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Federal District Court Finds Private-Insurer Relator Can Proceed with False Claims Action

Last month, the U.S. District Court for the District of New Jersey held that a private company, Allstate Insurance Company, could proceed with its whistleblower action against a clinical laboratory, Phoenix Toxicology and Lab...more

Eleventh Circuit Affirms Order for $1.195 Million in Restitution and 48 Month Sentence in Commercial Insurance Healthcare Fraud...

Last month, the Eleventh Circuit upheld a $1.195 million restitution order and 48-month sentence against Carlos Verdeza for three counts of healthcare fraud. See United States v. Verdeza, No. 21-10461, 2023 WL 3728960 (11th...more

Supreme Court Clarifies the False Claims Act’s Knowledge Requirement, Eliminating a Potential Defense for Government Contractors...

On June 1, 2023, the Supreme Court unanimously ruled in favor of whistleblower plaintiffs (referred to as “relators”) in consolidated False Claims Act (“FCA”) cases in a decision that clarified the application of the FCA’s...more

Seventh Circuit Upholds Decision In Favor of Insured Party Seeking Coverage for False Claims Act Settlement

On May 3, 2023, the US Court of Appeals for the Seventh Circuit sided with the policyholder, resolving a large insurance coverage dispute relating to a $100 million settlement involving claims under the federal Anti-Kickback...more

Distributor of Ophthalmic Surgical Products Found Guilty of Paying Kickbacks and Violating the False Claims Act: May Be Liable For...

On February 28, 2023, a federal jury in the District of Minnesota found the Cameron-Ehlen Group, d/b/a Precision Lens, and its founder and owner Paul Ehlen (the “Defendants”) guilty of paying kickbacks to ophthalmic surgeons...more

Pharmaceutical Manufacturer Agrees to $900 Million Dollar False Claims Act Settlement to Resolve Kickback Claims

On July 20th, on the eve of trial, Biogen Inc. agreed to pay $900 million dollars to settle claims that the company violated the False Claims Act (FCA) by allegedly paying improper consulting and speaker fees and providing...more

DOJ Settles First False Claims Act Enforcement Action Since Launch of Civil Cyber-Fraud Initiative

On March 8, 2022, the U.S. Department of Justice (DOJ) announced a $930,000 settlement with Comprehensive Health Services, LLC (CHS) for alleged violations of the False Claims Act (FCA). This settlement marks DOJ’s first...more

Gleanings From DOJ’s 2021 Healthcare Takedown Announcement

On Sept. 17, 2021, the U.S. Department of Justice (DOJ) announced the results of its 2021 Healthcare Takedown. The Healthcare Takedown is the industry nickname for DOJ’s annual announcement of multiple indictments across the...more

Healthcare Headlines Episode 3 - Stay Ready: Trends in Healthcare False Claims Act Investigations [Video]

Episode three of McGuireWoods’ video series “Healthcare Headlines” focuses on trends in False Claims Act investigations across the healthcare industry. Host Amber McGraw Walsh, chair of the firm’s nationally recognized...more

U.S. Attorney’s Office Settles with Urgent Care Providers to Resolve False Claims Act Allegations Related to Credentialing Issues

On April 8, 2021, the U.S. Attorney’s Office for the District of South Carolina announced a $22.5 million settlement with a network of urgent care providers, Doctors Care, P.A. (Doctors Care), and its management company, UCI...more

Health+Tech - Episode 1: Post-Pandemic Healthcare Compliance and Enforcement Priorities [Video]

In the first episode of McGuireWoods’ video series Health+Tech, “Post-Pandemic Healthcare Compliance & Biden Administration Enforcement Priorities,” hosts Andrea Lee Linna, Janice Walker-Suchyta and Jonathan Ishee discuss...more

DOJ Announces Plan for Coordinated Civil Rights Response to COVID-19

On April 2, 2021, Pamela S. Karlan, the Principal Deputy Assistant Attorney General for Civil Rights at the U.S. Department of Justice Civil Rights Division (DOJ), issued a public statement regarding the Division’s intent to...more

Eleventh Circuit Affirms 11-year Prison Sentence for Substance Abuse Treatment Center Physician

Last month, the Eleventh Circuit upheld the conviction and 11-year prison sentence of a physician-Medical Director of two substance abuse treatment centers in Florida who was convicted by a jury of participating in a...more

U.S. Supreme Court Declines to Clarify False Claims Act Falsity Standard

The U.S. Supreme Court recently declined to address a circuit split regarding the standard for establishing that a statement material to a claim for payment is false under the False Claims Act (FCA); specifically, whether the...more

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