Welcome to the Summer 2025 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
FCA Complaint Filed Against One of Nation’s Largest Specialty Wound Care Providers -
On April 4, the government filed a complaint against Vohra Wound Physicians Management LLC, its founder, Dr. Ameet Vohra, and VHS...more
4/14/2025
/ Department of Justice (DOJ) ,
Enforcement Actions ,
Exports ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Investigations ,
Medicare ,
Money Laundering ,
Nursing Homes ,
Physicians ,
Price-Fixing ,
Russia
Medical Group and Related Parties to Pay Over $62 Million to Resolve FCA Claims for False Diagnoses -
On March 26, the US Department of Justice (DOJ) announced that a California-based medical group and related parties...more
3/31/2025
/ California ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Imports ,
Medicare Advantage ,
Physicians ,
Settlement ,
Whistleblowers
Welcome to the Winter 2025 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
Jury Clears SuperValu of Liability in Whistleblower FCA Prescription Pricing Case -
A federal jury in Illinois recently found SuperValu not liable in a whistleblower lawsuit that accused the company of overcharging the...more
3/10/2025
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Medicare Fraud ,
Prescription Drugs ,
SCOTUS ,
Settlement ,
Whistleblowers
Massachusetts District Court Judge Applies Heightened Causation Standard in FCA Case -
On January 6, a District Court of Massachusetts judge granted summary judgment for defendants on allegations of violating the...more
1/27/2025
/ Anti-Kickback Statute ,
Causation ,
Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Medicare Advantage ,
Opioid ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
SCOTUS ,
Settlement ,
Skilled Nursing Facility ,
Whistleblowers
Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions -
In a brief filed earlier this week, the US federal government has urged the Eleventh Circuit Court of Appeals to uphold the...more
1/13/2025
/ Anti-Kickback Statute ,
Appeals ,
Appointments Clause ,
Article III ,
Constitutional Challenges ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
Misrepresentation ,
National Institute of Health (NIH) ,
Pharmaceutical Industry ,
Qui Tam ,
SCOTUS ,
Settlement ,
Stark Law ,
Unconstitutional Condition ,
Whistleblowers
Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim -
Steven Richardson, the owner of telemedicine companies Expansion Media, LLC and Hybrid Management Group LLC, agreed to settle allegations that...more
2/26/2024
/ Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Indictments ,
Kickbacks ,
Medicare ,
Settlement ,
Telemedicine
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
Nevada Man Sentenced to 51 Months Imprisonment for Prize-Notification Fraud Scheme -
Earlier this week, a Nevada man was sentenced to 51 months in prison for perpetrating a prize-notification scheme that defrauded...more
Government Brings FCA Action Against Laboratory Companies -
On July 18, 2023, the US Department of Justice (DOJ) announced it has filed a complaint against multiple laboratory companies and their owner, Patrick...more
7/24/2023
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Electronic Protected Health Information (ePHI) ,
False Claims Act (FCA) ,
Health Care Providers ,
Kickbacks ,
Laboratories ,
Medicare ,
Medicare Fraud ,
Virus Testing
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
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
Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act -
On February 22, 2021, the United States Supreme Court denied petitions for certiorari in a case that could have addressed the issue of...more
3/1/2021
/ Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Hospice ,
Investment Fraud ,
Objective Falsity ,
Qui Tam ,
SCOTUS ,
Securities and Exchange Commission (SEC) ,
Whistleblowers
HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute -
On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services (HHS) published...more
12/7/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
DEA ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Final Rules ,
Fraud ,
Health Care Providers ,
Inflated Projections ,
Medicaid ,
Medicare ,
Opioid ,
Physician Medicare Reimbursements ,
Purdue Pharma ,
Securities Fraud ,
Stark Law ,
Value-Based Care
Department of Justice Announces $8.3 Billion Settlement with Opioid Manufacturer Purdue Pharma and Members of the Sackler Family -
On October 21, the Department of Justice (DOJ) announced that it reached a global resolution...more
10/26/2020
/ Anti-Kickback Statute ,
Bankruptcy Court ,
DEA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Fraud ,
Health Care Providers ,
Opioid ,
Pharmaceutical Industry ,
Purdue Pharma ,
Securities Act of 1933 ,
Securities and Exchange Commission (SEC) ,
Settlement Agreements ,
Substance Abuse
SDNY Files Civil Fraud Lawsuit Against Anthem -
On March 27, 2020, the Manhattan U.S Attorney announced the filing of a civil fraud lawsuit against Anthem Inc. for allegedly falsely certifying the accuracy of diagnosis...more
Headlines that Matter for Companies and Executives in Regulated Industries -
Health Care Enforcement News -
Elder Care Companies Agree to Pay $15.5 Million to Resolve False Claims Act Allegations -
The Department...more
2/25/2020
/ Anti-Bribery ,
Bribery ,
Criminal Conspiracy ,
Department of Justice (DOJ) ,
Elder Care ,
Enforcement Actions ,
False Claims Act (FCA) ,
Foreign Agents ,
Foreign Agents Registration Act (FARA) ,
Guilty Pleas ,
Health Care Providers ,
Medicare ,
Money Laundering ,
National Security ,
Settlement Agreements
Headlines that Matter for Companies and Executives in Regulated Industries -
DOJ News -
Tenet Healthcare Agrees to $1.41 Million Settlement of FCA Claims -
Tenet Healthcare Corporation and its affiliated hospital,...more
Headlines that Matter for Companies and Executives in Regulated Industries -
DOJ News -
Four Physicians Found Guilty for Role in $150 Million Medicare Fraud Scheme -
Following a four-week trial, a federal jury in...more
2/7/2020
/ Bribery ,
Criminal Conspiracy ,
Criminal Prosecution ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Drug Distribution ,
False Billing ,
Foreign Corrupt Practices Act (FCPA) ,
Guilty Pleas ,
Health Care Providers ,
Healthcare Fraud ,
ITAR ,
Medicare ,
Opioid ,
Physicians ,
Securities Fraud ,
Stocks ,
Wire Fraud
In the DOJ’s first-ever criminal action against an electronic health records vendor, San Francisco-based Practice Fusion Inc. agreed to pay $145 million to resolve allegations that it received kickbacks from pharmaceutical...more
2/3/2020
/ Anti-Kickback Statute ,
Criminal Penalties ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Fraud ,
Investigations ,
Kickbacks ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Software ,
Whistleblowers
“Enforcing the False Claims Act is a top priority for the Department—not just for our office,” said Deputy Associate Attorney General Stephen Cox, the Keynote Speaker for the 2020 Advanced Forum on False Claims and Qui Tam...more
1/31/2020
/ Cooperation ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Investigations ,
Investors ,
Litigation Funding ,
Manufacturers ,
Pharmacies ,
Physicians ,
Qui Tam ,
Relators ,
Third Party Funding ,
Whistleblowers
Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme -
Two individuals pled guilty in Pennsylvania federal court to conspiracy to defraud the Pennsylvania Medicaid program and commit...more
1/24/2020
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Home Health Agencies ,
OIG ,
Whistleblowers
DOJ News -
Manufacturer to Pay Over $37.5 Million to Resolve False Claims Act Allegations -
On January 15, 2015, the DOJ announced that ResMed Corp., a manufacturer of durable medical equipment, agreed to pay over...more
1/20/2020
/ Anti-Kickback Statute ,
Clinical Trials ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Indictments ,
Misrepresentation ,
Physicians ,
Qui Tam ,
Settlement ,
Tax Deductions ,
Tax Fraud ,
Tax Returns ,
Whistleblowers