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California attorney Joseph Cavallo was convicted of violating Title 10, CCR section 2071, "recommendation of attorney by bail licensee". The authority to prosecute violations of the bail licensing regulations lies with the...more
When it comes to healthcare fraud enforcement, the government knows how to target its resources. It is estimated that at least 25 percent of all claims paid by Medicare are improper. The government understands the...more
Healthcare fraudsters do not discriminate between private and public health insurance. Fraudsters use similar schemes to defraud Medicare and Medicaid and private insurance companies. ...more
The Justice Department and the Department of Health and Human Services have made healthcare fraud a number one priority – it is another example of the synergy of politics and enforcement. Congress spends more money on...more
The Department of Justice continues to trumpet its healthcare fraud program. Just last week, the Justice Department and HHS announced another nationwide sweep resulting in the arrest of 91 individuals....more
Hospital administrators should be nervous. The Justice Department and HHS are out to pressure service providers, including hospitals and doctors, to reduce costs. In Washington, hospitals and doctors are perceived to be a...more
Sometimes the deck is stacked against you. No matter what you do and how hard you try, you will lose.
In the healthcare area, hospitals, doctors and other service providers have to feel the frustration when it comes...more
Secretary Sebelius and Attorney General Holder issued a joint letter to the American Hospital Association and four other associations representing hospitals and medical centers, warning of indications that some providers are...more
The owner of a Long Island medical supply company was convicted last week on charges of a $10.7 million Medicare fraud and wrongful disclosure of private medical information under the Health Insurance Portability and...more
In U.S. ex rel. Repko v. Guthrie Clinic et al., the Third Circuit recently ended an attempt by Rodney Repko, former general counsel and executive vice president for Guthrie Healthcare System and its related entities, to bring...more
On July 26, 2012, the U.S. Department of Health and Human Services (HHS) and the U.S. Attorney General’s Office announced that the federal government is creating a partnership with private payers and other state and private...more
Health care fraud enforcement continues to rack up successes. Prosecutors are employing aggressive investigative techniques and using non-health care fraud related statutes to prosecute individuals.
Less than a week ago, in testimony before Congress, a representative of the United States Department of Health and Human Services (“HHS”) offered a strikingly negative assessment of the reliability of data that the government...more
The U.S. Treasury Department’s criminal enforcement arm, the Financial Crimes Enforcement Network (FinCEN), has reached individual agreements with the states of Louisiana and California which will allow state insurance...more
On May 2, 2012, the Justice Department and the U.S. Department of Health and Human Services (HHS) announced a nationwide takedown of 107 individuals for Medicare fraud schemes involving approximately $452 million in false...more
On May 2, DOJ and HHS announced charges against 107 individuals, including doctors, nurses and other licensed medical professionals, across the country for allegedly participating in Medicare fraud schemes totaling $452...more
2012 is already a record-breaking year in health care fraud enforcement. This week Attorney General Eric Holder and Secretary of the Department of Health and Human Services (HHS) Kathleen Sebelius announced the biggest...more
The Medicare Fraud Strike Force's use of a pivotal ACA regulation to suspend payments during criminal investigations signals a turning point in its prosecution strategy.
On Wednesday, May 2, U.S. Attorney General Eric...more
A hearing titled Anatomy of a Fraud Bust: From Investigation to Conviction held by the Senate Committee on Finance (Committee) on April 24th allowed federal health care agencies to both tout their fraud-fighting successes,...more
This third, and final, installment in the “Year in Review” series examines how criminal health care fraud enforcement has changed in the past year, including the use of non-health-care-related statutes, the focus on specific...more
In This Issue:
"The Second Semester Begins: Outcome of High School SAT Scandal Prosecutions May Hinge Upon Privilege Issues" and "Health Care, Pharmaceutical and Medical Device Fraud Investigations-Unprecedented...more
On December 29, 2011, the Office of Inspector General of the Department of Health and Human Services ("OIG") published its annual notice ("Solicitation") soliciting recommendations and proposals for developing new and...more
Arrested for DWI in New Mexico? How to get your Ignition Interlock License....more
British pharmaceutical company GlaxoSmithKline (GSK) announced on November 3, 2011, that it had reached an agreement in principle with the United States government to resolve multiple federal investigations regarding the...more
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