Law Brief®: Steve Polyakov and Richard Schoenstein Explore Healthcare Agreements
On Demand Insurance is Here But Will it Stay?
In Seitz v. Marcum LLP, 2024 N.Y. Slip Op. 51141(U) (Sup. Ct., N.Y. County Aug. 30, 2024) (here), Justice Robert R. Reed of the New York County Commercial Division addressed the doctrine of in pari delicto, which “bars a...more
Precision Lens Pays $12 Million to Resolve FCA and AKS Violations - Late last week, Precision Lens and the estate of its former principal agreed to pay $12 million to resolve allegations regarding violations of the False...more
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
We have previously discussed the California Insurance Frauds Prevention Act (IFPA)–a state antifraud statute that, while modeled on the False Claims Act (FCA), is unique in targeting fraud in the commercial health insurance...more
Florida Lab Owner Agrees to Pay Over $27 Million to Resolve Three Whistleblower Lawsuits - Daniel Hurt, the prior owner and operator of Fountain Health Services LLC, Verify Health, Landmark Diagnostics LLC, First Choice...more
On April 11, 2024, a jury convicted Northern Kentucky Center for Pain Clinic owner Dr. Timothy Ehn (who was not a medical doctor) and medical director, Dr. William Lawrence Seifert, for their roles in a scheme that defrauded...more
The Third Circuit Court of Appeals held in a recent precedential case that the court must compel arbitration between Government Employees Insurance Company (Geico) and several medical practices, which Geico had sued for fraud...more
The U.S. District Court for the Northern District of Texas recently dismissed certain claims brought by a reinsurer related to its efforts to audit an insurer’s broker....more
Disgraced Crypto Mogul Bankman-Fried Sentenced to 25 Years in Prison - On March 28, Judge Lewis Kaplan of the United States District Court for the Southern District of New York handed down a substantial term of...more
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
A Long Island man who impersonated the general counsel of the NFL and an NBA player as part of his scheme for multiple frauds will now serve jail time. Sentenced in federal court in Central Islip, Matthew James used...more
Jason Brand made a claim for disability benefits under his disability policy with Principal Life Insurance Company on the basis that he was totally disabled by extreme anxiety that began in July 2014 after a warrant was...more
Health Care Network Settles False Claims Act Allegations for $345 Million - Community Health Network Inc. (CHN) has agreed to pay $345,000,000 to settle allegations that it violated the False Claims Act (FCA) for knowingly...more
For years, plaintiff’s attorney Montie S. Day has sued California auto insurers, arguing that the policy exclusion precluding coverage for first-party diminution of value damages claims is unenforceable. On November 30, 2023,...more
As interest rates and financial pressures on families continue to mount, more and more drivers may be unable to pay their repair bill for damage they caused or for mechanical issues on their vehicles. A common response is...more
The North Carolina Department of Insurance recently announced that a new investigative unit formed as part of the Cooperative Disability Investigations (CDI) Program will be located in Raleigh, North Carolina, with the goal...more
Gov’t Emps. Ins. Co. v. Koppel, No. 2:21-cv-03413-MEF-JRA, 2023 U.S. Dist. LEXIS 151531, (D.N.J. Aug. 28, 2023) - The insurance carrier brought a civil action against various medical providers, asserting an illegal kickback...more
The hype around ChatGPT and other artificial intelligence is hard to escape. The importance of learning the risks and advantages of artificial technology cannot be understated. This is especially true for the insurance...more
Regulators Hit Jackpot: Off-Channel Communications - Several years before announcing the first “off-channel” communications enforcement action, the SEC and FINRA cautioned broker-dealers and investment advisers about...more
On August 23, 2023, the National Association for Fixed Annuities (NAFA) filed an amicus brief in the case of SEC v. Cutter Financial Group LLC in federal district court in Boston. The brief followed the filing of an amended...more
Supreme Court to Hear US Government in FCA Scienter Oral Argument - On March 20, 2023, the US Supreme Court agreed to allow the federal government to participate in oral argument in the Supreme Court’s review of the...more
Personal injury attorney, George Constantine, and orthopedic surgeon, Andrew Dowd, were convicted by a Manhattan federal jury on Friday, December 16, for knowingly profiting from a $31 million personal injury litigation scam....more
Following the easing of Covid pandemic restrictions, we are now facing a fresh “cost of living crisis” created by rising inflation and soaring energy bills. The Guardian newspaper reported that forecourts at petrol...more
In its recent decision, People ex rel. Ellinger v. Magill, et al., —Cal.Rptr.3d—, No. E076378, 2022 WL 1077988 (Cal. Ct. App., Mar. 18, 2022), the California Court of Appeal refused to extend liability under California’s...more
Archegos Executives Charged With Conspiring To Defraud Banks Out of Billions - On Wednesday, April 27, 2022, the US Attorney’s Office for the Southern District of New York unsealed an indictment charging Sung Kook “Bill”...more