News & Analysis as of

Bribery Medicare

Greenbaum, Rowe, Smith & Davis LLP

First Circuit Decision Regarding Anti-Kickback Statute Standard Widens Circuit Split and Creates Potential for Supreme Court...

The U.S. Court of Appeals for the First Circuit, in United States v. Regeneron, has joined the Sixth and Eighth Circuits in adopting the “but-for” standard to find that a violation of the Anti-Kickback Statute (AKS) triggers...more

The Volkov Law Group

The Continuing Plague of Healthcare Fraud

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Healthcare fraud is an ever-growing constant in our economy.  It is a battle that presents new and exponential challenges.  The U.S. Department of Justice, the HHS-Office of Inspector general and State Attorneys’ General all...more

Rivkin Radler LLP

Lab Owner Pleads Guilty in Covid Test Kit Fraud Scheme

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Robert Clark of Pompano Beach, Florida recently pleaded guilty to his role in a Medicare fraud scheme. Clark and his co-conspirators purchased Medicare Beneficiary Identification numbers unlawfully and then billed Medicare...more

Dickinson Wright

NY Doctor Indicted for Medicare Fraud Related to Genetic Testing and Equipment

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The government is continuing to take a close look at laboratory testing in the wake of the COVID-19 pandemic. On February 21, 2024, a federal grand jury in New Jersey issued a superseding indictment against a New York...more

Rivkin Radler LLP

NY Physician, Wife and Staff Admit AKS Violations

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The U.S. Attorney’s Office in Trenton, NJ announced on November 22 that primary care physician Yitzchok “Barry” Kurtzer of Monsey, NY, and his wife pleaded guilty to soliciting and receiving kickbacks and bribes in exchange...more

ArentFox Schiff

Investigations Newsletter: Pennsylvania Medical Supply Company Agrees to $5 Million Settlement

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Pennsylvania Medical Supply Company Agrees to $5 Million Settlement - A Pennsylvania medical supply company, AdaptHealth LLC, formerly known as QMES LLC, agreed to a $5.3 million settlement to resolve allegations that it...more

ArentFox Schiff

Investigations Newsletter: Supreme Court to Hear US Government in FCA Scienter Oral Argument

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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

The Volkov Law Group

Modernizing Medicine Settles False Claims Act Violations for $45 Million

The Volkov Law Group on

The Justice Department continues to pile up healthcare enforcement actions — false claims, anti-kickback, and fraud.  DOJ is on its way to a record year....more

Rivkin Radler LLP

Fraud Week: Pharmacy Kickbacks, Fake Medical Directorships and More

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Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases....more

ArentFox Schiff

Investigations Newsletter: OIG Warns That Proposed Drug Discounts May Warrant Sanctions

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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

ArentFox Schiff

Investigations Newsletter: Medical Technology Company President Convicted for Participation in $77 Million COVID-19 and Allergy...

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Medical Technology Company President Convicted for Participation in $77 Million COVID-19 and Allergy Testing Scheme - On September 1, 2022, the president of Arrayit Corporation, a medical technology company in Silicon...more

Rivkin Radler LLP

Fraud Week: More Non-Existent Services

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If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually...more

Rivkin Radler LLP

Private Insurers Must Watch Out for Medical Equipment Fraud

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Healthcare fraud related to durable medical equipment (DME) is extremely costly to insurers yet often continues without criminal or civil consequences. Fraudulent schemes by DME supply companies vary in complexity but...more

ArentFox Schiff

Investigations Newsletter: DOJ and Treasury Announce Multilateral Russian Oligarch Task Force Called “REPO” 

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DOJ and Treasury Announce Multilateral Russian Oligarch Task Force Called “REPO” - On March 16, 2022, Attorney General Merrick Garland and Secretary of the Treasury Janet Yellen met with representatives from Australia,...more

ArentFox Schiff

Investigations Newsletter: Lab Owner Pleads Guilty to $6.9 Million Medicare Fraud Scheme Involving Kickbacks and Bribery

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Lab Owner Pleads Guilty to $6.9 Million Medicare Fraud Scheme Involving Kickbacks and Bribery - On January 13, 2022, the Department of Justice (DOJ) announced that a Florida man pled guilty in the Southern District of...more

ArentFox Schiff

Investigations Newsletter: DOJ Files Complaint in AWP False Claims Act Suit Against Pharmaceutical Ingredient Seller 

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DOJ Files Complaint in AWP False Claims Act Suit Against Pharmaceutical Ingredient Seller - On November 8, 2021, the Department of Justice (DOJ) announced that it intervened in a qui tam suit and filed a False Claims Act...more

ArentFox Schiff

Diabetic Testing Supplier Agrees to $160 Million Penalty to Resolve False Claims Act Charges

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On August 2, 2021, the Department of Justice (DOJ) announced that Arriva Medical LLC (Arriva), once the nation’s largest Medicare mail-order diabetic testing supplier, and its parent company, Alere Inc., have agreed to...more

The Volkov Law Group

False Claims Investigations and Criminal Prosecutions: Recent Examples of Criminal Charges – a Lab Owner, A Physician and a Nurse...

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A False Claims Act case can easily turn into a criminal prosecution.  The Federal Bureau of Investigation often initiates criminal investigations as part of its commitment to reducing health care fraud....more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 22. News Briefs: June 2021

Report on Medicare Compliance 30, no. 22 (June 14, 2021) - CMS’ supplemental medical review contractor (SMRC) is now doing postpayment reviews of Medicare claims for electrodiagnostic (EDX) testing axial muscles and...more

Polsinelli

DOJ Telemedicine Offensive Pushes Forward with New Charges

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For the past two years, telemedicine companies, durable medical equipment suppliers, pharmacies, and individuals and entities that market to such entities have been at the center of DOJ gunsights. In 2019, the Department...more

Rivkin Radler LLP

NYC Pharmacy Owner Charged With Healthcare Fraud

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The owner of Brooklyn Chemists in Gravesend, Brooklyn and Lucky Care Pharmacy in Flushing, Queens was recently indicted on charges of conspiracy to commit health care fraud, conspiracy to defraud the United States by paying...more

ArentFox Schiff

Investigations Newsletter: Investment Bank To Pay Over $130 Million To Resolve Foreign Corrupt Practices Act and Fraud Allegations

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Deutsche Bank to Pay Over $130 Million to Resolve Foreign Corrupt Practices Act and Fraud Allegations - Deutsche Bank Aktiengesellschaft (Deutsche Bank) has agreed to pay more than $130 million to resolve the government’s...more

ArentFox Schiff

Investigations Newsletter: DOJ Announces Charges Against 345 Defendants in Historic Nationwide Health Care Fraud and Opioid...

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DOJ Announces Charges Against 345 Defendants in Historic Nationwide Health Care Fraud and Opioid Takedown - The DOJ announced a nationwide enforcement action charging 345 defendants across 51 federal districts with...more

Thomas Fox - Compliance Evangelist

Novartis US Corruption Settlements: Part 1 – Introduction

I have written extensively about the Novartis International AG (Novartis) Foreign Corrupt Practices Act (FCPA) settlement, which was announced in late June. However, the enforcement action paled next to the Stipulation and...more

Mintz - Health Care Viewpoints

DOJ Announces Criminal Charges against Lab Executive Accused of Fraudulently Promoting COVID-19 Tests

The Department of Justice (DOJ) has announced its first criminal securities fraud prosecution related to COVID-19, and it involves health care fraud as well. Mark Schena, president of Arrayit Corporation, a publicly traded...more

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