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Enforcement Actions Healthcare Criminal Prosecution

Sheppard Mullin Richter & Hampton LLP

Inside the Ninth Circuit’s Interpretation of EKRA: Clarity for Kickback Law

On July 11, 2025, in United States v. Schena,[1] the Ninth Circuit adopted an expansive interpretation of the Eliminating Kickbacks in Recovery Act (EKRA), applying the law to any payment that could have the effect of...more

Herbert Smith Freehills Kramer

No Rest for the Caretakers: Health Care Industry in Crosshairs for Expanded False Claims Act and Criminal Enforcement Activity

The health care industry – already bracing for the financial impact of Medicaid cuts – faces another hard truth: This administration isn’t slowing the pace of health care fraud enforcement. Rather, it’s doubling down on...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

Rivkin Radler LLP

NY Medical Transport Owner Sentenced for Medicaid Fraud

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The owner of Sublime Medical Transportation in Schenectady County, New York was recently sentenced to three to nine years in state prison for orchestrating a large Medicaid fraud scheme. Muhammed Adnan Saeed netted over...more

Davis Wright Tremaine LLP

Healthcare Industry in the Crosshairs at DOJ and HHS

Any suggestion that the Trump Administration might not be committed to healthcare fraud enforcement was definitively quashed by two recent developments. First, on July 2, 2025, the U.S. Department of Justice (DOJ) and the...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

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

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

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

Lathrop GPM

DOJ Antitrust Division Secures First Win in Criminal Wage-Fixing Case

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On April 14, 2025, a federal jury in the U.S. District Court for the District of Nevada convicted the operator of a home healthcare staffing agency of a criminal violation of the federal antitrust laws. ...more

McCarter & English, LLP

Recent Trends in State Antitrust Enforcement

State attorneys general (state AGs) are expected to ramp up antitrust enforcement. Some would argue that enforcement is an effort to fill a perceived gap left by the Trump administration, but state AGs have been signaling...more

Skadden, Arps, Slate, Meagher & Flom LLP

Core False Claims Act Theories Top the List of DOJ Criminal Enforcement Priorities

The May 12, 2025, memo from the head of the Department of Justice’s (DOJ’s) Criminal Division highlights 10 “high-impact” areas as the focus of DOJ’s criminal enforcement efforts. (See our May 14, 2025, client alert “In a New...more

Husch Blackwell LLP

False Claims Act Insights - Trump DOJ Sharpens Its Focus on Healthcare Fraud

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Host Jonathan Porter welcomes to the show Husch Blackwell attorney Brandon Hall, a St. Louis-based member of the firm’s Healthcare group, to discuss how the Department of Justice’s reshuffling of priorities could lead to a...more

McDermott Will & Schulte

DOJ Secures Its First-Ever Conviction in a Criminal Antitrust Labor Market Trial

On April 14, 2025, a federal jury convicted an executive in a wage-fixing conspiracy under the Sherman Act. This marks the first time, after many tries, that the US Department of Justice (DOJ) has secured a conviction in a...more

White & Case LLP

DOJ Secures First-Ever Guilty Verdict in Criminal Labor Market Antitrust Case: Conviction Also Highlights Fraud Risks in M&A Sale...

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A federal jury in Las Vegas has convicted Eduardo "Eddie" Lopez, a former executive of a home healthcare staffing company, on charges of wage-fixing and wire fraud. The conviction marks the first successful jury verdict for...more

Vinson & Elkins LLP

Wage-Fixing: An Alternative to DOJ’s No-Poach Prosecutions?

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On April 14, 2025, the Department of Justice (“DOJ”) obtained a high-profile “wage-fixing” conviction under the Sherman Act against a former executive of multiple home health care agencies (“HHAs”). A federal jury convicted...more

Axinn, Veltrop & Harkrider LLP

A Labor of Love: Trump DOJ Obtains First Guilty Verdict in a Criminal Labor Case

In October 2016, the Obama Administration announced that it would criminally prosecute no-poach and wage-fixing agreements among competitors for talent. Starting in December 2020, through the Trump and Biden Administrations,...more

Wilson Sonsini Goodrich & Rosati

Perseverance Pays Off for DOJ in Labor Market Criminal Trial

After several unsuccessful attempts to convict a company or individual at trial for wage-fixing or a no-poach agreement, the Department of Justice’s (DOJ) Antitrust Division has secured its first conviction in a labor market...more

McCarter & English, LLP

A Fair Day’s Wage for a Fair Day’s Work: DOJ Scores First Guilty Verdict in a Wage-Fixing Case

After many attempts, the Department of Justice Antitrust Division (DOJ or Division) has scored the first guilty verdict on a wage-fixing case. For years, the Division has prosecuted wage-fixing and no-poach agreements with...more

Troutman Pepper Locke

Massachusetts AG Indicts Health Care Providers and Owners for Submission of Allegedly False Medicaid Claims

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The Office of Massachusetts Attorney General (AG) Andrea Campbell announced the criminal indictment of several Massachusetts-based health care providers and their owners in connection with allegedly false claims they...more

Epstein Becker & Green

Criminal Health Care Fraud Enforcement: Projections for 2025 and Beyond – Diagnosing Health Care Video Podcast

Since Pam Bondi was appointed U.S. Attorney General, we’ve seen notable shifts in the U.S. Department of Justice’s criminal enforcement priorities. How significant are some of these changes, and how might they affect your...more

Axinn, Veltrop & Harkrider LLP

Conspiracy Theories Newsletter, 2025 Edition: Predictions for Cartel Enforcement Under Trump 2.0

In many ways, criminal antitrust enforcement during President Trump’s first term illustrates what to expect under Trump 2.0. Among other highlights, the Delrahim DOJ obtained indictments and pleas involving public procurement...more

Robinson+Cole Health Law Diagnosis

DOJ Charges 36 Defendants in Connection with Telemedicine and Clinical Laboratory Fraud and Abuse Schemes

On June 27, 2024, the Department of Justice (DOJ) announced its 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants for alleged participation in various health care...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

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