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Criminal Investigations Healthcare Fraud

Health Care Compliance Association (HCCA)

The Latest on Healthcare Enforcement

Healthcare enforcement is never quiet. There’s always something, or many things, going on, and compliance teams need to stay on top of the trends to ensure that their programs are staying ahead of the risks. To find out...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 186: White Collar Crimes in Healthcare with Maynard...

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This week, Heather and Lauren welcome more members of the Maynard Nexsen team, White Collar attorneys Erica Barnes, Mark Moore, and Christian Dysart. The group takes a deep dive into discussing white-collar crime in the...more

ArentFox Schiff

Investigations Newsletters: Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations

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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

Foley & Lardner LLP

Remote Patient Monitoring: OIG Issues Consumer Alert

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On November 22, 2023, while many were preparing for the Thanksgiving holiday, the Office of Inspector General (OIG) posted a consumer alert (Alert) warning the public about a fraud scheme involving monthly billing for remote...more

Womble Bond Dickinson

Current Trends and Real-World Best Practices in Healthcare Fraud Compliance

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Recently, Womble Bond Dickinson held its First Annual Health Care Fraud Symposium, a webinar designed to discuss critical healthcare fraud topics. WBD Partner Joe Whitley moderated a discussion with WBD attorneys Luke Cass,...more

Oberheiden P.C.

Recent DOJ Consumer Protection Branch Cases Highlight the Branch’s Enforcement Priorities

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The U.S. Department of Justice’s (DOJ) Consumer Protection Branch works with other branches and federal law enforcement agencies to investigate and prosecute civil and criminal violations of the nation’s consumer protection...more

Robinson+Cole Health Law Diagnosis

The DOJ Continues to Prosecute Providers for Fraudulent Telemarketing and Telehealth

A physician in Washington state pled guilty on September 28, 2022, to a criminal charge of conspiring to accept kickbacks related to fraudulent genetic testing. According to the Department of Justice (DOJ), the physician...more

Oberheiden P.C.

Medicare TPE Audits: 6 Things You Need to Know

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Targeted Probe and Educate (TPE) audits have recently become a common tool used by both law enforcement and private insurers in the Medicare program. While they focus on educating Medicare providers about proper billing...more

Oberheiden P.C.

A Step-by-Step Guide to Dealing with Detroit Healthcare Fraud Charges

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Over recent years, the federal government has shown an increased interest in bringing healthcare fraud prosecutions. In fact, in 2020 alone, the federal government opened 1,148 new criminal healthcare fraud investigations,...more

Bradley Arant Boult Cummings LLP

DOJ Brings False Claims Act Suit Against Serial LTC Whistleblower

Thomas Prose is the founder and owner of a Michigan-based “post-hospitalist” company named General Medicine P.C. (GM), which purports to specialize in the care of post-acute patients in long-term care facilities by providing...more

Polsinelli

Another Wave of Criminal Charges Brought in COVID-Related Fraud

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The Department of Justice and the US Attorney offices around the country are continuing to be in hot pursuit of cases of fraud related to the COVID-19 pandemic. On April 20, 2022, the Department of Justice announced a new...more

Brownstein Hyatt Farber Schreck

Health Care Fraud Cases Shatter Records

As predicted, health care fraud enforcement under the False Claims Act (“FCA”) continues to be a top priority for the Department of Justice (“DOJ”). In fiscal year 2021, the DOJ obtained more than $5.6 billion in settlements...more

The Volkov Law Group

DOJ Continues Pace of Healthcare Fraud False Claims Act Prosecutions

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False Claims Act prosecutions continue against healthcare executives, physicians and professionals.  Last year, DOJ recovered over $5.6 billion in FCA enforcement. DOJ expects total recoveries to increase in 2022.  Over 95...more

Morgan Lewis

DOJ Ramping Up Fraud Enforcement Efforts: 2021 Year in Review Report

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The US Department of Justice’s Criminal Division Fraud Section released its annual Year in Review report on February 15, covering 2021. Despite ongoing aftershocks associated with the global pandemic, this year’s report...more

Baker Donelson

Planning for Increased Health-Related Enforcement Efforts in 2022

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The Department of Justice (DOJ) has made numerous recent public statements reflecting increased priorities for enforcement, especially in the health care industry. The DOJ has a variety of tools at its disposal to enforce...more

Steptoe & Johnson PLLC

Strike Force Takes Renewed Aim at Health Care Fraud and Abuse and Encourages Whistleblowers

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The United States Attorney’s Office for the Northern District of West Virginia announced a renewed emphasis on health care fraud prosecutions in West Virginia as of January 19, 2022. It formed the Mountaineer Health Care...more

ArentFox Schiff

Investigations Newsletter: Lab Owner Indicted For $100 Million Health Care Fraud Scheme

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Lab Owner Indicted For $100 Million Health Care Fraud Scheme - On November 2, 2021, a federal grand jury in the Western District of Arkansas indicted Billy Joe Taylor of Arkansas for an alleged health care fraud scheme. ...more

McDermott Will & Emery

The Growing Role of Data Analytics in Healthcare Enforcement

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The US Department of Justice (DOJ) and US Department of Health and Human Services, Office of Inspector General (HHS-OIG) are increasingly relying on sophisticated data analytics tools to identify and investigate fraud...more

Tarter Krinsky & Drogin LLP

Law Brief®: The Theranos Trial

On the latest Law Brief® episode, Co-Heads of the White Collar Practice Group, Michael Grudberg and Robert Heim, join Host, Richard Schoenstein to discuss the on-going trial of Elizabeth Holmes concerning her now-defunct...more

The Volkov Law Group

False Claims Investigations and Criminal Prosecutions: Recent Examples of Criminal Charges – a Lab Owner, A Physician and a Nurse...

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A False Claims Act case can easily turn into a criminal prosecution.  The Federal Bureau of Investigation often initiates criminal investigations as part of its commitment to reducing health care fraud....more

Steptoe & Johnson PLLC

Federal Authorities Ramping Up COVID-19 Related Health Care Fraud Prosecutions

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Recently announced Department of Justice (DOJ) priorities include a reinvigoration of health care fraud prosecutions. The COVID-19 crisis created fertile ground for not only fraud related to the Paycheck Protection Program...more

Oberheiden P.C.

Eleven of the IRS's Enforcement Priorities During the 2021 Tax Season

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It is tax season once again. While the Internal Revenue Service (IRS) has extended this year’s filing deadline to May 17, 2021 for individuals, businesses must still file by April 15, and all U.S. taxpayers must ensure that...more

McDermott Will & Emery

The Next Wave of COVID-Related Criminal And Civil Enforcement Actions Is Starting

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Given the rapid pace and volume of economic aid allocated by Congress to combat the COVID-19 pandemic and its economic impacts, it is no surprise that the federal government has focused heavily on identifying and prosecuting...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2020

Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more

Polsinelli

DOJ Creates National Rapid Responce Strike Force As Focus On Health Care Fraud Continues To Grow

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As COVID-19 continues to ravage the United States, the Department of Justice (DOJ) has recently announced its new National Rapid Response Strike Force within the Health Care Fraud Unit to investigate and prosecute fraud cases...more

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