Welcome to the Summer 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and...more
7/31/2024
/ Anti-Kickback Statute ,
Beneficiaries ,
Bring Your Own Device (BYOD) ,
But For Causation ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement ,
Fair Market Value ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Oral Argument ,
Physician Compensation Arrangements ,
Policies and Procedures ,
Portability ,
Settlement ,
Stark Law ,
TRICARE ,
Valuation
Federal Court Dismisses $680 Million FCA Suit -
On July 23, a Maryland federal judge, Ellen L. Hollander, dismissed a $680 million False Claims Act (FCA) suit that was previously revived by the US Supreme Court. The suit...more
Texas Pharmaceutical Marketer Sentenced for $59 Million Medications Fraud Conspiracy -
On July 12, Quintan Cockerell, a Texas pharmaceutical marketer, was sentenced to over two years in prison and ordered to pay more than...more
7/22/2024
/ Conspiracies ,
False Claims Act (FCA) ,
Fraud ,
Hospice ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Prescription Drugs ,
Sentencing ,
Settlement
On June 7, Adam Hart, a former employee of McKesson Corporation, filed a petition for certiorari to the US Supreme Court asking the Court to define the “willfulness” element of the Anti-Kickback Statute (AKS). United States...more
DOJ Announces Agreement With Rite Aid to Settle Allegations of Violating the FCA and CSA in Relation to Opioid Dispensing -
On July 10, the US Department of Justice (DOJ) announced that Rite Aid Corporation and 10 of its...more
7/15/2024
/ Anti-Kickback Statute ,
Assisted Living Facilities (ALFs) ,
Controlled Substances Act ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Fraud ,
Medicare ,
Opioid ,
Prescription Drugs ,
Rite Aid ,
Settlement
Health Care Fraud and Money Laundering of $18 Million Leads to Prison Sentence for New York Pharmacy Owners -
Two pharmacy owners from New York have been sentenced for using their pharmacies to submit fraudulent claims to...more
Teva and DOJ May Reach Settlement in Closely Watched AKS Lawsuit -
On June 16, Teva Pharmaceuticals filed a request with the First Circuit Court of Appeals seeking to hold in abeyance its interlocutory appeal concerning...more
6/24/2024
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Fraud ,
Interlocutory Appeals ,
Kickbacks ,
Money Laundering ,
Sentencing ,
Settlement ,
Teva Pharmaceuticals ,
Vaccinations ,
Wire Fraud
Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme -
The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more
6/17/2024
/ Chronic Care Managment (CCM) ,
Coronavirus/COVID-19 ,
Damages ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
TRICARE ,
Uninsured Patients
District Court Declines to Stay Case Pending Resolution of FCA Causation Standard Issue Before Court of Appeals -
Earlier this week, a Massachusetts federal judge denied a motion to stay proceedings filed by Medtronic,...more
6/10/2024
/ Anti-Kickback Statute ,
Appeals ,
Causation ,
Criminal Convictions ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Mail Fraud ,
Ponzi Scheme
Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits -
Daniel Hurt, the prior owner and operator of Fountain Health Services LLC, Verify Health, Landmark Diagnostics LLC, First Choice...more
6/3/2024
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Insurance Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
OIG ,
Qui Tam ,
Reimbursements ,
Settlement ,
Stark Law ,
Whistleblowers
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
5/13/2024
/ Anti-Kickback Statute ,
CIMA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Hospice ,
Kickbacks ,
Medicare ,
NBA ,
Wire Fraud
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
5/6/2024
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Guilty Pleas ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Medicare Fraud ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Retaliation ,
Telemarketing ,
Whistleblowers ,
Wire Fraud
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
3/25/2024
/ CARES Act ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
NBA ,
Paycheck Protection Program (PPP) ,
SBA ,
Staffing Agencies ,
Telemedicine ,
Wire Fraud
On March 12, the Second Circuit affirmed in part and reversed in part a district court dismissal of False Claims Act (FCA) claims predicated on alleged Anti-Kickback Statute (AKS) violations. Adam Hart brought the claims...more
On March 7, Deputy Attorney General Lisa Monaco delivered the keynote remarks at the American Bar Association’s (ABA) 39th National Institute on White Collar Crime.
She noted that artificial intelligence (AI) “holds great...more
3/15/2024
/ Algorithms ,
Artificial Intelligence ,
Banking Sector ,
Compliance ,
Corporate Crimes ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Electronic Protected Health Information (ePHI) ,
Enforcement Actions ,
False Claims Act (FCA) ,
FinCEN ,
FinTech ,
Fraud ,
Healthcare ,
IRS ,
Liability ,
Machine Learning ,
Securities and Exchange Commission (SEC) ,
White Collar Crimes
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
3/11/2024
/ Anti-Kickback Statute ,
Criminal Investigations ,
Department of Justice (DOJ) ,
Drug Testing ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Fines ,
Fraud ,
Guilty Pleas ,
Healthcare Fraud ,
IRS ,
Medicaid ,
Medicare Fraud ,
Opioid ,
Sentencing ,
Settlement ,
Tax Evasion ,
TRICARE
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
2/19/2024
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
False Billing ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Insurance Fraud ,
Mail Fraud ,
Medical Equipment ,
Medicare ,
Paycheck Protection Program (PPP) ,
Scams ,
Sentencing ,
TRICARE ,
Wire Fraud
Three Individuals Sentenced for $3.5 Million COVID-19 Relief Fraud Scheme-
On February 6, three individuals were sentenced for fraudulently obtaining and misusing Paycheck Protection Program (PPP) loans that the US Small...more
SCOTUS Declines to Hear False Claims Act Challenge -
On January 22, the US Supreme Court denied a petition to hear a challenge to a Fifth Circuit Court of Appeals decision that upheld scienter and False Claims Act (FCA)...more
1/29/2024
/ Confidential Information ,
Conspiracies ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Insider Trading ,
Medicare Fraud ,
Misappropriation ,
Reimbursements ,
SCOTUS ,
Securities Fraud ,
Sentencing
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
1/22/2024
/ Anti-Kickback Statute ,
Civil Monetary Penalty ,
Controlled Substances Act ,
Damages ,
False Claims Act (FCA) ,
FDCPA ,
Fraud ,
Healthcare Fraud ,
NBA ,
Paycheck Protection Program (PPP) ,
Reimbursements ,
Wire Fraud
Clinical Laboratory and CEO To Pay Over $13 Million to Settle False Claims Act Allegations -
A New Jersey-based laboratory, RDx Bioscience Inc. (RDX), and its owner and CEO, Eric Leykin, agreed to pay $10,315,023 to the US...more
1/15/2024
/ CEOs ,
Clinical Laboratories ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
FBI ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Reimbursements ,
Settlement ,
Whistleblowers
Ultragenyx to Pay $6 Million To Settle False Claims Act Case -
Ultragenyx Pharmaceutical Inc. recently agreed to pay $6 million to settle a qui tam action filed under the False Claims Act (FCA).
Ultragenyx manufactures a...more
1/8/2024
/ Anti-Kickback Statute ,
Billing Errors ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Fraud ,
Health Care Providers ,
Medicare ,
Popular ,
Qui Tam ,
Settlement
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
12/27/2023
/ Compensation ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Insurance Fraud ,
Medicare ,
Money Laundering ,
OIG ,
Securities Fraud ,
Sentencing ,
Special Purpose Acquisition Companies (SPACs) ,
Wire Fraud
Hospital Executive and Three Physicians to Pay More Than $880,000 to Resolve Kickback Allegations -
On Monday, December 4, 2023, a Lexington, Texas, hospital executive and three health care providers agreed to pay more...more
12/11/2023
/ Clinical Laboratory Testing ,
Conspiracies ,
Controlled Substances ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Facilities ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Settlement ,
TRICARE ,
Wire Fraud
Binance to Pay Historic $4 Billion Fine -
Binance Holdings Limited, the operator of the world’s largest cryptocurrency exchange, agreed to pay $4.3 billion to resolve allegations that it violated the Bank Secrecy Act (BSA)...more
12/4/2023
/ Anti-Kickback Statute ,
Anti-Money Laundering ,
Bank Secrecy Act ,
Compliance ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FinCEN ,
Fines ,
Fraud ,
International Emergency Economic Powers Act (IEEPA) ,
IRS ,
Kickbacks ,
Know Your Customers ,
Medicare ,
Money Laundering ,
Money Transmitter ,
Offshore Funds ,
Tax Fraud ,
Tax Preparers ,
Willful Misconduct