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Coronavirus/COVID-19 › Healthcare Fraud › Medicare

Read guidance, analysis, and updates on the myriad issues arising from the global response to the COVID-19 pandemic. Updated hourly every day, the insights published here are written by leading lawyers and law firms... more +
Read guidance, analysis, and updates on the myriad issues arising from the global response to the COVID-19 pandemic. Updated hourly every day, the insights published here are written by leading lawyers and law firms helping to make sense of insurance, employment, tax, securities, M&A, risk management, and every other consideration touched by this crisis. Follow the channel for a daily email brief of the latest and best updates. less -
Epstein Becker & Green

Complex Billing and Reasonable Interpretations: Jury Was Entitled to Find Fraud in Doctor’s Upcoding of Speedy COVID-19 Tests,...

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On July 17, 2025, the U.S. Court of Appeals for the Fourth Circuit held that a federal district court was “within bounds to order a do-over” in the case of Ron Elfenbein, a Maryland doctor who was found guilty of...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from the First Half of 2025

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With the first half of 2025 in the rearview mirror, the government’s continued focus on False Claims Act (FCA) enforcement shows no signs of slowing. In fact, the Department of Justice recently announced the results of a...more

Warner Norcross + Judd

Insights from the Largest DOJ Health Care Fraud Enforcement Effort in U.S. History

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On June 30, the Department of Justice (DOJ) announced the largest coordinated health care fraud enforcement effort in U.S. history, involving criminal charges against over 300 defendants and over $14.6 billion in health care...more

Wiley Rein LLP

DOJ Health Care Fraud Takedown and FCA Working Group Signal New Era of Enforcement and Compliance Risks

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On July 2, 2025, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) jointly announced the next phase of the Administration’s “Whole-of-Government” approach to fighting health care...more

ArentFox Schiff

Investigations Newsletter: Two Charged in Alleged $227 Million COVID-19 Test Kit Fraud

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Two Charged in Alleged $227 Million COVID-19 Test Kit Fraud - Syed Murtuza Kablazada and Mehdi Hussain, the owners and operators of medical laboratories in Illinois, were charged with submitting more than $227 million in...more

Rivkin Radler LLP

Lab Co-Owners Acquitted in Alleged COVID-19 Testing Scheme

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A Florida jury recently found two laboratory co-owners of Innovative Genomics LLC (“IGX”) not guilty in connection with an allegedly fraudulent COVID-19 testing scheme. The Government alleged that from November 2019 through...more

Morgan Lewis

DOJ Officials Commit to Aggressive FCA Enforcement, Signal Its Value and Direction

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In remarks delivered at the Federal Bar Association’s (FBA) annual Qui Tam Section Conference, Deputy Assistant Attorney General Michael Granston reiterated the US Department of Justice’s (DOJ or the Department) commitment to...more

Mintz - Health Care Viewpoints

EnforceMintz — False Claims Act Statistical Year in Review

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Health Care Cases Spur Largest FCA Recoveries - Mintz’s annual report on False Claims Act case activity analyzes data from DOJ and the firm’s Health Care Qui Tam Database, and explores the 2024 record high in FCA case...more

Bradley Arant Boult Cummings LLP

2024 False Claims Act Statistics Show More Cases Filed Than Ever Before

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The Justice Department released its annual False Claims Act statistics on Wednesday, January 15, detailing the number of cases filed, recoveries made, and relators’ shares awarded in fiscal year 2024. The government recovered...more

Wiley Rein LLP

DOJ Announces Larger FCA Recoveries and More Whistleblower Cases Filed in 2024

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On January 15, 2025, the U.S. Department of Justice (DOJ) announced $2.9 billion in total False Claims Act (FCA) recoveries for FY 2024, a slight increase from 2023. In addition to growing recoveries, DOJ announced a new...more

Mintz - Health Care Viewpoints

EnforceMintz — Long Tail of Pandemic Fraud Schemes Will Likely Result in Continued Enforcement for Years to Come

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In last year’s edition of EnforceMintz, we predicted that 2024 would bring an increase in False Claims Act (FCA) enforcement activity related to COVID-19 pandemic fraud. Those predictions proved correct. The COVID-19 Fraud...more

ArentFox Schiff

Investigations Newsletter: Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions

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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

ArentFox Schiff

Investigations Newsletter: Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme

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Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...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

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

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On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

FY 2023 False Claims Act Recoveries: $2.67 Billion In Recoveries And Over $349 Million In Awards To Whistleblowers

Pietragallo Gordon Alfano Bosick & Raspanti,... on

On February 22, 2024, the Department of Justice (“DOJ”) published its annual review of cases and recoveries under the False Claims Act. Through the end of fiscal year 2023, total recoveries (across all years) under the False...more

ArentFox Schiff

Investigations Newsletter: Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme

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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

Holland & Knight LLP

Federal Judge Cites Ambiguous Coding Guidance, Vacates Doctor's Healthcare Fraud Conviction

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A federal judge recently exposed weaknesses in the U.S. Department of Justice's (DOJ) criminal healthcare fraud enforcement efforts by vacating a jury's conviction of a prominent Maryland doctor. On Aug. 4, 2023, a federal...more

Husch Blackwell LLP

Federal Judge Acquits Physician Following Criminal E/M Fraud Conviction at Trial

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As previously reported in this post, criminal trials premised on upcoding evaluation and management (E/M) service codes are extremely rare. The Justice Department took that rare step in Maryland in connection with a practice...more

Harris Beach Murtha PLLC

HHS Office of Inspector General August 2023 Enforcement Activity

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The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

ArentFox Schiff

Investigations Newsletter: Walgreens Medicaid Fraud Case Kicked Back to Trial Court

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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

Epstein Becker & Green

Physicians Beware! Groups Providing DME, Prosthetic Devices, and Other Medical Supplies to Their Medicare Patients Risk Violating...

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When the COVID-19 Public Health Emergency (“PHE”) ended on May 11, 2023, many physician groups furnishing certain medical equipment, devices, and/or supplies to their Medicare patients became in violation of the federal...more

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | May 2023 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for May 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act (FCA)...more

Bass, Berry & Sims PLC

While Remote Supervision Remains Available for Direct Supervision, Be Mindful of the Other “Incident to” Requirements

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With the May 11, 2023 expiration of the federal public health emergency (PHE) for COVID-19, many operational flexibilities healthcare providers used during the PHE will now sunset. Some flexibilities end immediately while...more

Health Care Compliance Association (HCCA)

[Virtual Event] Columbus & Indianapolis Regional Healthcare Compliance Conference - June 2nd, 8:25 am - 4:30 pm ET

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General and specialty compliance education from the comfort of your home or office - HCCA’s Regional Healthcare Compliance Conferences provide practitioners with virtual compliance learning that covers a wide variety of...more

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