Previously, we discussed how the US Supreme Court’s opinion in Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce could create opportunities for private litigants to challenge health...more
7/30/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare ,
Loper Bright Enterprises v Raimondo ,
Payment Systems ,
Regulatory Agenda ,
SCOTUS ,
Secretary of HHS ,
Stark Law
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
The US Supreme Court recently overturned its ruling in Chevron USA, Inc. v. Natural Resources Defense Council, Inc., changing the landscape for federal agency rulemaking and actions, particularly in the health care industry....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
Biomedical Company Avoids DOJ Prosecution After First Ever Voluntary Corporate Self-Disclosure of Fraud Under NSD Enforcement Policy -
On May 22, the US Department of Justice (DOJ) announced that it will not prosecute a...more
5/28/2024
/ Biomedical Companies ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement ,
Enforcement Actions ,
Fraud ,
Healthcare Fraud ,
Medicare ,
National Security ,
Self-Disclosure Requirements ,
Voluntary Disclosure
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
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
Former Comptroller of Ecuador Convicted in International Bribery and Money Laundering Scheme -
On April 24, a Miami jury convicted Carlos Ramon Polit Faggioni, the former Comptroller General of Ecuador, for his role in an...more
4/30/2024
/ Bribery ,
Conspiracies ,
Controlled Substances ,
Dark Web ,
Department of Justice (DOJ) ,
Ecuador ,
Misrepresentation ,
Money Laundering ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Sentencing ,
Wire Fraud
Headlines that Matter for Companies and Executives in Regulated Industries-
Canadian Man Sentenced for Operating $175 Million Psychic Mass-Mailing Fraud Scheme -
On April 15, Patrice Runner, a Canadian and French...more
Trio Sentenced to Eight to 15 Years in Prison for Laundering Proceeds of Telephone Scam -
Following a jury trial, three individuals were convicted of a money laundering conspiracy and sentenced to eight, 10, and 15 years...more
Commonwealth Financial Network Must Pay $72 Million in SEC Enforcement Action -
Late last week, a Massachusetts federal judge ordered Commonwealth Financial Network to pay over $72 million due to its “egregious” failure to...more
4/8/2024
/ Broker-Dealer ,
Conflicts of Interest ,
Department of Justice (DOJ) ,
Disgorgement ,
Enforcement Actions ,
Financial Institutions ,
Fraud ,
Investment Adviser ,
NASA ,
Penalties ,
Securities and Exchange Commission (SEC) ,
Sentencing ,
Wire Fraud
Disgraced Crypto Mogul Bankman-Fried Sentenced to 25 Years in Prison -
On March 28, Judge Lewis Kaplan of the United States District Court for the Southern District of New York handed down a substantial term of...more
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
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
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