News & Analysis as of

Restitution Healthcare Fraud

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

Rivkin Radler LLP

CT Psychologists Convicted for Medicaid Fraud

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On December 19, Michael Lonski, a Greenwich psychologist, was sentenced to a 27-month prison term and three more years of supervised release for a scheme to defraud Medicaid. Lonski submitted over 80,000 claims from 2014 to...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

ArentFox Schiff

Investigations Newsletter: Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment

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Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment - Defunct BestCare Laboratory Services LLC and its founder will pay $5.7 million to settle an outstanding 2018 False Claims Act...more

McGuireWoods LLP

Eleventh Circuit Affirms Order for $1.195 Million in Restitution and 48 Month Sentence in Commercial Insurance Healthcare Fraud...

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Last month, the Eleventh Circuit upheld a $1.195 million restitution order and 48-month sentence against Carlos Verdeza for three counts of healthcare fraud. See United States v. Verdeza, No. 21-10461, 2023 WL 3728960 (11th...more

Carlton Fields

7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

Carlton Fields on

On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential...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

ArentFox Schiff

Investigations Newsletter: Home Health Agency Operator Agrees to Pay $17 Million to Resolve False Claims Act Allegations

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A group of New Jersey home health care companies (collectively, the BAYADA Companies), have agreed to pay $17 million to resolve claims that they violated the False Claims Act and Anti-Kickback Statute. Home Health Agency...more

Health Care Compliance Association (HCCA)

Physician sentenced to prison for fraud that led to deaths

Compliance Today (January 2021) - A Houston-area physician was sentenced to seven years in prison for healthcare fraud that resulted in the deaths of multiple patients due to opioid overdoses, as well as the death of an...more

Pullman & Comley - Connecticut Health Law

Health Care Billing Enforcement Not Stymied by COVID-19

Doctors, nurses, hospitals and other health care providers, should know that the pandemic has not deterred federal or state authorities from prosecuting false claims, HIPAA and other types of enforcement actions in...more

ArentFox Schiff

Investigations Newsletter: Ten Former NFL Players Charged with Defrauding League's Health Care Benefits Plan

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Ten Former NFL Players Charged with Defrauding League's Health Care Benefits Plan - On December 12, the DOJ unsealed two indictments charging ten retired NFL players with defrauding the league's retiree health care...more

Health Care Compliance Association (HCCA)

Telemedicine company owner pleads guilty

Compliance Today (November 2019) - On September 6, 2019, the US Department of Justice announced in a press release, “The owner and chief executive officer (CEO) of a telemedicine company pleaded guilty today for his role...more

Patterson Belknap Webb & Tyler LLP

Court Declines to Allow Defendants in Fraud Scheme to Utilize 28 U.S.C. § 2255 or Writ of Coram Nobis to Challenge Order of...

In United States v. Rutigliano, No. 16-3754 et al., the Second Circuit (Jacobs, Raggi, Droney) refused to endorse the reduction of a restitution order against defendants who had conspired to submit fraudulent disability...more

Faegre Drinker Biddle & Reath LLP

Co-Winners of May’s Low-Return Fraud Award

We have a tie! Danielle Burroughs and Tim Arthur are co-winners of the Low-Return Fraud Award for the month of May. On May 30 a federal court ordered Danielle to pay a whopping $2.8 million in restitution for her role in a...more

Pullman & Comley, LLC

Health Care Physicians in the Crosshairs: Criminal Prosecution

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Recent changes to our health care system have been at the forefront of the American news cycle for several years. But certain aspects have not received adequate attention. One example is the scrutiny federal and state...more

Troutman Pepper

Can A State Impose Civil Penalties On A Drug Or Device Company For Using A Federally-Approved Label?

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Overview - States have increasingly brought actions under Medicaid fraud or consumer protection statutes seeking civil penalties and restitution from the makers of prescription drugs. Many top-selling drugs have been...more

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