesota affirmed the entry of a $487 million...more
Recent Interview With FCA Plaintiff Bar Attorneys Offers Key Insight into Trends in Anti-Kickback Litigation -
During a recent interview commemorating the 50th anniversary of the enactment of the Anti-Kickback Statute, two...more
Anticipated Landmark Supreme Court Decision May Be Anything But On -
April 18, 2023, the US Supreme Court heard oral arguments in a set of highly anticipated cases regarding the scienter—or knowledge—provision of the False...more
4/24/2023
/ Appeals ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Oral Argument ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Restitution ,
SCOTUS
Supreme Court to Hear US Government in FCA Scienter Oral Argument -
On March 20, 2023, the US Supreme Court agreed to allow the federal government to participate in oral argument in the Supreme Court’s review of the...more
3/27/2023
/ Bribery ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Generic Drugs ,
Insurance Fraud ,
Medicaid ,
Medicare ,
Oral Argument ,
Scienter ,
SCOTUS ,
Securities and Exchange Commission (SEC)
DOJ Files FCA Complaint Against Major Pharmacy Retailer Based on Alleged Violations of Controlled Substances Act -
On March 13, 2023, the Department of Justice (DOJ) announced that it filed a complaint in intervention...more
3/20/2023
/ Cannabis-Related Businesses (CRBs) ,
Controlled Substances Act ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Workers ,
Home Health Care ,
Investment ,
Nurses ,
Pharmaceutical Industry ,
Pharmacies ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Sherman Act ,
Staffing Agencies ,
Wage-Fixing
SCOTUS Denies Cert In Cases Addressing FCA Pleadings Requirements -
On Monday, October 17, 2022, the US Supreme Court rejected three petitions asking the Court to resolve a circuit split regarding the Rule 9(b)...more
10/21/2022
/ CIGNA ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Kickbacks ,
Medicare ,
Medicare Advantage ,
SCOTUS ,
Solicitor General ,
TRICARE ,
Whistleblowers
DC Circuit Adopts Pro Tanto Approach to False Claims Act Settlement Offsets -
In an opinion issued on August 30, 2022, the US Court of Appeals for the DC Circuit held in United States v. Honeywell International, Inc., ---...more