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
Home Health Care Owner Sentenced to Nine Years in Prison for Medicare Fraud Scheme -
This week, the owner of a home health company was sentenced to nine years in prison for orchestrating a nearly $2.8 million scheme...more
2/5/2024
/ CARES Act ,
Coronavirus/COVID-19 ,
Email ,
Fraud ,
Healthcare Fraud ,
Home Health Care ,
Identity Theft ,
Income Taxes ,
IRS ,
Medicare Fraud ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Sentencing ,
Social Security ,
Tax Fraud ,
Wire Fraud ,
Witness Tampering
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
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
Three Men Sentenced for $54 Million TRICARE Fraud Scheme -
Three men were sentenced in connection with a $54 million bribery and kickback scheme involving TRICARE, a federal program that provides health insurance benefits...more
11/20/2023
/ Bribery ,
Department of Justice (DOJ) ,
False Statements ,
Fraud ,
Health Insurance ,
Healthcare Fraud ,
Kickbacks ,
Money Laundering ,
Pyramid Schemes ,
Reimbursements ,
TRICARE ,
Wire Fraud
DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence -
Mark Schena, the former president of Arrayit Corporation, a Silicon Valley-based medical technology company, was...more
10/23/2023
/ Conspiracies ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Emergency Use Authorization (EUA) ,
False Claims Act (FCA) ,
False Statements ,
Food and Drug Administration (FDA) ,
Healthcare Fraud ,
Investors ,
Kickbacks ,
Medicaid ,
Medical Technology Companies ,
Medicare Fraud ,
Restitution ,
Securities Fraud ,
Sentencing ,
Settlement ,
TRICARE ,
Wire Fraud
Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims -
On September 27, 2023, Chief Judge Dennis Saylor of the US District Court for the District of Massachusetts ruled that...more
10/9/2023
/ Anti-Kickback Statute ,
But For Causation ,
Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Home Health Care ,
Medicare ,
Medicare Fraud ,
Money Laundering ,
Settlement ,
Summary Judgment ,
Unjust Enrichment ,
Wire Fraud
Lab Owner Sentenced to Over 16 Years for Health Care Fraud, Money Laundering -
On September 26, 2023, a US District Judge for the Western District of North Carolina sentenced a Charlotte lab owner, Donald Booker, to over...more
10/2/2023
/ Criminal Convictions ,
Department of Justice (DOJ) ,
Gift-Cards ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare Fraud ,
Money Laundering ,
Sentencing ,
Wire Fraud ,
Witness Tampering
Engineering Company Agrees to Pay $4.4 Million to Settle FCA -
On Friday, September 15, 2023, the US Department of Justice (DOJ) announced a settlement agreement with Navmar Applied Sciences Corporation, a...more
9/25/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Acquisition Regulations (FAR) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Identity Theft ,
Kickbacks ,
Settlement ,
U.S. Navy ,
Whistleblowers
Walgreens Medicaid Fraud Case Kicked Back to Trial Court -
On August 15, 2023, the US Court of Appeals for the Fourth Circuit issued an opinion reversing a district judge’s dismissal of False Claims Act (FCA) claims...more
8/21/2023
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicaid Act ,
Medicare ,
Money Laundering ,
Reimbursements ,
Trial Court Orders ,
Virus Testing ,
Walgreens
Former NBA Player Sentenced to 10 Years in Prison for Health Care Fraud -
Terrence Williams, a former NBA player, was sentenced to 10 years in prison for his participation in a scheme to defraud the NBA’s Health and...more
8/14/2023
/ Bitcoin ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
False Advertising ,
Federal Trade Commission (FTC) ,
Healthcare Fraud ,
Kickbacks ,
Misleading Statements ,
Money Laundering ,
NBA ,
Penalties ,
Reimbursements ,
Sentencing ,
Theft ,
Unfair or Deceptive Trade Practices
Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment -
Defunct BestCare Laboratory Services LLC and its founder will pay $5.7 million to settle an outstanding 2018 False Claims Act...more
8/7/2023
/ Beneficiaries ,
Blue Cross ,
Blue Shield ,
DEA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare ,
Mileage Reimbursement ,
Nursing Homes ,
Pharmacies ,
Restitution ,
Settlement
$140 Million Healthcare Fraud Case to Be Retried -
On June 27, a Houston federal district court judge indicated that a $140 million healthcare fraud case, which ended in mistrial in December 2022 due to allegations of...more
Recent Filings Shed Light on DOJ’s View of Supreme Court’s Recent FCA Ruling -
On June 1, 2023, the US Supreme Court explained that an assessment of a defendant’s subjective beliefs — rather than what an objectively...more
6/19/2023
/ Chief Compliance Officers ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
IRS ,
Medicare ,
Opioid ,
Pharmacies ,
Pharmacist ,
Scienter ,
SCOTUS ,
Tax Fraud ,
Wire Fraud
Nurse Pleads Guilty to Health Care Fraud, Distributing Controlled Substances -
On May 9, 2023, an advanced practice registered nurse pleaded guilty to unlawfully distributing controlled substances and committing health...more
Anticipated Landmark Supreme Court Decision May Be Anything But On -
April 18, 2023, the US Supreme Court heard oral arguments in a set of highly anticipated cases regarding the scienter—or knowledge—provision of the False...more
4/24/2023
/ Appeals ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Oral Argument ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Restitution ,
SCOTUS
A laboratory company based in Texas, Genotox Laboratories Ltd., recently reached an agreement with the federal government to resolve False Claims Act and Anti-Kickback Statute violations, stemming from allegations related to...more
4/10/2023
/ Anti-Kickback Statute ,
C-Suite Executives ,
Civil Monetary Penalty ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Medical Devices ,
Medicare ,
Settlement ,
Texas
Ophthalmology Distributer and Owner Oppose Government Request for $490 Million Award After Jury Verdict -
A federal jury in Milwaukee recently returned a verdict against the Cameron-Ehlen Group, Inc., d/b/a Precision Lens,...more
Headlines that Matter for Companies and Executives in Regulated Industries-
Government Wins $43 Million Verdict in False Claims Act Case -
On February 28, 2023, a federal jury in Minnesota handed down a $43 million...more
Florida Doctor Receives 20-Year Prison Sentence for Substance Abuse Treatment Fraud -
Following a guilty plea to conspiracy to commit health care and wire fraud, a Florida doctor was sentenced to 20 years in prison for...more
1/16/2023
/ CARES Act ,
Criminal Convictions ,
Drug Treatment ,
False Claims Act (FCA) ,
FIRREA ,
Fraud ,
Healthcare Fraud ,
Mail Fraud ,
Paycheck Protection Program (PPP) ,
Settlement ,
Substance Abuse ,
Telemarketing ,
Wire Fraud
Medical Device Company to Pay Over $700,000 To Resolve Criminal Allegations -
On January 4, 2023, a criminal information was filed in the Southern District of Illinois, in which Jet Medical Inc. (Jet), a medical device...more
1/6/2023
/ Civil Monetary Penalty ,
Coronavirus/COVID-19 ,
Criminal Penalties ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Food and Drug Administration (FDA) ,
Fraud ,
Healthcare Fraud ,
Medical Billing Codes ,
Medical Devices ,
Medicare ,
Paycheck Protection Program (PPP) ,
SBA ,
Settlement ,
Tax Evasion
Pharmacy Owners Plead Guilty to COVID Fraud and Money Laundering Scheme -
Two New York men pled guilty for their alleged involvement in a complex money laundering conspiracy to launder proceeds from a fraudulent health...more
Headlines that Matter for Companies and Executives in Regulated Industries-
Amici Seek Dismissal of Qui Tam Suit From High Court -
Various medical, business and legal organizations are asking the US Supreme Court to...more
10/28/2022
/ Amicus Briefs ,
Anti-Money Laundering ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Indictments ,
Motion to Dismiss ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Whistleblowers ,
Wire Fraud
OIG Warns That Proposed Drug Discounts May Warrant Sanctions -
On October 5, the US Department of Health and Human Services’ Office of Inspector General (OIG) issued an advisory opinion assessing a proposal that involved...more
10/10/2022
/ Anti-Competitive ,
Anti-Kickback Statute ,
Bid Rigging ,
Bribery ,
Caltrans ,
Contractors ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Discounts ,
Drug Pricing ,
Economic Injury Disaster Loans ,
False Statements ,
Fraud and Abuse ,
Healthcare Fraud ,
IRS ,
Medicare ,
Medicare Part D ,
OIG ,
Sanctions ,
Tyson Foods ,
Wire Fraud