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Criminal Law Government Contracting

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Client Alert: Feds Shine a Light on Medicare Advantage Plans and Physicians Related to Risk Adjustment Practices

Although the sufficiency of medical records documentation supporting beneficiary diagnoses for Medicare Advantage (MA) risk adjustment has been on the OIG’s work plan since 2013, the Department of Justice has upped the ante...more

The Lowdown On Takedowns

by Ifrah PLLC on

Attorney General Jeff Sessions and a battery of other federal law enforcement officials today announced the “largest health care fraud takedown” in U.S. history, with 412 charged defendants, including 56 doctors, accused of...more

Twelve-Year Sentence for Medicaid Diaper Scam

by Faegre Baker Daniels on

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas...more

This Month in Corruption: Bilking of Disabled Veterans a Notable Low

by PretiFlaherty on

Ex-Cop Guilty of Misusing Funds for Disabled Veterans. On May 16, Glenn P. Pearson, a former sergeant in the Whitman Police Department, pleaded guilty in connection with the misappropriation of funds from accounts owned by...more

Seven Takeaways from the ABA National Institute On Health Care Fraud

On May 17, 2017 the American Bar Association convened its 27th National Institute on Health Care Fraud. I have attended many of the past annual meetings, and always enjoy the presentations and the opportunity to network with...more

Energy & Process Corp. Settles Whistleblower Action Related to Construction of Nuclear Waste Treatment Facility

by Dorsey & Whitney LLP on

On Monday, April 24, the U.S. Department of Justice announced that Energy & Process Corp. agreed to pay $4.6 million to settle False Claims Act allegations concerning the construction of a large nuclear waste treatment...more

Can Overpayments Create Criminal Liability?

by Ruder Ware on

We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges...more

Fighting fraud and corruption: increasing the government’s powers of detection

by Dentons on

On 30 March 2017, the Australian Parliament introduced the Crimes Legislation Amendment (Powers, Offences and Other Measures) Bill 2017 into the Legislative Assembly. The Bill aims to provide a range of amendments to improve...more

A “Change of Heart” in a Health Care Fraud Prosecution - Inconsistent angiogram interpretations establish reasonable doubt in...

On March 7, 2017, the U.S. District Court for the Eastern District of Kentucky reversed the October 27, 2016 criminal jury verdict against Kentucky cardiologist Dr. Richard E. Paulus, and acquitted him on all counts of health...more

Three Recent Fraud Cases Involving Dermatologists Illustrate Primary Compliance Risks in Dermatology Practices

by Ruder Ware on

Three relatively recent cases involving dermatology billing practices illustrate some of the main compliance risks faced by dermatology practices...more

This Month in Corruption: Smuggled Drugs, Bogus Billing, Tampered Equipment

by PretiFlaherty on

Wrong Way to Keep Prisoners in Line. The office of William D. Weinreb, acting U.S. Attorney for the District of Massachusetts, announced March 3 that two former corrections officers at the Essex County Correctional facility...more

Mintz Levin Health Care Qui Tam Update: Recently Unsealed Whistleblower Cases

Featured Unsealed Cases United States ex rel. Thomas v. Best Choice Home Health Care Agency, Inc., No. 2:13-cv-02209 (D. Kan.) - Complaint Filed: May 6, 2013 - Complaint Unsealed: October 24, 2016...more

President’s Budget Blueprint Increases Funds For Health Care Fraud Enforcement

The President has released a “budget blueprint” for fiscal year 2018. Although there are many aspects of the budget blueprint to digest, several budget items signal that government health care fraud enforcement remains a...more

Pharmaceutical Manufacturers and Healthcare Leaders cite Fraud and Abuse Laws as Obstacle to Value-Based Arrangements

As the healthcare industry moves towards value-based purchasing, pay-for-performance, and other payment reform models, industry leaders have identified federal fraud and abuse laws as a barrier to full implementation of such...more

Health Care FCA Decisions Applied to Criminal Case

by Bryan Cave on

False Claims Act (“FCA”) cases involving medical necessity continue to receive great attention. A March 7, 2017 opinion that overruled a jury’s criminal fraud conviction of a cardiologist demonstrates the broader implications...more

A Parallel Universe: Navigating Discovery in Concurrent Civil and Criminal Proceedings

by Ward and Smith, P.A. on

As criminal law has expanded into almost every sector of the American economy, one byproduct is the rise of "parallel proceedings"—lawsuits that proceed concurrently in criminal and civil court based on largely the same...more

DOJ Issues New Guidance on the Evaluation of Corporate Compliance Programs in Federal Fraud Investigations

On February 8th, the U.S. Department of Justice (DOJ) quietly issued new guidance on how the agency evaluates corporate compliance programs during fraud investigations. The guidance, published on the agency’s website as the...more

Antitrust Alert: Mexico Brings First Criminal Antitrust Actions for Bid Rigging

by Jones Day on

In an unprecedented action, this month the Investigation Bureau of the Mexican Federal Competition Commission (COFECE) has brought criminal prosecutions against individuals who allegedly participated in bid rigging activities...more

Former NSA Contractor Indicted for Theft of Government Property

The United States Department of Justice (DOJ) has announced that a former contractor of a defense contractor has been indicted for stealing over 75 percent of hacking tools belonging to the Nations Security Agency’s offensive...more

White Collar Enforcement and the New Trump Administration: Your Top Ten Questions Answered

by Foley & Lardner LLP on

Enforcement activity under the Obama administration often made headlines for the eye-popping level of fines, with the Foreign Corrupt Practices Act (FCPA), Anti-Money Laundering (AML) regulations, and economic sanctions...more

You’re Fired: What Impact Will Sally Yates’ Departure Have on the DOJ’s Fraud Enforcement?

by Snell & Wilmer on

As most of the world now knows, President Trump fired acting Attorney General Sally Yates last week after she declined to defend the President’s travel ban. Dana Boente has replaced Ms. Yates, but he may not be long for the...more

Modern Enforcement: Rolls-Royce’s $800 Million Global Settlement

by Bracewell LLP on

Rolls-Royce plc, a UK-based company that manufactures engines and generators for the aerospace, defense, marine, and energy sectors, has agreed to pay over $800 million to resolve parallel investigations by U.S., UK, and...more

Fourth Circuit Holds that the False Claims Act Does Not Expand Common Law Corporate Successor Liability

by Ropes & Gray LLP on

In United States ex rel. Bunk v. Gov’t Logistics N.V., 2016 U.S. App. LEXIS 20481, 842 F.3d 261 (4th Cir. 2016), the Fourth Circuit addressed a successor corporation’s liability for a predecessor corporation’s liabilities...more

POD Update: Physician Investor of Physician-Owned Distributor Sentenced to Nearly 20 Years in Prison

by Ropes & Gray LLP on

On January 9, 2017, a physician was sentenced in federal court in the Eastern District of Michigan to 19 years, 7 months in prison for his role in criminal health care fraud totaling $2.8 million. The settlement has some...more

Jury Verdict in Declined Civil FCA Action Need Not Bar Criminal Prosecution for Same Conduct

by Dorsey & Whitney LLP on

The qui tam provisions of the False Claims Act allow private citizens to file FCA claims on behalf of the government. The government may elect to intervene in the action—or it may not. The United States District Court for...more

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