News & Analysis as of

Medicare Durable Medical Equipment Healthcare Fraud

Bricker Graydon LLP

Marketing Risks in Telehealth: Recent Prosecutions and Important Reminders

Bricker Graydon LLP on

On July 9, 2025, Dr. Mohammed Ahmad of Avon, Ohio, pleaded guilty to making false statements related to health care matters in connection with a telemedicine scheme involving durable medical equipment (DME). ...more

Katten Muchin Rosenman LLP

Potential Changes Coming to Medicare Provider Enrollment and DMEPOS Accreditation

Often there is a lot of attention paid to the Centers for Medicare & Medicaid Services (“CMS”) Inpatient Prospective Payment System (“IPPS”), Outpatient Prospective Payment System (“OPPS”), and Medicare Physician Fee Schedule...more

Benesch

DOJ and HHS Launch Joint False Claims Act Working Group: Heightened Enforcement Risk Ahead for Healthcare and Government-Funded...

Benesch on

The U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) have formed a new False Claims Act (FCA) Working Group, according to a joint announcement issued by DOJ on July 2, 2025....more

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | April 2025 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2025, including Centers for Medicare & Medicaid Services (CMS) updates to Medicare Advantage (MA) and other Medicare programs....more

Rivkin Radler LLP

Seventh Circuit Rejects Extension of AKS to Marketing Companies Without Evidence of Intent to Induce Referrals

Rivkin Radler LLP on

The U.S. Court of Appeals for the Seventh Circuit recently rejected an effort by the federal government to extend the federal Anti-Kickback Statute (AKS) to a marketing company in the absence of influence by the company over...more

King & Spalding

Seventh Circuit Reverses AKS Conviction Involving Payments to Marketers and DME Manufacturer

King & Spalding on

On April 14, 2025, the U.S. Court of Appeals for the Seventh Circuit issued its opinion in United States v. Sorensen, No. 24-1557, reversing the criminal conviction of Mark Sorensen, the owner of SyMed Inc., a...more

Rivkin Radler LLP

Guilty Plea in $50 Million Medicare Fraud Scheme

Rivkin Radler LLP on

Manishkumar Patel of Pelham Manor, NY recently pleaded guilty in connection with a healthcare fraud and kickback scheme involving the sale of fraudulent prescriptions to pharmacies, durable medical equipment suppliers, and...more

Rivkin Radler LLP

NP Gets Jail Time for DME Fraud Scheme

Rivkin Radler LLP on

On April 10, Virginia-based nurse practitioner Daphne Jenkins was sentenced to prison for her participation in a $7.8 million telemedicine fraud scheme that involved medically unnecessary orders for durable medical equipment...more

ArentFox Schiff

Investigations Newsletter: Cooperation Spares Former NBA Shooting Guard From Prison

ArentFox Schiff on

Cooperation Spares Former NBA Shooting Guard From Prison - Former National Basketball Association (NBA) shooting guard, Antoine Wright, was sentenced to time served after he pled guilty to conspiracy and aggravated...more

Foley & Lardner LLP

Remote Patient Monitoring: OIG Issues Consumer Alert

Foley & Lardner LLP on

On November 22, 2023, while many were preparing for the Thanksgiving holiday, the Office of Inspector General (OIG) posted a consumer alert (Alert) warning the public about a fraud scheme involving monthly billing for remote...more

Rivkin Radler LLP

Fraud Week: Garden State Fraud Roundup; Much Compounding

Rivkin Radler LLP on

Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding...more

Rivkin Radler LLP

Fraud Week: Focus on Florida Fraud

Rivkin Radler LLP on

To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence...more

Rivkin Radler LLP

Fraud Week: DOJ Targets DME Fraud

Rivkin Radler LLP on

Home health-related fraud and dentists behaving badly (see this week’s earlier posts) have both been notable recent trends, but the U.S. Department of Justice (DOJ) has been even busier lately cracking down on fraud involving...more

Rivkin Radler LLP

Pharmacy Owners Charged for Fraud and Kickbacks to a Marketing Company

Rivkin Radler LLP on

The U.S. Department of Justice recently announced that a federal grand jury has charged two pharmacy owners, a mother-daughter duo from South Florida, with healthcare fraud, wire fraud, and payment of kickbacks in exchange...more

Venable LLP

HHS 2021 Semiannual Report to Congress Draws Attention to Genetic Testing, Durable Medical Equipment, and Opioid Disorder...

Venable LLP on

On June 6, 2022, the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), released its spring 2022 semiannual report to Congress. The semiannual report covers the period of October 1, 2021 to...more

Oberheiden P.C.

Seven Points to be Aware of for Durable Medical Equipment Company Compliance

Oberheiden P.C. on

Durable medical equipment (DME) is particularly important for many Medicare beneficiaries. However, companies that manufacture and sell DME need to be careful because there are strict federal regulations outlining almost...more

Polsinelli

DOJ Telemedicine Offensive Pushes Forward with New Charges

Polsinelli on

For the past two years, telemedicine companies, durable medical equipment suppliers, pharmacies, and individuals and entities that market to such entities have been at the center of DOJ gunsights. In 2019, the Department...more

Sheppard Mullin Richter & Hampton LLP

OIG Warns Telehealth Industry: “With Great Power Comes Great Responsibility”

On February 4, 2021, the Department of Justice (“DOJ”), Office of Public Affairs, issued a Press Release (the “DOJ Press Release”) announcing that Kelly Wolfe, President of Regency, Inc., a medical billing company located in...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 2. News Briefs: January 2020 #2

Report on Medicare Compliance 29, no. 2 (January 20, 2020) - - The HHS Office of Inspector General has updated its Work Plan, which includes an item on early discharges from inpatient rehabilitation facilities to home...more

Dorsey & Whitney LLP

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

Dorsey & Whitney LLP on

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

Epstein Becker & Green

New Program Integrity Rule Expanding Medicare Revocation and Denial Authorities Took Effect Yesterday

Epstein Becker & Green on

Yesterday, a final rule issued by the Centers for Medicare & Medicaid Services (CMS) establishing new enforcement initiatives aimed at removing and excluding previously sanctioned entities from Medicare, Medicaid, and the...more

Williams Mullen

Civil Investigative Demands and ZPIC Audits Can Be Traps for the Unwary

Williams Mullen on

Many people reasonably expect that when the government is targeting a company or individual for some adverse action, they will know it—there will be a lawsuit, an indictment, or some other clear demarcating event. ...more

Robinson+Cole Health Law Diagnosis

Series of 2019 Enforcement Actions Highlight Continued Federal and State Scrutiny of Health Care Billing in Connecticut

Since the beginning of 2019, federal and state authorities in Connecticut have announced a number of enforcement actions targeting alleged health care fraud in the state. ...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

CMS's Payment Suspensions Wreak Havoc: Understanding the Risks

Baker Donelson on

CMS payment suspensions can cripple any provider's or supplier's operations. Yet, CMS has the authority to impose a payment suspension upon the mere existence of "reliable information" that an overpayment or fraud may exist....more

29 Results
 / 
View per page
Page: of 2

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide