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
Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties -
A Connecticut Superior Court judge found Assured Rx, LLC, a Florida-based pharmacy, liable for violating the Connecticut...more
11/4/2024
/ Anti-Kickback Statute ,
Damages ,
Department of Justice (DOJ) ,
Depositions ,
False Claims Act (FCA) ,
Fraud ,
Guilty Pleas ,
Healthcare Fraud ,
IRS ,
Liability ,
Medicare ,
Penalties ,
Pharmacies ,
Settlement
US Supreme Court Declines to Consider AKS ‘Willfulness’ Question -
On October 7, the US Supreme Court denied a petition in which a whistleblower asked the Court to decide whether a “willful” act under the federal...more
10/14/2024
/ Anti-Kickback Statute ,
Bribery ,
Criminal Conspiracy ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Home Health Care ,
Kickbacks ,
Medicaid ,
Money Laundering ,
Popular ,
Scienter ,
SCOTUS ,
Telehealth ,
Whistleblowers
Florida Federal Judge Strikes Down FCA’s Qui Tam Provision as Unconstitutional -
On September 30, US District Judge Kathryn Kimball Mizelle of the Middle District of Florida held in a historic decision that the federal...more
10/7/2024
/ Anti-Kickback Statute ,
Appointments Clause ,
Criminal Convictions ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
False Statements ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Misrepresentation ,
OIG ,
Qui Tam ,
Sentencing ,
Settlement ,
Unconstitutional Condition
Medical Device Manufacturer THD Pays $700,000 to Resolve FCA Allegations -
On September 6, the US Attorney’s Office for the District of Maryland announced that THD America, Inc., and its parent company, THD SpA of Italy,...more
9/16/2024
/ False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Health Insurance ,
Healthcare Fraud ,
Manufacturers ,
Medicaid ,
Medical Billing Codes ,
Medical Devices ,
Medicare ,
Reimbursements ,
Securities and Exchange Commission (SEC)
Federal Court Permits Investors to Resume Kickback Suit Against Teva -
After a two-year long stay, on August 30, Judge Karen S. Marston of the US District Court for the Eastern District of Pennsylvania ruled that investors...more
9/9/2024
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Investors ,
Kickbacks ,
Medicaid ,
Medicare ,
Permits ,
Reimbursements ,
Settlement
DOJ Launches Corporate Whistleblower Awards Pilot Program -
On August 1, the US Department of Justice (DOJ) announced the details of its new Corporate Whistleblower Awards Pilot Program. According to the DOJ, the...more
8/12/2024
/ Bribery ,
Controlled Substances Act ,
DEA ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
False Claims Act (FCA) ,
FinCEN ,
Foreign Corrupt Practices Act (FCPA) ,
Health Insurance ,
Healthcare Fraud ,
Internal Reporting ,
Kickbacks ,
Opioid ,
Pilot Programs ,
Securities and Exchange Commission (SEC) ,
Whistleblower Awards ,
Whistleblowers ,
Wire Fraud
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
Federal Court Dismisses $680 Million FCA Suit -
On July 23, a Maryland federal judge, Ellen L. Hollander, dismissed a $680 million False Claims Act (FCA) suit that was previously revived by the US Supreme Court. The suit...more
Health Care Fraud and Money Laundering of $18 Million Leads to Prison Sentence for New York Pharmacy Owners -
Two pharmacy owners from New York have been sentenced for using their pharmacies to submit fraudulent claims to...more
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
District Court Declines to Stay Case Pending Resolution of FCA Causation Standard Issue Before Court of Appeals -
Earlier this week, a Massachusetts federal judge denied a motion to stay proceedings filed by Medtronic,...more
6/10/2024
/ Anti-Kickback Statute ,
Appeals ,
Causation ,
Criminal Convictions ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Mail Fraud ,
Ponzi Scheme
Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits -
Daniel Hurt, the prior owner and operator of Fountain Health Services LLC, Verify Health, Landmark Diagnostics LLC, First Choice...more
6/3/2024
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Insurance Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
OIG ,
Qui Tam ,
Reimbursements ,
Settlement ,
Stark Law ,
Whistleblowers
Biomedical Company Avoids DOJ Prosecution After First Ever Voluntary Corporate Self-Disclosure of Fraud Under NSD Enforcement Policy -
On May 22, the US Department of Justice (DOJ) announced that it will not prosecute a...more
5/28/2024
/ Biomedical Companies ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement ,
Enforcement Actions ,
Fraud ,
Healthcare Fraud ,
Medicare ,
National Security ,
Self-Disclosure Requirements ,
Voluntary Disclosure
Testing Facility Settles $2.5 Million Anti-Kickback Lawsuit -
On May 15, the US Attorneys for the Southern District of New York announced that they had settled their civil fraud lawsuit against Balance Diagnostics USA,...more
Big Baby’s Big Foul: Former NBA Star Glen 'Big Baby' Davis Sentenced to 40 Months for Healthcare Fraud Scheme -
On May 9, former Boston Celtics forward Glen “Big Baby” Davis was sentenced to 40 months in prison following...more
5/13/2024
/ Anti-Kickback Statute ,
CIMA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Hospice ,
Kickbacks ,
Medicare ,
NBA ,
Wire Fraud
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
Disgraced Crypto Mogul Bankman-Fried Sentenced to 25 Years in Prison -
On March 28, Judge Lewis Kaplan of the United States District Court for the Southern District of New York handed down a substantial term of...more
Cooperation Spares Former NBA Shooting Guard From Prison -
Former National Basketball Association (NBA) shooting guard, Antoine Wright, was sentenced to time served after he pled guilty to conspiracy and aggravated...more
3/25/2024
/ CARES Act ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
NBA ,
Paycheck Protection Program (PPP) ,
SBA ,
Staffing Agencies ,
Telemedicine ,
Wire Fraud
Telemedicine Owner Pleads Guilty to $136 Million Medicare Fraud -
A licensed nurse practitioner in New Jersey, Jean Wilson, pleaded guilty to conspiracy to commit health care fraud and wire fraud. According to court...more
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
Department of Justice Designates First Chief AI Officer -
On February 22, the US Department of Justice (DOJ) designated Jonathan Mayer as the DOJ’s first “Chief Science Technology Advisor and Chief Artificial Intelligence...more