News & Analysis as of

Criminal Prosecution Criminal Convictions Healthcare Fraud

Hendershot Cowart P.C.

EKRA Gets Its Second Major Court Test: What the Schena Decision Means for Lab Marketing and Sales Compensation

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On July, 11, 2025, the Ninth Circuit Court of Appeals affirmed laboratory operator Mark Schena’s conviction under Eliminating Kickbacks in Recovery Act (EKRA). This is the first time a higher court has addressed the lab...more

King & Spalding

Ninth Circuit Decision Clarifies EKRA Enforcement

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On July 11, 2025, the Ninth Circuit issued a decision clarifying the scope of Eliminating Kickbacks in Recovery Act (EKRA). In affirming a Northern California-based medical testing laboratory’s convictions under EKRA, the...more

Venable LLP

EKRA Has Teeth: Ninth Circuit Upholds Lab Operator’s Criminal Conviction for Paying Marketers for Referrals

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In a matter of first impression, the Ninth Circuit Court of Appeals interpreted the scope of the 2018 Eliminating Kickbacks in Recovery Act (EKRA) in the context of a lab operator who allegedly paid marketers to induce...more

BakerHostetler

In Case of First Impression, Looking to AKS Precedent, Ninth Circuit Affirms EKRA Conviction for Improper Payments to Marketers

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In one of the few prosecutions based on the Eliminating Kickbacks in Recovery Act (EKRA), and in an even rarer Court of Appeals opinion interpreting the statute, the Ninth Circuit in United States v. Schena, No. 23-2989, 2025...more

Mintz - Health Care Viewpoints

Ninth Circuit Court of Appeals Affirms EKRA Conviction for Lab Operator and Provides Insight into Key Provisions

On July 11, 2025, the Ninth Circuit Court of Appeals affirmed the criminal conviction of laboratory operator Mark Schena for violations of the Eliminating Kickbacks in Recovery Act, 18 U.S.C. § 220 (EKRA) based on...more

Troutman Pepper Locke

New York AG Intensifies Investigation and Enforcement Against Alleged Medicaid Fraud

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On June 30, 2025, New York Attorney General (AG) Letitia James announced new lawsuits, criminal charges, and settlements with 25 New York transportation companies related to alleged schemes to defraud Medicaid of millions....more

Polsinelli

EKRA Gets Teeth: Ninth Circuit Strengthens EKRA Enforcement in Schena Ruling

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Key Takeaways - First Appellate Interpretation of EKRA: The Ninth Circuit’s decision in United States v. Schena marks the first appellate court interpretation of the Eliminating Kickbacks in Recovery Act (EKRA), affirming...more

Troutman Pepper Locke

Arizona AG Secures More Than $30M in Restitution After Obtaining Criminal Conviction in Health Care Fraud Scheme

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On May 8, the Superior Court of Arizona in Maricopa County ordered a health care company to pay more than $30 million in restitution to the Arizona Health Care Cost Containment System (AHCCCS) due to the company’s alleged...more

Benesch

From the NBA Finals to Federal Prison - “Big Baby” Sentenced to 40 months in NBA Healthcare Plan Scheme

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Former NBA player Glen “Big Baby” Davis was sentenced to 40 months in prison after being convicted for his role in a scheme to defraud the NBA healthcare plan. Davis’ sentence comes almost a year after the scheme’s...more

Kaufman & Canoles

K&C Sports & Entertainment Law Weekly Roundup - January 2024 #2

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A Florida State assistant coach has been suspended for the first three games of the 2024 season for violating recruiting rules by connecting a potential transfer with a representative from an NIL collective during an official...more

Holland & Knight LLP

Supreme Court Narrows Scope of Aggravated Identity Theft Law in Healthcare Fraud Case

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The healthcare industry is one of the most heavily regulated industries in the United States. Healthcare companies and practitioners devote significant resources to complying with the complex and often changing legal and...more

Zuckerman Spaeder LLP

In a win for defendants, the Supreme Court limits the aggravated identity theft statute and resulting prosecutorial...

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Federal prosecutors will now be cabined in their ability to use aggravated identity theft charges to pressure defendants to plead guilty to other offenses in exchange for avoiding the two-year mandatory minimum, mandatory...more

Orrick, Herrington & Sutcliffe LLP

Supreme Court Cautions Against Overly Broad Criminal Charging Decisions

The U.S. Supreme Court recently struck another blow against overcriminalization of federal criminal statutes, i.e., the application of criminal provisions in specific laws in ways that Congress never intended. The court’s...more

Bradley Arant Boult Cummings LLP

Supreme Court Unanimously Reins in the Government’s Use of the Aggravated Identify Theft Statute

In an extremely consequential decision issued last week, the United States Supreme Court reined in what the Court termed the government’s “boundless interpretation” of the aggravated identity theft statute, 18 U.S.C. § 1028A....more

Sheppard Mullin Richter & Hampton LLP

Is this “Good-Bye” to the Two Year Mandatory Minimum in Healthcare Fraud Cases?

On June 8, 2023, the Supreme Court issued a unanimous decision holding that the aggravated identity theft statute –and its mandatory minimum of two years – is not triggered merely because someone else’s identification...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

ArentFox Schiff

Investigations Newsletter: Millennial Couple Faces Twenty Years in Prison for Largest DOJ Bitcoin Seizure in History

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Millennial Couple Faces Twenty Years in Prison for Largest DOJ Bitcoin Seizure in History - On February 7, 2022, authorities arrested a husband and wife in their 30s, Ilya Lichtenstein and Heather Morgan, accused of...more

McGuireWoods LLP

Sixth Circuit Affirms Jury Criminal Conviction in Federal Healthcare Kickback Scheme

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In a recent opinion from the United States Court of Appeals for the Sixth Circuit, the court analyzed several alleged points of error from a criminal jury trial about a healthcare kickback scheme. See United States v....more

Dorsey & Whitney LLP

OIG’s Latest Congressional Report Sees Continued Emphasis on Fraud and Abuse Enforcement

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In the final quarter of calendar year 2019, the Department of Health and Human Services Office of Inspector General (“OIG”) released its Semiannual Report to Congress (the “Report”). The Report covers the six-month period...more

ArentFox Schiff

Investigations Newsletter: Patient Recruiter Convicted in $1.3 Million Kickback Conspiracy Scheme

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Patient Recruiter Convicted in $1.3 Million Kickback Conspiracy Scheme - After a six-day trial, a federal jury in Detroit found a patient recruiter guilty of one count of conspiracy to pay and receive health care...more

Patterson Belknap Webb & Tyler LLP

Court Declines to Allow Defendants in Fraud Scheme to Utilize 28 U.S.C. § 2255 or Writ of Coram Nobis to Challenge Order of...

In United States v. Rutigliano, No. 16-3754 et al., the Second Circuit (Jacobs, Raggi, Droney) refused to endorse the reduction of a restitution order against defendants who had conspired to submit fraudulent disability...more

The Volkov Law Group

ArthroCare CEO Reconvicted for Fraud

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The healthcare industry continues to be a frequent target for criminal prosecutions. More importantly, federal prosecutors are ready, willing and able to bring criminal cases against C-Suite actors involved in healthcare...more

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