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
$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
On June 16, 2023, in United States, ex rel. Polansky v. Executive Health Resources, Inc., the US Supreme Court addressed the government’s authority to dismiss a qui tam False Claims Act (FCA) suit over a relator’s objection...more
6/22/2023
/ Article II ,
Constitutional Challenges ,
Corporate Misconduct ,
Dismissals ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Fraud ,
Healthcare ,
Inpatient Billing ,
Investigations ,
Qui Tam ,
Relators ,
SCOTUS ,
United States ex rel Polansky v Executive Health Resources Inc ,
Whistleblowers
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
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
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
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
DOJ Issues Corporate Self-Disclosure Policy -
The US Department of Justice (DOJ) released a Voluntary Self-Disclosure Policy that sets a consistent standard for corporate self-disclosures for all US Attorney’s Offices. The...more
2/27/2023
/ Appeals ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health and Welfare Plans ,
Medicaid ,
Medicare ,
NBA ,
Proposed Amendments ,
Restitution ,
SCOTUS ,
Self-Disclosure Requirements ,
Whistleblowers
DOJ’s FCA Recoveries Were Lowest Level Since 2008 -
On February 7, 2023, the US Department of Justice (DOJ) released statistics about False Claim Act (FCA) settlements and judgments for the 2022 fiscal year. Total...more
$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
Florida Doctor Receives 20-Year Prison Sentence for Substance Abuse Treatment Fraud -
Following a guilty plea to conspiracy to commit health care and wire fraud, a Florida doctor was sentenced to 20 years in prison for...more
1/16/2023
/ CARES Act ,
Criminal Convictions ,
Drug Treatment ,
False Claims Act (FCA) ,
FIRREA ,
Fraud ,
Healthcare Fraud ,
Mail Fraud ,
Paycheck Protection Program (PPP) ,
Settlement ,
Substance Abuse ,
Telemarketing ,
Wire Fraud
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
Elizabeth Holmes Sentenced to 11 Years in Prison -
On November 18, 2022, former Theranos CEO, Elizabeth Holmes, was sentenced to 11 years and three months in prison for defrauding investors regarding Theranos’ blood...more
12/5/2022
/ Asset Freeze ,
Beneficial Owner ,
Corporate Transparency Act ,
Criminal Convictions ,
Enforcement Actions ,
Final Rules ,
FinCEN ,
Foreign Policy ,
Fraud ,
Investment Fraud ,
Investors ,
Office of Financial Sanctions Implementation (OFSI) ,
Russia ,
Sanctions and Anti-Money Laundering Act 2018 (SAMLA) ,
Sentencing ,
UK ,
Ukraine
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
DOJ Announces $3.3 Billion Cryptocurrency Seizure and Fraud Conviction -
On Friday, November 4, James Zhong pled guilty to committing wire fraud in September 2012, when he allegedly executed a scheme to defraud “Silk...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
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
DOJ Indicts 47 Individuals in Largest COVID-19 Fraud Scheme To Date -
On September 20, 2022, the US Department of Justice (“DOJ”) announced federal criminal charges against 47 defendants from the nonprofit, Feeding Our...more
9/23/2022
/ Compliance Monitoring ,
Coronavirus/COVID-19 ,
Criminal Investigations ,
Department of Justice (DOJ) ,
E-Cigarettes ,
Enforcement ,
False Documentation ,
FOIA ,
Food and Drug Administration (FDA) ,
Fraud ,
Kickbacks ,
New Guidance ,
Reimbursements ,
USDA