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Fraud › Blue Shield

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
ArentFox Schiff

Investigations Newsletter: Surgeon To Pay Up to $43 Million for FCA Fraud

ArentFox Schiff on

Surgeon To Pay Up to $43 Million for FCA Fraud - A Michigan vascular surgeon, Vasso Godiali, was sentenced to 80 months in prison for defrauding health care programs in connection with his submission of false claims for...more

Buchalter

From Frying Pan to Fire: Strategic Issues When Reimbursement Disputes Turn Into Criminal Investigations

Buchalter on

Early on the morning of June 13, 2017, over one hundred federal agents raided facilities across southern California belonging to behavioral health provider Sovereign Heath. The agents provided search warrants indicating that...more

Goodwin

Sixth Circuit Addresses Plan Assets and Limitations Issues in Holding Service Provider’s Fee Assessments Constituted Self-Dealing

Goodwin on

The Sixth Circuit held in Hi-Lex Controls, Inc. v. Blue Cross and Blue Shield of Michigan that a service provider was liable as a fiduciary under ERISA for unauthorized fees it assessed against a self-funded health plan. In...more

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