News & Analysis as of

Healthcare Fraud Criminal Prosecution

Epstein Becker & Green

DOJ Criminal Fraud Section’s Annual Health Care Fraud Enforcement Action: “We Are a Target-Rich Environment”

On June 27, 2024, the U.S. Department of Justice (“DOJ”) and the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), along with other federal and state law enforcement partners, announced...more

Lathrop GPM

Nearly 200 Health Care Providers Charged in Aggressive Enforcement Action by DOJ Health Care Fraud Strike Force Alleging Schemes...

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The Department of Justice announced one if its most aggressive and wide-ranging enforcement actions to date, a coordinated two-week operation spanning 32 federal districts. The orchestrated effort involved the FBI, HHS-OIG,...more

Mintz - Health Care Viewpoints

A First-of-its-Kind Telemedicine Criminal Prosecution: Key Takeaways

The indictment, arrest, and arraignment of Ruthia He, the founder, CEO, and clinical president of Done Global (Done), and David Brody, clinical president of Done and the sole shareholder of Done Health, P.C. (PC) in...more

Holland & Knight LLP

Supreme Court's Decision in Diaz Could Be a Boon for Criminal Healthcare Fraud Defendants

Holland & Knight LLP on

A defendant's mens rea, or intent, is almost always a contested element in a criminal prosecution, particularly in criminal healthcare fraud cases that frequently arise out of complex legal and regulatory regimes....more

Robinson+Cole Health Law Diagnosis

DOJ Charges 36 Defendants in Connection with Telemedicine and Clinical Laboratory Fraud and Abuse Schemes

On June 27, 2024, the Department of Justice (DOJ) announced its 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants for alleged participation in various health care...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

Benesch

From the NBA Finals to Federal Prison - “Big Baby” Sentenced to 40 months in NBA Healthcare Plan Scheme

Benesch on

Former NBA player Glen “Big Baby” Davis was sentenced to 40 months in prison after being convicted for his role in a scheme to defraud the NBA healthcare plan. Davis’ sentence comes almost a year after the scheme’s...more

Morgan Lewis - Health Law Scan

Mass. USAO Hints at Healthcare Fraud Enforcement Focus in Rare Disease Space at White Collar Crime Conference

The Boston Bar Association hosted its fifth annual White Collar Crime Conference on May 2, 2024, featuring prosecutors from the US Attorney’s Office for the District of Massachusetts (the Office) and the Office of the...more

Morgan Lewis

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

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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

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 186: White Collar Crimes in Healthcare with Maynard...

Maynard Nexsen on

This week, Heather and Lauren welcome more members of the Maynard Nexsen team, White Collar attorneys Erica Barnes, Mark Moore, and Christian Dysart. The group takes a deep dive into discussing white-collar crime in the...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

Kaufman & Canoles

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

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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

The Volkov Law Group

DOJ Declines Prosecution Applying Corporate Enforcement Program in Healthcare Fraud Case

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The Justice Department’s Corporate Enforcement Policies and Program applies to prosecutions outside of the FCPA context.  The impact of DOJ’s new approach, encouraging voluntary disclosures, applies to other federal criminal...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - November 2023

The November Monthly Minute digs into the new proposed LTPT regulations, 2024 benefit limits, and the NBA health plan fraud verdict. Indigestion from Turkey and Stuffing or the IRS’ Proposed LTPT Regulations? ...more

American Conference Institute (ACI)

[Event] 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement - January 23rd - 24th, New York, NY

Hosted by American Conference Institute, the 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement returns for another exciting year for lively discussions on FCA enforcement including the ramifications of two...more

Epstein Becker & Green

Rare DOJ Criminal Indictment Related to Medicare Advantage Risk Adjustment

Epstein Becker & Green on

In an indictment announced on October 26, 2023 in Miami, the U.S. Department of Justice, Criminal Division’s Fraud Section, working with the FBI and HHS-OIG, brought what may be only the second federal criminal charges...more

ArentFox Schiff

Investigations Newsletter: DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence

ArentFox Schiff on

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

McGuireWoods LLP

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

McGuireWoods LLP on

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

Holland & Knight LLP

Supreme Court Narrows Scope of Aggravated Identity Theft Law in Healthcare Fraud Case

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The healthcare industry is one of the most heavily regulated industries in the United States. Healthcare companies and practitioners devote significant resources to complying with the complex and often changing legal and...more

Morgan Lewis - Health Law Scan

Chief Compliance Officer Convicted in Healthcare Fraud Case

The US Department of Justice (DOJ) announced on June 8, 2023 that Steven King, a compliance executive of pharmacy holding company A1C Holdings LLC, was convicted of defrauding Medicare out of more than $50 million in a scheme...more

Zuckerman Spaeder LLP

In a win for defendants, the Supreme Court limits the aggravated identity theft statute and resulting prosecutorial...

Zuckerman Spaeder LLP on

Federal prosecutors will now be cabined in their ability to use aggravated identity theft charges to pressure defendants to plead guilty to other offenses in exchange for avoiding the two-year mandatory minimum, mandatory...more

Orrick, Herrington & Sutcliffe LLP

Supreme Court Cautions Against Overly Broad Criminal Charging Decisions

The U.S. Supreme Court recently struck another blow against overcriminalization of federal criminal statutes, i.e., the application of criminal provisions in specific laws in ways that Congress never intended. The court’s...more

Bradley Arant Boult Cummings LLP

Supreme Court Unanimously Reins in the Government’s Use of the Aggravated Identify Theft Statute

In an extremely consequential decision issued last week, the United States Supreme Court reined in what the Court termed the government’s “boundless interpretation” of the aggravated identity theft statute, 18 U.S.C. § 1028A....more

Sheppard Mullin Richter & Hampton LLP

Is this “Good-Bye” to the Two Year Mandatory Minimum in Healthcare Fraud Cases?

On June 8, 2023, the Supreme Court issued a unanimous decision holding that the aggravated identity theft statute –and its mandatory minimum of two years – is not triggered merely because someone else’s identification...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

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