News & Analysis as of

Department of Justice (DOJ) False Billing Medicaid

Pietragallo Gordon Alfano Bosick & Raspanti,...

Recent False Claims Act Settlement Should Put Treatment Centers on Notice

Late last month, the federal government announced a False Claims Act settlement with Summit BHC New Jersey, LLC, d/b/a Seabrook (“Seabrook”), a prominent New Jersey Drug & Alcohol Rehabilitation facility. The joint settlement...more

Harris Beach Murtha PLLC

OIG January 2024 Enforcement Summary

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

Health Care Compliance Association (HCCA)

News Briefs: August 14, 2023

Report on Medicare Compliance Volume 32, no 29 (August 2023) In a new Medicare transmittal (12,202), CMS introduced a new place of service (POS) code (27) for “Outreach Site/Street.” POS 27 is defined as “a non-permanent...more

Husch Blackwell LLP

Justice Department Sues Iowa Surgeon Under False Claims Act for Masking Non-Covered Cosmetic Procedures as Covered Surgeries

Husch Blackwell LLP on

Cosmetic surgeries are on the rise. One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. Facelifts were up 54...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Cozen O'Connor

Physicians Group Services Fined by DOJ, Florida AG and HHS for Alleged False Urine Test Claims

Cozen O'Connor on

Physicians Group Services, P.A. (PGS) has reached a settlement with the U.S. and Florida to resolve allegations that it submitted false or fraudulent claims to the Florida Medicaid Program....more

The Volkov Law Group

DOJ Announces Two Significant Indictments Charging Individuals with Healthcare Fraud

The Volkov Law Group on

The Justice Department is continuing to use criminal enforcement as an important tool in the fight against healthcare fraud.  While the False Claims Act continues its important place in the fight against healthcare fraud, DOJ...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

The Reverse False Claims Act: A Relatively Unknown, But Increasingly Used, Provision Of The FCA

Volumes have been written about the False Claims Act as a tool to pursue fraud against the government in circumstances where the defendant has allegedly made false statements to receive money from the government. For...more

ArentFox Schiff

Investigations Newsletter: Lab Owner Indicted For $100 Million Health Care Fraud Scheme

ArentFox Schiff on

Lab Owner Indicted For $100 Million Health Care Fraud Scheme - On November 2, 2021, a federal grand jury in the Western District of Arkansas indicted Billy Joe Taylor of Arkansas for an alleged health care fraud scheme. ...more

Rivkin Radler LLP

NYC Pharmacy Owner Charged With Healthcare Fraud

Rivkin Radler LLP on

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

The Volkov Law Group

Universal Health Agrees to Pay $122 Million for False Claims Act Violations

The Volkov Law Group on

DOJ announced a False Claims Act settlement with Universal Health (“UHS”) and related companies for $122 million for billing for medically unnecessary inpatient behavioral health services, failing to provide adequate services...more

Stinson - Corporate & Securities Law Blog

SEC Brings Enforcement Action for Loss Contingency Disclosure

The SEC recently settled an enforcement action against Mylan N.V., claiming Mylan failed to timely disclose to investors a possible loss relating to a nearly two-year Department of Justice  probe into whether Mylan...more

The Volkov Law Group

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

The Volkov Law Group on

Despite the controversial impact of the Supreme Court’s Escobar decision, the Justice Department’s False Claims Act prosecutions and settlements are continuing at a consistent rate – heading towards another multi-billion...more

K&L Gates LLP

K&L Gates Triage: 2018 Health Care Fraud Takedown

K&L Gates LLP on

Recently, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced its largest ever national health care fraud takedown, resulting in charges against 601 diverse defendants including...more

Jackson Walker

U.S. Department of Justice Announces National Healthcare Fraud Takedown

Jackson Walker on

601 Criminal Healthcare Fraud Indictments Proves Enforcement Remains a Top Priority for Federal and State Authorities - The Department of Justice and the U.S. Department of Health and Human Services Office of Inspector...more

Sheppard Mullin Richter & Hampton LLP

Recent Department of Justice Crackdown on Fraud and Abuse

As reported by the New York Times in an article dated July 13, 2017, in an effort to crack down on fraud and abuse, and with a particular focus on opioids, the Department of Justice (“DOJ”) is charging 412 individuals for...more

Carlton Fields

Health Care Fraud and Abuse in the Middle District of Florida in 2016 - a Year in Review

Carlton Fields on

The United States Attorney’s Office (USAO) for the Middle District of Florida (USAO-MDFL) prosecuted several civil health care fraud matters in 2016 and issued related press releases. A review of the USAO-MDFL’s criminal and...more

Baker Donelson

Health Care Fraud Prosecutions: Strong Seas and High Winds Ahead for Individuals and Corporations

Baker Donelson on

During the past nine months, the U.S. Department of Justice (DOJ) has made several significant policy pronouncements that impact health care organizations and individual providers. These directives and initiatives reflect...more

The Volkov Law Group

Compliance Reminder — DOJ Announces Largest Healthcare Fraud Takedown

The Volkov Law Group on

On Wednesday, June 22, 2016, the DOJ announced the largest nationwide heath care fraud takedown in history, which resulted in criminal and civil charges against 301 individuals for alleged participation in health care fraud...more

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