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Department of Justice (DOJ) Kickbacks False Billing

Kohn, Kohn & Colapinto LLP

Kickbacks and Medically Unnecessary Treatments: Five Major Qui Tam Settlements from May 2024

In May, the U.S. Department of Justice (DOJ) and U.S. Attorneys’ Offices announced several significant False Claims Act (FCA) settlements resolving qui tam whistleblower lawsuits. Under the FCA’s qui tam provisions, a...more

Harris Beach PLLC

False Claims Act Enforcement Highlights Need for Robust Compliance Programs

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The U.S. Department of Justice (“DOJ”) announced its False Claims Act (“FCA”) enforcement statistics for FY 2023 and identified key priorities for FCA enforcement in 2024 and beyond. The DOJ continues to pursue FCA...more

Cozen O'Connor

Whistleblower Watch - A quarterly update on FCA Enforcement and Qui Tam Litigation - Winter 2024

Cozen O'Connor on

Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

ArentFox Schiff

Investigations Newsletter: Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim

ArentFox Schiff on

Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim - Steven Richardson, the owner of telemedicine companies Expansion Media, LLC and Hybrid Management Group LLC, agreed to settle allegations that...more

Harris Beach PLLC

OIG January 2024 Enforcement Summary

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The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - October 2023

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Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2023

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There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023.  Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more

Rivkin Radler LLP

Fraud Week: Focus on Florida Fraud

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To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence...more

Rivkin Radler LLP

Pharmacy Owners Charged for Fraud and Kickbacks to a Marketing Company

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The U.S. Department of Justice recently announced that a federal grand jury has charged two pharmacy owners, a mother-daughter duo from South Florida, with healthcare fraud, wire fraud, and payment of kickbacks in exchange...more

Rivkin Radler LLP

Fraud Week: More Non-Existent Services

Rivkin Radler LLP on

If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually...more

Rivkin Radler LLP

HHS OIG Issues Telehealth Fraud Alert

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On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth...more

Fox Rothschild LLP

US Launches Nationwide Coordinated Law Enforcement Action to Combat Health Care-Related COVID-19 Fraud

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As part of its ongoing effort to crack down on health care-related COVID-19 fraud, the U.S. Justice Department has launched a nationwide coordinated law enforcement action that recently led to criminal charges against 21...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

The Reverse False Claims Act: A Relatively Unknown, But Increasingly Used, Provision Of The FCA

Volumes have been written about the False Claims Act as a tool to pursue fraud against the government in circumstances where the defendant has allegedly made false statements to receive money from the government. For...more

Rivkin Radler LLP

21 Charged in Federal COVID-19 Fraud Sweep

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On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal...more

Wiley Rein LLP

2021 FCA Recoveries Bounce Back from Decade-Low . . . Maybe

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On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more

Robinson+Cole Health Law Diagnosis

DOJ Focused on Toxicology Testing – EKRA and Anti-Kickback Statute Violations Abound

On November 4, 2021, the Department of Justice (DOJ) announced the conviction of several South Florida addiction treatment facility operators following a seven-week trial. ...more

Goodwin

Alere Pays $198.75 Million to Settle False Claims for Allegedly Billing Medicare for Defective POC Devices, Not Charging Copays,...

Goodwin on

Alere Inc. and Alere San Diego Inc. (collectively “Alere”) have come under fire recently by the U.S. Department of Justice (“DOJ”) and other government agencies, agreeing to settle several rounds of accusations of False...more

Cozen O'Connor

Hospital System And Doctors Pay Over $37 Million To Resolve State And Federal False Claims Allegations

Cozen O'Connor on

California AG Rob Bonta and the U.S. Department of Justice reached a settlement with hospital system Prime Healthcare Services System, Prime Healthcare’s founder and chief executive officer, Dr. Prem Reddy, and related...more

Jones Day

DOJ Ramps Up Coordinated Law Enforcement Action to Combat Health Care Fraud Related to COVID-19

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On May 26, 2021, DOJ announced a series of coordinated law enforcement actions against 14 defendants across seven federal districts for alleged participation in fraudulent health care schemes that, according to the...more

Rivkin Radler LLP

DOJ Announces COVID-19 Fraud Takedown

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On May 26, the U.S. Department of Justice (DOJ) announced criminal charges against 14 defendants in six states for participation in healthcare fraud schemes related to the COVID-19 pandemic. The coordinated takedown involved...more

The Volkov Law Group

Universal Health Agrees to Pay $122 Million for False Claims Act Violations

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DOJ announced a False Claims Act settlement with Universal Health (“UHS”) and related companies for $122 million for billing for medically unnecessary inpatient behavioral health services, failing to provide adequate services...more

ArentFox Schiff

Investigations Newsletter: Health Information Technology Developer to Pay $145 Million to Resolve Kickback Allegations

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In the DOJ’s first-ever criminal action against an electronic health records vendor, San Francisco-based Practice Fusion Inc. agreed to pay $145 million to resolve allegations that it received kickbacks from pharmaceutical...more

Robinson+Cole Health Law Diagnosis

DOJ Announces $26.67 Million Settlement with Laboratory to Resolve FCA Allegations

On November 26, 2019, the Department of Justice (DOJ) announced a $26.67 million settlement with a laboratory testing corporation, Boston Heart Diagnostics Corporation (Boston Heart). The settlement resolves allegations of...more

ArentFox Schiff

Investigations Newsletter: Kickback Allegations Settled for $20.25 Million

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Kickback Allegations Settled for $20.25 Million - Sanford Health, Sanford Medical Center, and Sanford Clinic (collectively, Sanford), a South Dakota health system, will pay $20.25 million to settle allegations that they...more

The Volkov Law Group

Department of Justice Brings Criminal Charges Against 35 Individuals for Involvement in $2.1 Billion in Fraudulent Genetic Testing...

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The Justice Department, in coordination with HHS-OIG and the FBI recently announced the arrest and prosecution of 35 individuals for a massive genetic testing fraud scheme involving dozens of telemedicine companies and cancer...more

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