News & Analysis as of

Fraud Healthcare Fraud

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Epstein Becker & Green

The Department of Justice’s COVID-19 Enforcement Task Force 2024 Report: A Continued Commitment to Combatting COVID-19-Related...

Since the pandemic, COVID-19-related fraud has been a consistent target of the Department of Justice....more

Benesch

Dental/DSO Intelligence Monthly Report: July/August 2024

Benesch on

Background on Indiana’s “Baby HSR” Law - Indiana passed Senate Bill 9 in March 2024, which requires an Indiana healthcare entity involved in a merger or acquisition with another healthcare entity with a value of at least...more

Holland & Hart LLP

Key Compliance Takeaways for Companies from the DOJ's New Corporate Whistleblower Program

Holland & Hart LLP on

On August 1, 2024, the U.S. Department of Justice (“DOJ”) announced its new “Corporate Whistleblower Awards Pilot Program” (“DOJ Program”), a three-year initiative managed by DOJ’s Money Laundering and Asset Recovery Section....more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - July 2024

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Oberheiden P.C.

A Guide to Qui Tam Lawsuits for Whistleblowers

Oberheiden P.C. on

One avenue for whistleblowers to take to report fraud against the government is to file a qui tam lawsuit under the federal False Claims Act. These lawsuits are complex because they have not two, but three parties to them –...more

Foley Hoag LLP

Foley Hoag 2024 White Collar Year In Preview Series

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The government had another busy year in 2023, investigating and prosecuting healthcare fraud cases on multiple fronts. Contending with the enormous healthcare crises of the now-concluded COVID-19 pandemic and the ongoing...more

McGuireWoods LLP

Federal District Court Finds Private-Insurer Relator Can Proceed with False Claims Action

McGuireWoods LLP on

Last month, the U.S. District Court for the District of New Jersey held that a private company, Allstate Insurance Company, could proceed with its whistleblower action against a clinical laboratory, Phoenix Toxicology and Lab...more

ArentFox Schiff

Investigations Newsletter: Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme

ArentFox Schiff on

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

ArentFox Schiff

Investigations Newsletter: Biomedical Company Avoids DOJ Prosecution After First Ever Voluntary Corporate Self-Disclosure of Fraud...

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Biomedical Company Avoids DOJ Prosecution After First Ever Voluntary Corporate Self-Disclosure of Fraud Under NSD Enforcement Policy - On May 22, the US Department of Justice (DOJ) announced that it will not prosecute a...more

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

Morgan Lewis

DOJ COVID-19 Fraud Enforcement Task Force Releases Report on Combating Fraud

Morgan Lewis on

The US Department of Justice’s (DOJ’s) COVID-19 Fraud Enforcement Task Force (CFETF) released a report on April 9 summarizing its efforts to identify, investigate, and prosecute fraud related to COVID-19 relief programs....more

ArentFox Schiff

Investigations Newsletter: Cooperation Spares Former NBA Shooting Guard From Prison

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Cooperation Spares Former NBA Shooting Guard From Prison - Former National Basketball Association (NBA) shooting guard, Antoine Wright, was sentenced to time served after he pled guilty to conspiracy and aggravated...more

Morgan Lewis

DOJ Releases 2023 Fraud Section Year in Review

Morgan Lewis on

In recent weeks, the US Department of Justice (DOJ) Criminal Division’s Fraud Section released its annual Year in Review report, summarizing the Fraud Section’s accomplishments in 2023. This detailed account points to a...more

ArentFox Schiff

Investigations Newsletters: Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations

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Georgia Laboratory Owner Pleads Guilty to Felony Anti-Kickback Statute Violations - On February 28, the US Department of Justice (DOJ) announced the guilty plea of Andrew Maloney, who, along with his clinical laboratory...more

Harris Beach PLLC

False Claims Act Enforcement Highlights Need for Robust Compliance Programs

Harris Beach PLLC on

The U.S. Department of Justice (“DOJ”) announced its False Claims Act (“FCA”) enforcement statistics for FY 2023 and identified key priorities for FCA enforcement in 2024 and beyond. The DOJ continues to pursue FCA...more

Fox Rothschild LLP

FCA Enforcement Remains Fixed on Healthcare and Cybersecurity

Fox Rothschild LLP on

On February 22, 2024, the U.S. Department of Justice (“DOJ”) released its Fiscal Year 2023 False Claims Act (“FCA”) statistics showing recoveries of almost $2.7 billion. Last year’s recoveries exceeded 2022’s $2.2 billion...more

PilieroMazza PLLC

Settlements and Judgments from FCA and Fraud Matters Top $2.68 Billion in 2023

PilieroMazza PLLC on

On February 22, 2024, the Department of Justice (DOJ) released its annual statistical report (Annual Report) regarding settlements and judgments obtained in the False Claims Act (FCA) and fraud matters for Fiscal Year (FY)...more

ArentFox Schiff

Investigations Newsletter: Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme

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Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme - Steven Dorfman, the former chief executive officer and owner of the Florida-based healthcare company Simple Health, and John Sand, a former...more

Kaufman & Canoles

K&C Sports & Entertainment Law Weekly Roundup - February 2024 #2

Kaufman & Canoles on

Florida State University is pushing for the dismissal of the Atlantic Coast Conference’s NC lawsuit, saying it was prematurely filed to preempt the university’s own suit against the conference, in an attempt to win a “race to...more

Rivkin Radler LLP

CT Psychologists Convicted for Medicaid Fraud

Rivkin Radler LLP on

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: Home Health Care Owner Sentenced to Nine Years in Prison for Medicare Fraud Scheme

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Home Health Care Owner Sentenced to Nine Years in Prison for Medicare Fraud Scheme - This week, the owner of a home health company was sentenced to nine years in prison for orchestrating a nearly $2.8 million scheme...more

ArentFox Schiff

Investigations Newsletter: DC Federal Judge Dramatically Amplifies False Claims Act Damages Award

ArentFox Schiff on

DC Federal Judge Dramatically Amplifies False Claims Act Damages Award - On January 16, Judge Rudolph Contreras of the US District Court for the District of Columbia issued an opinion agreeing in part with the federal...more

Benesch

Dialysis & Nephrology Digest - January 2024

Benesch on

NY Governor vetoes noncompete ban bill after opposition from health, business groups - Kathy Hochul vetoed a bill passed by both houses of the NY legislature in June that would’ve imposed bans of non-compete clauses in...more

Kaufman & Canoles

K&C Sports & Entertainment Law Weekly Roundup - January 2024 #2

Kaufman & Canoles on

A Florida State assistant coach has been suspended for the first three games of the 2024 season for violating recruiting rules by connecting a potential transfer with a representative from an NIL collective during an official...more

Sheppard Mullin Richter & Hampton LLP

HHS & DOJ FY 2022 Enforcement Targeted Fraud in COVID-19, Telemedicine, Opioid and Prescription Drugs, and Substance Use Treatment...

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released its “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022” (the “Report”), highlighting...more

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