Welcome to the Summer 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...more
7/31/2024
/ Anti-Kickback Statute ,
Beneficiaries ,
Bring Your Own Device (BYOD) ,
But For Causation ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement ,
Fair Market Value ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Oral Argument ,
Physician Compensation Arrangements ,
Policies and Procedures ,
Portability ,
Settlement ,
Stark Law ,
TRICARE ,
Valuation
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
Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations -
On February 28, the US Department of Justice (DOJ) announced the guilty plea of Andrew Maloney, who, along with his clinical laboratory...more
3/11/2024
/ Anti-Kickback Statute ,
Criminal Investigations ,
Department of Justice (DOJ) ,
Drug Testing ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Fines ,
Fraud ,
Guilty Pleas ,
Healthcare Fraud ,
IRS ,
Medicaid ,
Medicare Fraud ,
Opioid ,
Sentencing ,
Settlement ,
Tax Evasion ,
TRICARE
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
Three Men Sentenced for $54 Million TRICARE Fraud Scheme -
Three men were sentenced in connection with a $54 million bribery and kickback scheme involving TRICARE, a federal program that provides health insurance benefits...more
11/20/2023
/ Bribery ,
Department of Justice (DOJ) ,
False Statements ,
Fraud ,
Health Insurance ,
Healthcare Fraud ,
Kickbacks ,
Money Laundering ,
Pyramid Schemes ,
Reimbursements ,
TRICARE ,
Wire Fraud
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
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
Lens Manufacturer Agrees To Pay $16.4 Million To Resolve Alleged Violations of the False Claims Act and Anti-Kickback Statute -
Essilor International, Essilor of America, Inc., Essilor Laboratories of America Inc., and...more
The owner of Campbell Medical Clinic in Houston and her medical group agreed to resolve fraudulent billing allegations for $2.6 million.
Chiropractor Agrees to Pay $2.6 Million and to 10-Year Exclusion from Federal Health...more
Pharmaceutical Company Agrees to Pay $12.6 Million to Settle FCA Allegations Involving Kickbacks -
On Tuesday, the Department of Justice announced a $12.6 million settlement with Incyte Corporation, a Delaware...more
5/10/2021
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Frivolous Lawsuits ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Money Laundering ,
Settlement ,
Telemarketing ,
TRICARE
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
4/19/2021
/ Corporate Integrity Agreement ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Medicaid ,
Medicare ,
Money Laundering ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Settlement ,
TRICARE ,
Whistleblowers ,
Wire Fraud
Despite Decrease in 2020 False Claims Act Recoveries, Investigations and Litigation Expected to Rise Under the Biden Administration -
As previously detailed by Arent Fox, total False Claims Act (FCA) recoveries for the...more
2/1/2021
/ Anti-Kickback Statute ,
Biden Administration ,
CARES Act ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Investigations ,
Kickbacks ,
Medicare ,
Paycheck Protection Program (PPP) ,
Recovery Plans ,
Settlement Agreements ,
TRICARE
Medical Device Manufacturer Settles Improper Payment Allegations for $18 Million -
Merit Medical Systems Inc. (MMSI), a Utah-based medical device maker, will pay $18 million to settle allegations that it engaged in a...more
10/19/2020
/ Child Care ,
Corporate Integrity Agreement ,
Department of Energy (DOE) ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Mail Fraud ,
Medicaid ,
Medical Devices ,
Medicare ,
Settlement Agreements ,
Subcontractors ,
TRICARE ,
Wire Fraud
Biotechnology Company Settles False Claims Act Charges for $11.5 million -
The Acting U.S. Attorney for the Southern District of New York announced a settlement with Bio-Reference Laboratories, Inc. (“BRL”), a New...more
9/28/2020
/ Anti-Fraud Provisions ,
Anti-Kickback Statute ,
Biotechnology ,
Broker-Dealer ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Medicare ,
New Jersey ,
Securities and Exchange Commission (SEC) ,
Settlement Agreements ,
TRICARE ,
Whistleblowers
Acute Care Hospital Agrees to Pay $50 Million to Settle Alleged Stark Law and Anti-Kickback Statute Violations -
On September 9, 2020, the Department of Justice (“DOJ”) announced that Wheeling Hospital Inc. (“Wheeling...more
9/14/2020
/ Anti-Kickback Statute ,
California ,
Campaign Contributions ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Fair Market Value ,
False Claims Act (FCA) ,
Fraud ,
Medicaid ,
Medicare ,
Qui Tam ,
Risk Assessment ,
Settlement Agreements ,
Stark Law ,
TRICARE ,
Wire Fraud
Drug Testing Lab Pays Nearly $12 Million to Settle False Claims Act Allegations -
On July 20, 2020, the Department of Justice (DOJ) announced a civil settlement with Sterling Healthcare Opco, LLC d/b/a Cordant Health...more
7/27/2020
/ Anti-Fraud Provisions ,
Anti-Kickback Statute ,
Corporate Integrity Agreement ,
Department of Justice (DOJ) ,
Drug Testing ,
False Claims Act (FCA) ,
Fraud ,
Inspector General ,
Kickbacks ,
Medicare ,
Securities and Exchange Commission (SEC) ,
TRICARE
COVID Relief Program Fraud Charges -
DOJ continues to announce charges against defendants accused of fraud in connection with allegedly false loan applications submitted under the Paycheck Protection Program (PPP)...more
7/20/2020
/ Bank Fraud ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Loan Applications ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
SBA ,
Skilled Nursing Facility ,
Tax Returns ,
TRICARE ,
Wire Fraud
DOJ Announces $72.3 Million False Claims Act Settlement -
Oklahoma Center for Orthopaedic and Multi-Specialty Surgery, its part-owner and management company, a physician group, and other affiliated entities and...more
7/13/2020
/ Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Genetic Testing ,
Kickbacks ,
Medicaid ,
Medicare ,
Qui Tam ,
Settlement ,
stark ,
TRICARE ,
Whistleblowers
SBA and Department of Treasury Announce Disclosure of PPP Recipients -
After weeks of mounting public and congressional pressure, on Friday, June 19, the SBA and Department of Treasury announced that it will make...more
6/26/2020
/ Department of Justice (DOJ) ,
Disclosure ,
Financial Institutions ,
Food and Drug Administration (FDA) ,
Fraud ,
Kickbacks ,
NAICS ,
Paycheck Protection Program (PPP) ,
Prescription Drugs ,
SBA ,
TRICARE ,
U.S. Treasury ,
Wire Fraud
Business Owner Charged with Fraud Connected to the Paycheck Protection Program -
On June 15, 2020, the owner of several information technology companies was charged in a criminal complaint with bank fraud and for making...more
6/22/2020
/ Business Ownership ,
CARES Act ,
False Claims Act (FCA) ,
Financial Institutions ,
Fraud ,
Healthcare ,
IRS ,
Kickbacks ,
Loan Applications ,
Medicare ,
Paycheck Protection Program (PPP) ,
SBA ,
TRICARE
Medical Technology Company President Charged in $69 Million COVID-19 Testing Fraud Scheme -
A complaint in the Northern District of California was unsealed on June 9, 2020, charging the president of Arrayit Corporation, a...more
6/15/2020
/ Alaska Native Claims Settlement Act (ANCSA) ,
Coronavirus/COVID-19 ,
Department of Defense (DOD) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
General Services Administration (GSA) ,
Kickbacks ,
Medicare ,
Pharmacies ,
Probation ,
Securities Fraud ,
South Korea ,
TRICARE ,
US Army Corps of Engineers ,
Virus Testing ,
Wire Fraud
SEC Adopts Aggressive Approach to COVID-19 Fraud -
The US Securities and Exchange Commission has already initiated multiple investigations into companies seeking to illegally profit from the global coronavirus pandemic...more
5/4/2020
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Fraud ,
Inspector General ,
Medicare ,
Pandemic ,
Securities and Exchange Commission (SEC) ,
Trading Suspension ,
TRICARE ,
Whistleblowers
Omnicare and CVS Face Fraudulent Billing Lawsuit -
On Tuesday, the US Attorney’s Office for the Southern District of New York announced a False Claims Act lawsuit against Omnicare, Inc. and its parent company, CVS Health...more
12/20/2019
/ CVS ,
Department of Justice (DOJ) ,
Dismissals ,
False Claims Act (FCA) ,
Government Investigations ,
Medicaid ,
Medicare ,
Medicare Part D ,
Omnicare ,
Pharmacies ,
Prescription Drugs ,
Rite Aid ,
State Attorneys General ,
TRICARE ,
Whistleblowers
Defense Vehicle Manufacturer Accused of Defrauding the Government by $1.2 Billion -
On Tuesday, December 3, the United States District Court for the District of Columbia unsealed a six-year-old False Claims Act complaint...more
12/9/2019
/ Anti-Kickback Statute ,
Clinical Laboratory Testing ,
Criminal Prosecution ,
Defense Sector ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
Guilty Pleas ,
Healthcare Fraud ,
Manufacturers ,
Medicaid ,
Medicare ,
Settlement ,
Stark Law ,
TRICARE ,
United Auto Workers