Supreme Court to Hear US Government in FCA Scienter Oral Argument -
On March 20, 2023, the US Supreme Court agreed to allow the federal government to participate in oral argument in the Supreme Court’s review of the...more
3/27/2023
/ Bribery ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Generic Drugs ,
Insurance Fraud ,
Medicaid ,
Medicare ,
Oral Argument ,
Scienter ,
SCOTUS ,
Securities and Exchange Commission (SEC)
DOJ Issues Corporate Self-Disclosure Policy -
The US Department of Justice (DOJ) released a Voluntary Self-Disclosure Policy that sets a consistent standard for corporate self-disclosures for all US Attorney’s Offices. The...more
2/27/2023
/ Appeals ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health and Welfare Plans ,
Medicaid ,
Medicare ,
NBA ,
Proposed Amendments ,
Restitution ,
SCOTUS ,
Self-Disclosure Requirements ,
Whistleblowers
US Supreme Court to Address FCA’s Scienter Requirement in Safeway Case -
The US Supreme Court granted certiorari to resolve a circuit split regarding whether a defendant “knowingly” violates the False Claims Act (FCA) if...more
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
Lens Manufacturer Agrees To Pay $16.4 Million To Resolve Alleged Violations of the False Claims Act and Anti-Kickback Statute -
Essilor International, Essilor of America, Inc., Essilor Laboratories of America Inc., and...more
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
Eli Lilly Accused of Defrauding Government in $60 Million Qui Tam Suit -
In a qui tam suit alleging that Eli Lilly and Co. (“Eli Lilly”) violated the False Claims Act, a whistleblower contended that Eli Lilly defrauded...more
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 Indicted For $100 Million Health Care Fraud Scheme -
On November 2, 2021, a federal grand jury in the Western District of Arkansas indicted Billy Joe Taylor of Arkansas for an alleged health care fraud scheme. ...more
11/5/2021
/ Criminal Investigations ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Diagnostic Tests ,
Enforcement Actions ,
False Billing ,
FBI ,
Fraud and Abuse ,
Healthcare Fraud ,
Indictments ,
Medicaid ,
Regulatory Violations
A regional hospital system in Akron, Ohio, Akron General Health System (AGHS) reached a $21.25 million settlement over allegations that an improper physician referral arrangement violated the Anti-Kickback Statute, Physician...more
On May 21, 2021, SavaSeniorCare LLC and several of its affiliates, which own and operate skilled nursing facilities across the country, agreed to pay $11.2 million to resolve claims that the companies billed Medicare for...more
6/1/2021
/ Coronavirus/COVID-19 ,
Corporate Integrity Agreement ,
Defense Production Act ,
Department of Defense (DOD) ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Medicaid ,
Medical Reimbursement Plans ,
Medicare ,
OIG ,
Provider Relief Fund ,
Securities and Exchange Commission (SEC) ,
Skilled Nursing Facility ,
USPTO
COVID-19 Task Force Established to Enhance Enforcement Efforts against Fraud -
On May 17, 2021, the Department of Justice and U.S. Attorney General announced the establishment of the COVID-19 Fraud Enforcement Task Force,...more
5/24/2021
/ Attorney General ,
Centers for Disease Control and Prevention (CDC) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Department of Labor (DOL) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Falsified Documents ,
Fraud ,
Health Insurance ,
Healthcare Fraud ,
Medicaid ,
OIG ,
Paycheck Protection Program (PPP) ,
SBA ,
Vaccinations ,
Wire Fraud
Pharmaceutical Company Agrees to Pay $12.6 Million to Settle FCA Allegations Involving Kickbacks -
On Tuesday, the Department of Justice announced a $12.6 million settlement with Incyte Corporation, a Delaware...more
5/10/2021
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Frivolous Lawsuits ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Money Laundering ,
Settlement ,
Telemarketing ,
TRICARE
Court Rules Prescription Drug Event and Enrollee Encounter Data Are 'Claims for Payment' Under the False Claims Act -
US District Judge Noel L. Hillman approved a whistleblower’s request to file a Fourth Amended Complaint...more
4/26/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Fair Market Value ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Mail Fraud ,
Medicaid ,
Medicare Part A ,
Medicare Part D ,
Oil & Gas ,
Securities Fraud ,
Whistleblowers ,
Wire Fraud
Judge Rules Against Seizure of $330 Million Allegedly Connected to 1MDB Fraud Scheme -
On March 9, California District Court Judge Dale S. Fischer ruled that the government could not seize about $330 million in assets...more
3/22/2021
/ FinTech ,
Fraud ,
Healthcare Fraud ,
Identity Theft ,
Kickbacks ,
Mail Fraud ,
Malaysia ,
Medicaid ,
Medicare ,
Money Laundering ,
Saudi Arabia ,
Securities and Exchange Commission (SEC) ,
Wire Fraud
DOJ’s 2020 False Claims Act Recoveries Lowest Since 2008 -
On January 14, 2021, the Department of Justice (DOJ) announced that it obtained more than $2.2 billion in settlements and judgments from civil cases involving...more
1/25/2021
/ Bribery ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Food and Drug Administration (FDA) ,
Fraud ,
IRS ,
Kickbacks ,
Medicaid ,
Medical Devices ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Relief Measures ,
SBA ,
Settlement ,
Whistleblowers ,
Wire Fraud
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
Medical Device Manufacturer Settles Improper Payment Allegations for $18 Million -
Merit Medical Systems Inc. (MMSI), a Utah-based medical device maker, will pay $18 million to settle allegations that it engaged in a...more
10/19/2020
/ Child Care ,
Corporate Integrity Agreement ,
Department of Energy (DOE) ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Mail Fraud ,
Medicaid ,
Medical Devices ,
Medicare ,
Settlement Agreements ,
Subcontractors ,
TRICARE ,
Wire Fraud
Acute Care Hospital Agrees to Pay $50 Million to Settle Alleged Stark Law and Anti-Kickback Statute Violations -
On September 9, 2020, the Department of Justice (“DOJ”) announced that Wheeling Hospital Inc. (“Wheeling...more
9/14/2020
/ Anti-Kickback Statute ,
California ,
Campaign Contributions ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Fair Market Value ,
False Claims Act (FCA) ,
Fraud ,
Medicaid ,
Medicare ,
Qui Tam ,
Risk Assessment ,
Settlement Agreements ,
Stark Law ,
TRICARE ,
Wire Fraud
Defense Contractor Pays $1.1 Million to Resolve Civil Fraud Claims -
Islands Mechanical Contractor, Inc. (IMC), a construction contractor, has agreed to pay $1.1 million to settle civil fraud claims relating to improperly...more
DME Provider to Plead Guilty to $109 Million Medicare Fraud Scheme -
A Florida-based individual was charged with one count of health care fraud and one count of payment of kickbacks in connection with a federal health care...more
8/3/2020
/ Durable Medical Equipment ,
Identity Theft ,
Kickbacks ,
Market Manipulation ,
Medicaid ,
Medicare ,
Medicare Fraud ,
NFL ,
Popular ,
Shell Corporations ,
Whistleblowers
COVID Relief Program Fraud Charges -
DOJ continues to announce charges against defendants accused of fraud in connection with allegedly false loan applications submitted under the Paycheck Protection Program (PPP)...more
7/20/2020
/ Bank Fraud ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Loan Applications ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
SBA ,
Skilled Nursing Facility ,
Tax Returns ,
TRICARE ,
Wire Fraud
DOJ Announces $72.3 Million False Claims Act Settlement -
Oklahoma Center for Orthopaedic and Multi-Specialty Surgery, its part-owner and management company, a physician group, and other affiliated entities and individuals...more
Nonprofit Hospital System and Physician Practice Reach $10 Million Settlement for False Claims Act Allegations -
Centra Health Inc., a nonprofit hospital system, and Blue Ridge Ear, Nose, Throat and Plastic Surgery, Inc.,...more
4/27/2020
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Kickbacks ,
Maryland ,
Medicaid ,
New York ,
Patient Referrals ,
Qui Tam ,
Relators ,
Stark Law ,
State and Local Government ,
Tax Fraud ,
Whistleblower Awards ,
Whistleblowers
Omnicare and CVS Face Fraudulent Billing Lawsuit -
On Tuesday, the US Attorney’s Office for the Southern District of New York announced a False Claims Act lawsuit against Omnicare, Inc. and its parent company, CVS Health...more
12/20/2019
/ CVS ,
Department of Justice (DOJ) ,
Dismissals ,
False Claims Act (FCA) ,
Government Investigations ,
Medicaid ,
Medicare ,
Medicare Part D ,
Omnicare ,
Pharmacies ,
Prescription Drugs ,
Rite Aid ,
State Attorneys General ,
TRICARE ,
Whistleblowers