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
Long Island Businessman Arrested in $22 Million Medicare Fraud Scheme -
A Long Island, New York, businessman was arrested on conspiracy, kickback, and money laundering charges stemming from an alleged scheme to defraud...more
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
US Supreme Court Declines to Consider AKS ‘Willfulness’ Question -
On October 7, the US Supreme Court denied a petition in which a whistleblower asked the Court to decide whether a “willful” act under the federal...more
10/14/2024
/ Anti-Kickback Statute ,
Bribery ,
Criminal Conspiracy ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Home Health Care ,
Kickbacks ,
Medicaid ,
Money Laundering ,
Popular ,
Scienter ,
SCOTUS ,
Telehealth ,
Whistleblowers
Florida Federal Judge Strikes Down FCA’s Qui Tam Provision as Unconstitutional -
On September 30, US District Judge Kathryn Kimball Mizelle of the Middle District of Florida held in a historic decision that the federal...more
10/7/2024
/ Anti-Kickback Statute ,
Appointments Clause ,
Criminal Convictions ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
False Statements ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Misrepresentation ,
OIG ,
Qui Tam ,
Sentencing ,
Settlement ,
Unconstitutional Condition
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
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
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
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
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