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
DOJ Announces $3.3 Billion Cryptocurrency Seizure and Fraud Conviction -
On Friday, November 4, James Zhong pled guilty to committing wire fraud in September 2012, when he allegedly executed a scheme to defraud “Silk...more
SCOTUS Denies Cert In Cases Addressing FCA Pleadings Requirements -
On Monday, October 17, 2022, the US Supreme Court rejected three petitions asking the Court to resolve a circuit split regarding the Rule 9(b)...more
10/21/2022
/ CIGNA ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Kickbacks ,
Medicare ,
Medicare Advantage ,
SCOTUS ,
Solicitor General ,
TRICARE ,
Whistleblowers
COVID-19 Fraud Update: DOJ Prosecutes More than 150 Defendants, 95 Criminal Cases -
Since the inception of the CARES Act, DOJ’s Fraud Section has prosecuted over 150 defendants in over 95 criminal cases. The Fraud Section...more
9/30/2022
/ CARES Act ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Genetic Testing ,
IRS ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Payroll Expenses
DOJ Indicts 47 Individuals in Largest COVID-19 Fraud Scheme To Date -
On September 20, 2022, the US Department of Justice (“DOJ”) announced federal criminal charges against 47 defendants from the nonprofit, Feeding Our...more
9/23/2022
/ Compliance Monitoring ,
Coronavirus/COVID-19 ,
Criminal Investigations ,
Department of Justice (DOJ) ,
E-Cigarettes ,
Enforcement ,
False Documentation ,
FOIA ,
Food and Drug Administration (FDA) ,
Fraud ,
Kickbacks ,
New Guidance ,
Reimbursements ,
USDA
Medical Technology Company President Convicted for Participation in $77 Million COVID-19 and Allergy Testing Scheme -
On September 1, 2022, the president of Arrayit Corporation, a medical technology company in Silicon...more
9/9/2022
/ Bribery ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Disclosure Requirements ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Investors ,
Kickbacks ,
Medical Technology Companies ,
Medicare ,
Prison ,
Puerto Rico ,
Securities and Exchange Commission (SEC) ,
Wire Fraud
Jury Orders Eli Lilly To Pay $61 Million -
A federal jury in Illinois found that, beginning around 2004, drug manufacturer Eli Lilly deliberately underpaid rebates to Medicare programs by excluding retroactive drug prices...more
8/8/2022
/ Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Falsified Documents ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Paycheck Protection Program (PPP) ,
Rebates ,
SBA ,
Skilled Nursing Facility ,
Wire Fraud
On July 20, 2022, the Justice Department announced that it brought criminal charges against 36 defendants in 13 federal districts across the country, charging more than $1.2 billion in alleged telemedicine, cardiovascular and...more
7/25/2022
/ Bank Fraud ,
CARES Act ,
Criminal Conspiracy ,
Criminal Convictions ,
Criminal Investigations ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Fraud ,
International Banks ,
Kickbacks ,
Medicare ,
Paycheck Protection Program (PPP) ,
Telemedicine ,
Ukraine
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
DOJ Denies Alleged Circuit Split on Particularity Requirement in FCA Cases -
In a much-anticipated filing by the Department of Justice (DOJ), following the US Supreme Court’s request for briefing by the US Office of the...more
California Man Convicted in $27 Million PPP Fraud Scheme -
After a trial before a federal jury, a California man was convicted of bank fraud, making false statements to a financial institution, and money laundering for...more
4/1/2022
/ Bank Fraud ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Statements ,
Financial Institutions ,
Fraud ,
Healthcare Fraud ,
IRS ,
Kickbacks ,
Medicare ,
Paycheck Protection Program (PPP)
DOJ and Treasury Announce Multilateral Russian Oligarch Task Force Called “REPO” -
On March 16, 2022, Attorney General Merrick Garland and Secretary of the Treasury Janet Yellen met with representatives from Australia,...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 Secures $5.6 Billion in False Claims Act Recoveries in Fiscal Year 2021 -
On February 1, 2022, the U.S. Department of Justice (DOJ) announced that the Department recovered approximately $5.6 billion in False Claims Act...more
2/4/2022
/ CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Fraud ,
Kickbacks ,
Managed Care Contracts ,
Medicare Advantage ,
Misappropriation ,
NFL ,
PSLRA ,
Purdue Pharma ,
Securities Fraud
4th Circuit Affirms Dismissal of FCA Medicaid Suit Against Allergan -
On January 25, 2022, a majority of the Fourth Circuit panel affirmed the dismissal of a relator's False Claims Act complaint against Allergan Sales LLC,...more
1/31/2022
/ Allergan Inc ,
Criminal Conspiracy ,
Criminal Convictions ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Mail Fraud ,
Medicaid ,
Pharmacist ,
Sentencing ,
TRICARE
Lab Owner Pleads Guilty to $6.9 Million Medicare Fraud Scheme Involving Kickbacks and Bribery -
On January 13, 2022, the Department of Justice (DOJ) announced that a Florida man pled guilty in the Southern District of...more
1/24/2022
/ Bribery ,
Coronavirus/COVID-19 ,
DEA ,
Department of Defense (DOD) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
FBI ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Virus Testing
Texas Man Sentenced to More Than Nine Years in Prison for COVID-19 Fraud Scheme -
After pleading guilty to two charges of wire fraud and money laundering, a Texas man was sentenced to 110 months in prison for his scheme to...more
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
Court Reinstates Life Insurance Company's Fraud Claims Over Defunct Laboratory -
A New Jersey state appeals court reinstated Aetna Life Insurance Company’s (Aetna) fraud claims against the minority owners of the now defunct...more
10/18/2021
/ Aetna ,
Bribery ,
Criminal Conspiracy ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Hemp Related Businesses ,
Insurance Fraud ,
Kickbacks ,
Life Insurance ,
Popular ,
Securities and Exchange Commission (SEC) ,
UFTA
A Florida owner of telemedicine companies is charged with orchestrating a health care fraud and illegal kickback scheme that involved the submission of over $784 million in false Medicare claims.
DOJ Charges Telemedicine...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