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
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
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
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
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
Ramesh “Sunny” Balwani, Former Theranos President and COO, Found Guilty on All Twelve Fraud Counts in High-Profile Trial -
On July 7, 2022, a federal jury in the Northern District of California found Ramesh “Sunny”...more
7/11/2022
/ Administrative Law Judge (ALJ) ,
Appeals ,
Corruption ,
Criminal Conspiracy ,
Criminal Convictions ,
Cyber Crimes ,
Cybersecurity ,
Department of Justice (DOJ) ,
En Banc Review ,
Enforcement ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Securities and Exchange Commission (SEC) ,
Settlement ,
Theranos ,
Unconstitutional Condition ,
Wire Fraud
SCOTUS Raises the Bar for Proof of Intent Under the Controlled Substances Act -
This week, the US Supreme Court issued a ruling in Ruan v. United States requiring subjective intent of wrongdoing in order to convict...more
7/1/2022
/ Controlled Substances Act ,
Criminal Investigations ,
Department of Justice (DOJ) ,
Fraud ,
Kickbacks ,
NBA ,
Proof of Intent ,
Reimbursements ,
SCOTUS ,
Settlement ,
Stark Law
KBR Reaches $13 Million Settlement To Resolve Kickback Allegations -
Kellogg Brown & Root Services Inc. and three related companies (collectively “KBR”) reached a $13.67 million settlement to resolve a suit alleging...more
6/17/2022
/ Army ,
Department of Justice (DOJ) ,
Environmental Protection Agency (EPA) ,
False Claims Act (FCA) ,
FIFRA ,
Investment Fraud ,
KBR (formerly Kellogg Brown & Root) ,
Kickbacks ,
Mail Fraud ,
Money Laundering ,
Qui Tam ,
Settlement ,
Subcontracts ,
Wire Fraud
Physician Partners of America Agrees To Pay $24.5 Million To Resolve False Claims Act Allegations -
Physician Partners of America LLC (PPOA), its founder, and its former chief medical officer agreed to pay $24.5 million to...more
Headlines that Matter for Companies and Executives in Regulated Industries.
DOJ Civil Cyber-fraud Initiative Obtains First Settlement -
The Department of Justice announced on Tuesday, March 8th, that Comprehensive...more
3/11/2022
/ Department of Energy (DOE) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Pharmaceutical Industry ,
Settlement ,
Subcontractors
DOJ Continues To Prosecute PPP Fraud -
Earlier this week, Ana Soto of Newark, Delaware pled guilty to fraudulently obtaining and spending money received through Paycheck Protection Program (“PPP”) loans. Between March...more
3/7/2022
/ Anti-Kickback Statute ,
Anti-Money Laundering ,
Bank Secrecy Act ,
CARES Act ,
Department of Justice (DOJ) ,
Drug Pricing ,
Fraud ,
Office of Foreign Assets Control (OFAC) ,
Paycheck Protection Program (PPP) ,
Prescription Drugs ,
Settlement
CEO of Defunct Medical Testing Lab to Pay $1.1 Million to Settle FCA and AKS Case -
Jae Lee, the former CEO of defunct Northwest Physicians Laboratory (NWPL), agreed to pay $1.1 million to resolve allegations that he...more
10/22/2021
/ Anti-Kickback Statute ,
CARES Act ,
Contractors ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Paycheck Protection Program (PPP) ,
SBA ,
Settlement ,
TRICARE ,
Unemployment Benefits ,
Wire Fraud
Pharmacist Sentenced to 70 Months in Prison for Prescription Drug Fraud -
An Orange County-based pharmacist and owner of TC Medical Pharmacy pled guilty to one count of health care fraud and was sentenced to 70 months in...more
The New York Attorney General’s office announced that drugmaker Endo Health Solutions has agreed to pay $50 million dollars to resolve a lawsuit brought by the state of New York as well as two New York counties alleging that...more
John Peter Smith Hospital (JPS) agreed to pay more than $3.3 million to settle allegations that it violated the False Claims Act by upcoding hundreds of claims submitted to federal healthcare programs.
Texas Hospital to...more
On August 2, 2021, the Department of Justice (DOJ) announced that Arriva Medical LLC (Arriva), once the nation’s largest Medicare mail-order diabetic testing supplier, and its parent company, Alere Inc., have agreed to...more
8/9/2021
/ Bribery ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Money Laundering ,
Patients ,
Publicly-Traded Companies ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Settlement
On Monday, Senator Chuck Grassley, R-Iowa, introduced the False Claims Amendments Act of 2021, section 2 of which would provide that defendants “may rebut an argument of materiality” as to an allegedly false claim submitted...more
8/2/2021
/ Charles Grassley ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Investigations ,
Materiality ,
Proposed Legislation ,
Qui Tam ,
Settlement ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers
US-based multinational medical device company, Avanos Medical Inc., entered into a deferred prosecution agreement and agreed to pay more than $22 million in connection with a criminal complaint charging the company with one...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
DOJ Updates Actions to Combat Fraud Related to COVID-19 -
On March 26, 2021, the Department of Justice provided an update on its criminal and civil enforcement efforts to combat fraud related to the COVID-19 pandemic....more