News & Analysis as of

Healthcare Fraud Criminal Prosecution

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

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

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

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

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

Health Care Compliance Association (HCCA)

Private-pay “crime stoppers”: Digesting the Corporate Whistleblower Awards Pilot Program

The U.S. Department of Justice’s (DOJ) Criminal Division launched its Corporate Whistleblower Awards Pilot Program (“Criminal Whistleblower Program”) in August of 2024 to encourage tips for various types of fraud, including...more

Lowenstein Sandler LLP

Virginia Hospital Indicted for Allegedly Turning a Blind Eye to Doctor’s Crimes

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In an unusual criminal prosecution, the Chesapeake Regional Medical Center (CRMC), a hospital in Chesapeake, Virginia, was indicted last week by a federal grand jury in Virginia for conspiring to defraud the United States and...more

Foley Hoag LLP - White Collar Law &...

Health Care Enforcement: Review of 2022 and A Look Ahead to 2023

This is the third part in our 2023 series examining important trends in white collar law and investigations. Up next: congressional investigations. Health care fraud enforcement remained a top priority at both the national...more

Brooks Pierce

Increased DOJ Enforcement in the Health Care Space

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Health care providers and entities take note: The Department of Justice (DOJ) is increasingly focused on enforcement in the health care space. DOJ has long prioritized health care fraud, but under the prior administration...more

Polsinelli

DOJ Hires Compliance Counsel to Aid in Charging Decisions

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In today’s robust enforcement climate, most companies have taken at least the first steps towards establishing a formal corporate compliance program. The mere existence of such a program, however, will not by itself protect a...more

BakerHostetler

Consumer Fraud Complaints Rise With Rollout of Affordable Care Act Exchanges

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Criminal Prosecutions Expected in 2014 Related to ACA Fraud - Last month's troubled rollout of HealthCare.gov, the federal marketplace for online health insurance enrollment under the Affordable Care Act (ACA),...more

Mintz - Health Care Viewpoints

Health Care Enforcement in 2012: A Year in Review

Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more

The Volkov Law Group

Protecting Your Hospital From Over-Utilization Prosecutions

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The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more

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