News & Analysis as of

Pharmacy Benefit Manager (PBM) Healthcare Fraud

King & Spalding

District Court Orders CVS Caremark to Pay U.S. Government $95 Million

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On June 25, 2025, Chief Judge Mitchell S. Goldberg of the U.S. District Court for the Eastern District of Pennsylvania issued a ruling in the case of U.S. ex rel. Sarah Behnke v. CVS Caremark Corp. et al., ordering CVS...more

ArentFox Schiff

Investigations Newsletter: Co-Founder and Accountant of Leading Special Needs Trusts Charged in $100 Million Alleged Fraud Scheme

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Earlier this week, the government unsealed an indictment against Leo Joseph Govoni, the co-founder of the nonprofit Center for Special Needs Trust Administration (CSNT), and John Leo Witeck, an accountant for CSNT, charging...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

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - February 2024 #4

News Briefs - State AGs Urge Congress to Reform Pharmacy Benefit Managers - A bipartisan group of 39 state attorneys general sent a letter to Congress urging lawmakers to take "decisive action" to reform pharmacy benefit...more

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | May 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for May 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act (FCA)...more

ArentFox Schiff

Investigations Newsletter: Anticipated Landmark Supreme Court Decision May Be Anything But

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Anticipated Landmark Supreme Court Decision May Be Anything But On - April 18, 2023, the US Supreme Court heard oral arguments in a set of highly anticipated cases regarding the scienter—or knowledge—provision of the False...more

Cozen O'Connor

Centene to Pay Indiana $66.5 Million in Latest Medicaid Overbilling Settlement

Cozen O'Connor on

Indiana AG Todd Rokita reached a settlement with pharmacy benefit manager (PBM) Centene Corporation and its subsidiaries (collectively, “Centene”) in connection with alleged overcharges by Centene to Indiana’s Medicaid...more

Rivkin Radler LLP

Fraud Week: Pharmacy Kickbacks, Fake Medical Directorships and More

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Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases....more

ArentFox Schiff

Investigations Newsletter: DOJ Denies Alleged Circuit Split on Particularity Requirement in FCA Cases

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DOJ Denies Alleged Circuit Split on Particularity Requirement in FCA Cases - In a much-anticipated filing by the Department of Justice (DOJ), following the US Supreme Court’s request for briefing by the US Office of the...more

ArentFox Schiff

What Should Pharma Companies Expect From the Biden Administration?

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With the change of administrations typically comes a flurry of activity across all government agencies, and the same can be expected with the official start of the Biden Administration now well underway. What should...more

American Conference Institute (ACI)

[Virtual Event] 11th Annual Advanced Forum on Managed Care Disputes and Litigation - July 22nd-23rd

ACI’s 11th Annual Advanced Forum on Managed Care Disputes and Litigation will be offered in a virtual format this year to help you make sense of these developments, and their profound impact for managed care....more

Troutman Pepper Locke

Third Circuit Provides Defense for FCA Claims Concerning Pre-2010 Conduct

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On June 18, the Third Circuit affirmed a District of Delaware decision dismissing a False Claims Act (FCA) case against Medco Health Solutions, Inc. because the relator was not an original source of the information underlying...more

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