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Criminal Prosecution Centers for Medicare & Medicaid Services (CMS)

Mintz - Health Care Viewpoints

Health Care Fraud Enforcement Developments: the 2025 Takedown and a “New” False Claims Act Working Group

This year’s National Health Care Fraud Takedown (Takedown) announced recently by the Department of Justice was touted by the Department of Justice (DOJ) as the largest to date, involving over $14.6 billion in “intended loss”...more

Cole Schotz

“First Do No Harm” Considerations for Healthcare Providers in Light of Historic Healthcare Fraud Enforcement Announcement by the...

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On Monday, the Department of Justice Criminal Division, led by Matthew R. Galeotti, announced its largest healthcare fraud enforcement charging individuals and entities across the globe in allegedly $14.6 billion criminal and...more

BakerHostetler

DOJ Announces Record-Breaking National Health Care Fraud Takedown Against 324 Defendants with Over $14.6 Billion in Alleged Fraud

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The DOJ announced on June 30 an unprecedented Health Care Fraud Takedown resulting in criminal charges against 324 defendants (including 96 doctors, nurse practitioners, pharmacists and other licensed providers), with an...more

Tucker Arensberg, P.C.

DOJ Announces Largest Health Care Fraud Takedown in U.S. History

In the largest health care fraud takedown in U.S. history, the Justice Department announced charges against 324 individuals—including 96 licensed medical professionals—in connection with schemes involving over $14.6 billion...more

Rivkin Radler LLP

PA Nursing Home Companies to Pay $15 Million for Healthcare Fraud

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Two Pennsylvania nursing home operators were recently sentenced in federal court to pay more than $15 million in restitution in a healthcare fraud case. Comprehensive Healthcare Management Services, the operator of Brighton...more

Benesch

Dialysis & Nephrology Digest - May 2025

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DOJ scores first victory in criminal antitrust labor market trial - A federal jury convicted a former home healthcare staffing executive in Las Vegas for orchestrating a three-year wage-fixing conspiracy targeting...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

Goodwin

Health Headlines: March 2025

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Welcome to the third issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice....more

Rivkin Radler LLP

Online DME Company Billed Insurers for Unnecessary Medical Supplies

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DMERx, an online DME platform, served as the basis for a massive fraud against Medicare and other insurers. Gregory Schreck, a Kansas man who was the vice president of DMERx, orchestrated a sophisticated fraud scheme to bill...more

Lathrop GPM

Nearly 200 Health Care Providers Charged in Aggressive Enforcement Action by DOJ Health Care Fraud Strike Force Alleging Schemes...

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The Department of Justice announced one if its most aggressive and wide-ranging enforcement actions to date, a coordinated two-week operation spanning 32 federal districts. The orchestrated effort involved the FBI, HHS-OIG,...more

The Volkov Law Group

DOJ Declines Prosecution Applying Corporate Enforcement Program in Healthcare Fraud Case

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The Justice Department’s Corporate Enforcement Policies and Program applies to prosecutions outside of the FCPA context.  The impact of DOJ’s new approach, encouraging voluntary disclosures, applies to other federal criminal...more

WilmerHale

Criminal Indictment for Medicare Advantage Fraud

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The U.S. Department of Justice (DOJ) recently announced a rare criminal indictment involving the Medicare Advantage program—a contrast from DOJ’s more typical use of its civil enforcement authority to pursue similar issues...more

Foley Hoag LLP

United States v. Elizabeth Holmes and Ramesh Balwani

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I. WHY THIS CASE MADE THE LIST - A highly publicized and long-running multi-agency action against the former Chief Executive Officer and the former Chief Operating Officer of Theranos Inc. resulted in criminal convictions...more

Benesch

Dialysis & Nephrology Digest - April 2023

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ME trial reminiscent of DaVita anti-poaching case that also ended in acquittal; DOJ strategy questioned - In Apr. 2022, juries in TX and CO acquitted healthcare companies charged by the DOJ’s Antitrust Division. In the CO...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | January 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity and developments occurring in January 2023, including several criminal and civil enforcement actions related to the federal...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

BakerHostetler

Second Circuit Vacates Insider Trading Convictions, Narrowing the Scope of Future Prosecutions

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As discussed more fully in our alert when Blaszczak I was issued, the crux of this case was that four individuals were charged with and convicted of an alleged scheme to obtain nonpublic information from the Centers for...more

Sheppard Mullin Richter & Hampton LLP

2023 Top-of-Mind Issues for Life Sciences Companies

Pharma and Life Sciences Investigations and Prosecutions: The First Two Years of the Biden Administration - With the two-year mark of the Biden presidency looming, the administration’s approach to prosecuting and...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | November 2022 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity between October 21 and November 18, 2022, including recent enforcement activity, new litigation associated with the Office of...more

Benesch

Dialysis & Nephrology Digest - August 2022

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DOJ files civil complaint alleging Fresenius performed unnecessary procedures on dialysis patients - In June, it was revealed that DOJ would partially join a whistleblower lawsuit against the dialysis provider. In a civil...more

Oberheiden P.C.

DOJ Announces Criminal Charges in Alleged $1.2 Billion Health Care Fraud Scheme

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Yesterday, the U.S. Department of Justice (DOJ) announced that it has filed charges against 36 defendants in relation to an alleged health care fraud scheme that resulted in approximately $1.2 billion in fraudulent payments....more

McDermott Will & Emery

DOJ Demonstrates Commitment to COVID-19-Related Healthcare Enforcement with New Criminal Charges

On April 20, 2022, the US Department of Justice (DOJ) announced a nationwide coordinated law enforcement action focused on COVID-19-related healthcare fraud. In total, DOJ brought criminal charges against 21 individuals,...more

Womble Bond Dickinson

“Carrots & Sticks”: Individual Accountability in Corporate Criminal Enforcement Remains a Top DOJ Priority

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On March 3, 2022, at the 37th Annual American Bar Association Criminal Justice Section National Institute on White Collar Crime in San Francisco, Attorney General Merrick B. Garland emphasized that “the prosecution of...more

Benesch

Dialysis & Nephrology Digest - August 2021

Benesch on

DaVita, former CEO indicted in federal market collusion case - DaVita and the company’s former CEO, Kent Thiry, were alleged to have conspired with Surgical Care Affiliates to suppress competition for senior-level...more

Jones Day

DOJ Ramps Up Coordinated Law Enforcement Action to Combat Health Care Fraud Related to COVID-19

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On May 26, 2021, DOJ announced a series of coordinated law enforcement actions against 14 defendants across seven federal districts for alleged participation in fraudulent health care schemes that, according to the...more

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