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Wire Fraud Healthcare Fraud

Rivkin Radler LLP

Lab Owner Pleads Guilty to COVID-19 Testing Fraud Scheme

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On October 1, the U.S. Attorney’s Office for the Northern District of Illinois announced that Zishan Alvi, the owner of a Chicago laboratory, pleaded guilty to one count of wire fraud for his role in a COVID-19 testing fraud...more

Rivkin Radler LLP

High-Profile Sports Insurance Fraud Rings: A Recent Conviction

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No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more

ArentFox Schiff

Investigations Newsletter: DOJ Launches Corporate Whistleblower Awards Pilot Program

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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

ArentFox Schiff

Investigations Newsletter: Testing Facility Settles $2.5 Million Anti-Kickback Lawsuit

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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

Benesch

From the NBA Finals to Federal Prison - “Big Baby” Sentenced to 40 months in NBA Healthcare Plan Scheme

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Former NBA player Glen “Big Baby” Davis was sentenced to 40 months in prison after being convicted for his role in a scheme to defraud the NBA healthcare plan. Davis’ sentence comes almost a year after the scheme’s...more

ArentFox Schiff

Investigations Newsletter: Big Baby’s Big Foul: Former NBA Star Glen 'Big Baby' Davis Sentenced to 40 Months for Healthcare Fraud...

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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

ArentFox Schiff

Investigations Newsletter: DOJ Secures Plea in $50 Million Medicare Fraud and Kickback Scheme

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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

ArentFox Schiff

Investigations Newsletter: Cooperation Spares Former NBA Shooting Guard From Prison

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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

ArentFox Schiff

Investigations Newsletter: Telemedicine Owner Pleads Guilty to $136 Million Medicare Fraud

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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

Harris Beach PLLC

OIG February 2024 Enforcement Actions

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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

ArentFox Schiff

Investigations Newsletter: Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme

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Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme - Steven Dorfman, the former chief executive officer and owner of the Florida-based healthcare company Simple Health, and John Sand, a former...more

ArentFox Schiff

Investigations Newsletter: Home Health Care Owner Sentenced to Nine Years in Prison for Medicare Fraud Scheme

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Home Health Care Owner Sentenced to Nine Years in Prison for Medicare Fraud Scheme - This week, the owner of a home health company was sentenced to nine years in prison for orchestrating a nearly $2.8 million scheme...more

ArentFox Schiff

Investigations Newsletter: DC Federal Judge Dramatically Amplifies False Claims Act Damages Award

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DC Federal Judge Dramatically Amplifies False Claims Act Damages Award - On January 16, Judge Rudolph Contreras of the US District Court for the District of Columbia issued an opinion agreeing in part with the federal...more

ArentFox Schiff

Investigations Newsletter: Health Care Network Settles False Claims Act Allegations for $345 Million

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Health Care Network Settles False Claims Act Allegations for $345 Million - Community Health Network Inc. (CHN) has agreed to pay $345,000,000 to settle allegations that it violated the False Claims Act (FCA) for knowingly...more

ArentFox Schiff

Investigations Newsletter: Three Men Sentenced for $54 Million TRICARE Fraud Scheme

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Three Men Sentenced for $54 Million TRICARE Fraud Scheme - Three men were sentenced in connection with a $54 million bribery and kickback scheme involving TRICARE, a federal program that provides health insurance benefits...more

ArentFox Schiff

Investigations Newsletter: DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence

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DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence - Mark Schena, the former president of Arrayit Corporation, a Silicon Valley-based medical technology company, was...more

ArentFox Schiff

Investigations Newsletter: Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims

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Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims - On September 27, 2023, Chief Judge Dennis Saylor of the US District Court for the District of Massachusetts ruled that...more

Harris Beach PLLC

HHS Office of Inspector General September 2023 Enforcement Activity

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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

ArentFox Schiff

Investigations Newsletter: Lab Owner Sentenced to Over 16 Years for Health Care Fraud, Money Laundering

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Lab Owner Sentenced to Over 16 Years for Health Care Fraud, Money Laundering - On September 26, 2023, a US District Judge for the Western District of North Carolina sentenced a Charlotte lab owner, Donald Booker, to over...more

Arnall Golden Gregory LLP

The Government Cannot Cut Corners: Appellate Courts Reverse Sentences in Three Recent Cases Because the Government Did Not...

Three appellate courts recently reversed sentences because the government did not adequately present evidence to support the alleged loss calculation underlying the court’s determination of the sentencing guidelines range. In...more

Rivkin Radler LLP

NJ DME Company Owner Pleads Guilty to Kickback Scheme

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The U.S. Attorney’s Office for New Jersey recently announced that Alexander Schleider of Lakewood pleaded guilty to wire fraud and conspiracy to commit healthcare fraud in a durable medical equipment (DME) kickback scheme....more

ArentFox Schiff

Investigations Newsletter: Recent Filings Shed Light on DOJ’s View of Supreme Court’s Recent FCA Ruling

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Recent Filings Shed Light on DOJ’s View of Supreme Court’s Recent FCA Ruling - On June 1, 2023, the US Supreme Court explained that an assessment of a defendant’s subjective beliefs — rather than what an objectively...more

Mintz - Health Care Viewpoints

Operation Nightingale: Fraudulent Nursing Diploma Scheme and Its Implications on Health Care

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently partnered with various law enforcement agencies in a multi-state enforcement action aimed at uncovering a nursing degree fraud...more

ArentFox Schiff

Investigation Newsletter: Florida Doctor Receives 20-Year Prison Sentence for Substance Abuse Treatment Fraud

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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

Foley & Lardner LLP

Sentencing Guidelines: Third Circuit Rejects Use of “Intended” Loss in Favor of “Actual” Loss

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Sentencing in federal fraud cases is driven by loss amounts. To seek a higher sentencing guidelines range, the government often relies on a defendant’s “intended” loss,” rather than the “actual” loss. That approach no longer...more

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