News & Analysis as of

Kickbacks Medicaid Healthcare Fraud

Cozen O'Connor

AGs Inject Accountability into Pharma Practices via $202M Gilead Settlement

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New York AG Letitia James, along with a bipartisan coalition of 48 other AGs and in coordination with the U.S. DOJ, announced a $202 million settlement in principle with Gilead Sciences, Inc. (“Gilead”), to resolve...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

Wiley Rein LLP

DOJ Health Care Fraud Takedown and FCA Working Group Signal New Era of Enforcement and Compliance Risks

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On July 2, 2025, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) jointly announced the next phase of the Administration’s “Whole-of-Government” approach to fighting health care...more

Husch Blackwell LLP

DOJ and HHS Launch New False Claims Act Working Group: What The Healthcare Industry Needs to Know

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On July 2, 2025, the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) announced the creation of the DOJ-HHS False Claims Act Working Group, a high-level interagency initiative aimed at...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

Husch Blackwell LLP

Beware of Offers Too Good to Be True: Recent Federal Lawsuit Highlights Kickback and False Claims Risks

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As of February 18, 2025, the First Circuit Court of Appeals requires the government to prove “but-for” causation in Anti-Kickback Statute (AKS)-based False Claims Act (FCA) cases. The court reasoned in United States v....more

Morgan Lewis

First Circuit Holds ‘But For’ Causation Required to Demonstrate Falsity in Kickback-Based FCA Cases, Growing Circuit Split

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In United States v. Regeneron Pharmaceuticals Inc., the US Court of Appeals for the First Circuit held that when the government seeks to establish False Claims Act liability under the 2010 amendment to the Anti-Kickback...more

Rivkin Radler LLP

Owners of Transportation Company Defrauded Medicaid of $3.8M

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The New York State Attorney General’s Office announced on December 5 that Muhammad Rizwan Khan, Muhammad Usman Khan and Farhan Khan and their Orange County-based transportation companies, Tristate Express NY, Inc., Meditrans...more

ArentFox Schiff

Investigations Newsletter: Owner, Operator of Texas Lab Charged for $79 Million Medical Testing Fraud Scheme

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Owner, Operator of Texas Lab Charged for $79 Million Medical Testing Fraud Scheme - On November 20, Osman Syed, the owner and operator of a laboratory in Texas, was charged with three counts of health care fraud,...more

ArentFox Schiff

Investigations Newsletter: Judge Orders Government to Pay Relators a Cut of FCA Settlement

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Judge Orders Government to Pay Relators a Cut of FCA Settlement - On November 4, a federal judge from the US District Court for the District of Massachusetts ordered the government to pay the relators’ share of a...more

Rivkin Radler LLP

Eight Charged in $68 Million Brooklyn Medicaid Fraud Scheme

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Eight individuals associated with two Brooklyn social adult day care centers and a home health care intermediary have been charged in an alleged $68 million Medicaid fraud scheme. The defendants, including owners and staff...more

Rivkin Radler LLP

$68 Million CDPAP Fraud Indictment Unsealed Amidst Industry Changes

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On October 9, 2024, the United States Attorney’s office in the Eastern District of New York unsealed an indictment alleging that eight defendants defrauded Medicaid of approximately $68 million. The alleged scheme involved...more

Troutman Pepper Locke

Precision Toxicology Agrees to Pay $27M Over Drug Testing and Kickback Allegations

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On October 15, Maryland Attorney General Anthony G. Brown announced that his office reached a $27 million settlement with Precision Toxicology to resolve allegations that it submitted false claims to government health...more

ArentFox Schiff

Investigations Newsletter: US Supreme Court Declines to Consider AKS ‘Willfulness’ Question

ArentFox Schiff on

US Supreme Court Declines to Consider AKS ‘Willfulness’ Question - On October 7, the US Supreme Court denied a petition in which a whistleblower asked the Court to decide whether a “willful” act under the federal...more

ArentFox Schiff

Investigations Newsletter: Florida Federal Judge Strikes Down FCA’s Qui Tam Provision as Unconstitutional

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Florida Federal Judge Strikes Down FCA’s Qui Tam Provision as Unconstitutional - On September 30, US District Judge Kathryn Kimball Mizelle of the Middle District of Florida held in a historic decision that the federal...more

ArentFox Schiff

Investigations Newsletter: Federal Court Permits Investors to Resume Kickback Suit Against Teva

ArentFox Schiff on

Federal Court Permits Investors to Resume Kickback Suit Against Teva - After a two-year long stay, on August 30, Judge Karen S. Marston of the US District Court for the Eastern District of Pennsylvania ruled that investors...more

Foley & Lardner LLP

Health Care Enforcement: “Tea Leaves” in the 2024 National Health Care Fraud Summer Takedown

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Each summer in recent years, the U.S. Department of Justice (DOJ) and associated fraud enforcement partners have indicted many health care defendants, in multiple cases across the country. This summer continued the tradition....more

ArentFox Schiff

Investigations Newsletter: Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme

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Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more

ArentFox Schiff

Investigations Newsletter: Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits

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Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits - Daniel Hurt, the prior owner and operator of Fountain Health Services LLC, Verify Health, Landmark Diagnostics LLC, First Choice...more

Harris Beach Murtha PLLC

OIG February 2024 Enforcement Actions

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

ArentFox Schiff

Investigations Newsletter: Department of Justice Designates First Chief AI Officer

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Department of Justice Designates First Chief AI Officer - On February 22, the US Department of Justice (DOJ) designated Jonathan Mayer as the DOJ’s first “Chief Science Technology Advisor and Chief Artificial Intelligence...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

ArentFox Schiff

Investigations Newsletter: Clinical Laboratory and CEO To Pay Over $13 Million to Settle False Claims Act Allegations

ArentFox Schiff on

Clinical Laboratory and CEO To Pay Over $13 Million to Settle False Claims Act Allegations - A New Jersey-based laboratory, RDx Bioscience Inc. (RDX), and its owner and CEO, Eric Leykin, agreed to pay $10,315,023 to the US...more

Harris Beach Murtha PLLC

HHS Office of Inspector General November 2023 Enforcement Activity

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

ArentFox Schiff

Investigations Newsletter: DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence

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DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence - Mark Schena, the former president of Arrayit Corporation, a Silicon Valley-based medical technology company, was...more

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