News & Analysis as of

Kickbacks

CFPB Loses Borders Case: the Court Construes RESPA’s Statutory ABA Exemption according to its Plain Language

by Foley & Lardner LLP on

On July 12, 2017, a federal district court in Kentucky issued a summary judgment ruling for the defense in the ongoing Borders & Borders case brought by the Consumer Financial Protection Bureau (CFPB or Bureau). In this...more

Second Circuit Applies Morrison to Rule 23 Predominance Analysis, in In re Petrobras Securities, but Rejects Third Circuit’s...

On July 7, the Second Circuit affirmed in part and vacated in part an order by Judge Rakoff of the S.D.N.Y. certifying two classes in the In re Petrobras Securities litigation, — F.3d –, 2017 WL 2883874 (2d Cir., July 7,...more

CFPB Loses Another RESPA Case

by Ballard Spahr LLP on

A federal district court recently ruled against the CFPB in a long-standing case under the Real Estate Settlement Procedures Act (RESPA) involving a Louisville, Kentucky law firm Borders & Borders, PLC (Borders). In the...more

Amounts Billed Do Not Indicate Fair Market Value In FCA Case

by Reed Smith on

Our day job has been keeping us busy, so busy with depositions, motions, delayed flights, and assorted drama that we have not posted in more than a month. After such a long layoff, we had hoped to return with a vengeance, a...more

Second Circuit Reinforces Narrow Definition of 'Official Act' in Politician's Fraud Case

by Pepper Hamilton LLP on

On July 13, the U.S. Court of Appeals for the Second Circuit vacated the conviction of former New York State Assembly Speaker Sheldon Silver, who was convicted in 2015 on seven counts of honest services fraud, Hobbs Act...more

Silver Conviction Vacated Due To Jury Instructions

Yesterday the Second Circuit (Cabranes, Wesley, Sessions, D.J.) released an opinion vacating the conviction of Sheldon Silver and remanding the case to the district court for further proceedings including a retrial. The...more

Reimbursement Manager Pleads Guilty for Prior Authorization Process Issues

by Bass, Berry & Sims PLC on

On Monday, June 19, 2017, Elizabeth Gurrieri became the second former employee of Insys Therapeutics (Insys) to plead guilty to federal anti-kickback charges related to the drug Subsys, an expensive fentanyl-based painkiller....more

Pennsylvania Federal Court Finds Continuing Violations Doctrine Applicable To RESPA Claims

by Carlton Fields on

A Pennsylvania federal court applied the continuing violations theory to RESPA’s one-year statute of limitations, and allowed Plaintiffs leave to amend their complaint to modify their RESPA claim....more

Twelve-Year Sentence for Medicaid Diaper Scam

by Faegre Baker Daniels on

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas...more

The 2017 Fla. Legislature Returns To CondoLand

Once again, after a one-year hiatus, the Florida Legislature has produced several condominium bills. Typically, the Legislature passes a single condominium bill into which other approved bills have been...more

New York Man Sentenced To 10 Years In Prison For Involvement In $26 Million “Billing Mill”

by Fox Rothschild LLP on

Last month, a New York man was sentenced to 10 years in prison for allegedly operating a $26 million scheme to defraud Medicare and Medicaid. The defendant allegedly established 6 medical clinics in Brooklyn that paid elderly...more

Seven Takeaways from the ABA National Institute On Health Care Fraud

On May 17, 2017 the American Bar Association convened its 27th National Institute on Health Care Fraud. I have attended many of the past annual meetings, and always enjoy the presentations and the opportunity to network with...more

Hospital and its Clinic Agree to $34 Million Settlement to False Claims Act Allegation that Compensation to Oncologists Violated...

Last week, the Department of Justice (DOJ) entered into a $34 million settlement with Mercy Hospital Springfield (“Hospital”) of Springfield, Missouri, and its affiliate Mercy Clinic (“Clinic”). The settlement resolves an...more

Operationalizing Compliance: Part III – Human Resources

by Thomas Fox on

This week I am engaging in a week-long series on how a Chief Compliance Officer (CCO) or compliance practitioner might think about operationalizing a compliance program with other corporate functions and disciplines. I am...more

South Korea Fines Prominent Pharmaceutical Manufacturer in Latest Anti-Corruption Enforcement Efforts

by Ropes & Gray LLP on

In a sign that South Korea is ramping up its anti-corruption enforcement efforts, Korean authorities announced on April 27 that they plan to levy a $48 million fine against Swiss pharmaceutical giant Novartis International AG...more

Revenue sharing costs money

by Ary Rosenbaum on

I guess my comments regarding revenue sharing is a bit sarcastic, but I think accurate. While revenue sharing payments from mutual funds to TPA to help defray the costs of administration of a plan sponsor’s plan is legal, it...more

Appellate Court Notes

by Pullman & Comley, LLC on

Supreme Court Advance Release Opinions: SC19734 - Wall Systems, Inc. v. Pompa - Plaintiff - construction company - discovered one of its supervisors who was paid ~$200k/year was working for a competitor at the same...more

The Downside of the Advice-of-Counsel Defense

by Faegre Baker Daniels on

Intent is a necessary element of a False Claims Act (FCA) violation. If a defendant reasonably relied on advice of counsel in performing the actions at issue, the intent element is absent. That’s the upside of the...more

Five Trends in False Claims Act Enforcement: Take Two

In July 2015, we posted about the N.Y. Attorney General’s False Claims Act (FCA) settlements with Trinity HomeCare and its related entities, and how the case provided insight into the future of FCA enforcement. We identified...more

Supreme Court to Resolve Whether Failure to Disclose under Item 303 of SEC Regulation S-K Gives Rise to Securities Fraud Claims

by Carlton Fields on

On March 27, 2017, the Supreme Court granted certiorari in the case of Leidos Inc., f/k/a SAIC Inc. v. Indiana Public Retirement System, a securities fraud class action. The case will resolve a circuit split over whether a...more

U.S. Supreme Court Agrees To Hear Securities Fraud Omissions Case

by Dorsey & Whitney LLP on

The U.S. Supreme Court will resolve a critical question governing the scope of liability in securities fraud cases which has split the circuit courts to date. The case, Leidos Inc. v. Indiana Public Retirement System, No....more

Is Disloyalty Its Own Reward?

May a disloyal employee keep the compensation his employer paid him, even while he was betraying his employer’s trust? In a recent case, the Connecticut Supreme Court said “yes, at least in some circumstances.” Here’s the...more

Mintz Levin Health Care Qui Tam Update: Recently Unsealed Whistleblower Cases

Featured Unsealed Cases United States ex rel. Thomas v. Best Choice Home Health Care Agency, Inc., No. 2:13-cv-02209 (D. Kan.) - Complaint Filed: May 6, 2013 - Complaint Unsealed: October 24, 2016...more

Connecticut Supreme Court Explains Remedies Available to Employers Winning Breach of Duty of Loyalty Claims against Employees

by Robinson & Cole LLP on

In Wall Systems, Inc. v. Pompa, No. SC19734 (Mar. 7, 2017), the Connecticut Supreme Court explained the legal and equitable remedies available to employers that win breach of duty of loyalty claims against their current or...more

SEC Charges Five Senior Executives With Financial Fraud

by Dorsey & Whitney LLP on

Five executives took advantage of their employer’s weak internal controls to repeatedly misappropriate funds, causing a loss of over $11 million over a four year period beginning in 2008. The scheme was discovered when a firm...more

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