Top Reasons for 2022’s Downward Trend in False Claims Act Recoveries -
Following the US Department of Justice’s (DOJ) release of statistics regarding FCA settlements and judgments for the 2022 fiscal year, Law360 spoke...more
2/20/2023
/ CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fees ,
Fraud and Abuse ,
Healthcare ,
Kickbacks ,
Medicare Advantage ,
Opioid ,
Private Equity ,
Proposed Amendments ,
Qui Tam ,
Settlement ,
Stark Law ,
Telehealth ,
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
US Supreme Court to Address FCA’s Scienter Requirement in Safeway Case -
The US Supreme Court granted certiorari to resolve a circuit split regarding whether a defendant “knowingly” violates the False Claims Act (FCA) if...more
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
Former Theranos Executive Ramesh “Sunny” Balwani Sentenced to Nearly 13 Years -
On December 7, 2022, Ramesh “Sunny” Balwani, a former Theranos executive, was sentenced to nearly 13 years in prison, and three years of...more
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
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
Court Rejected Former Theranos Executive Sunny Balwani’s Request For New Trial -
On October 11, 2022, a California federal court rejected former Theranos Chief Operating Officer Sunny Balwani’s request for a new trial,...more
10/17/2022
/ Anti-Money Laundering ,
Bank Secrecy Act ,
Consent Order ,
DNA ,
FinCEN ,
Office of Foreign Assets Control (OFAC) ,
SDN List ,
Settlement ,
Suspicious Activities ,
Theranos ,
U.S. Treasury
OIG Warns That Proposed Drug Discounts May Warrant Sanctions -
On October 5, the US Department of Health and Human Services’ Office of Inspector General (OIG) issued an advisory opinion assessing a proposal that involved...more
10/10/2022
/ Anti-Competitive ,
Anti-Kickback Statute ,
Bid Rigging ,
Bribery ,
Caltrans ,
Contractors ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Discounts ,
Drug Pricing ,
Economic Injury Disaster Loans ,
False Statements ,
Fraud and Abuse ,
Healthcare Fraud ,
IRS ,
Medicare ,
Medicare Part D ,
OIG ,
Sanctions ,
Tyson Foods ,
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
EmpiresX Head Trader Pleads Guilty to $100M Cryptocurrency Investment Fraud Scheme -
On September 8, 2022, the “Head Trader” for EmpiresX, a purported cryptocurrency platform, pled guilty to one count of conspiracy to...more
9/16/2022
/ Bid Rigging ,
Criminal Conspiracy ,
Cryptocurrency ,
Fraud ,
Investment Fraud ,
Mail Fraud ,
Misrepresentation ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Sherman Act ,
Theranos ,
Wire Fraud
Medical Technology Company President Convicted for Participation in $77 Million COVID-19 and Allergy Testing Scheme -
On September 1, 2022, the president of Arrayit Corporation, a medical technology company in Silicon...more
9/9/2022
/ Bribery ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Disclosure Requirements ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Investors ,
Kickbacks ,
Medical Technology Companies ,
Medicare ,
Prison ,
Puerto Rico ,
Securities and Exchange Commission (SEC) ,
Wire Fraud
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
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
Former Portfolio Manager Convicted in Bond Fraud Trial -
On Friday, August 12, 2022, Daniel Small — a former portfolio manager for Platinum Partners LP (Platinum) — was convicted of securities fraud and conspiracy to...more
Khadijah Chapman of Georgia, Daniel Labrum of Utah, and Eric O’Neil of Connecticut were all charged in separate indictments with submitting fraudulent Paycheck Protection Program (PPP) loan applications. According to the DOJ,...more
8/15/2022
/ Anti-Money Laundering ,
Bank Fraud ,
Bank Secrecy Act ,
BSA/AML ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
Criminal Convictions ,
Crypto Exchanges ,
Department of Justice (DOJ) ,
Healthcare Fraud ,
Indictments ,
Paycheck Protection Program (PPP) ,
Wire Fraud
Jury Orders Eli Lilly To Pay $61 Million -
A federal jury in Illinois found that, beginning around 2004, drug manufacturer Eli Lilly deliberately underpaid rebates to Medicare programs by excluding retroactive drug prices...more
8/8/2022
/ Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Falsified Documents ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Paycheck Protection Program (PPP) ,
Rebates ,
SBA ,
Skilled Nursing Facility ,
Wire Fraud