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Medicaid › Criminal Prosecution

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Mintz - Health Care Viewpoints

DOJ Releases COVID-19 Fraud Enforcement Task Force Report Touting Its Successes and Urging Lawmakers to Enact New Legislation

Mintz - Health Care Viewpoints on

The government’s continued dedication of resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs appears to have borne fruit according to the results of the COVID-19 Fraud Enforcement Task...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

Holland & Knight LLP

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

Holland & Knight LLP on

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

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

Orrick, Herrington & Sutcliffe LLP on

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

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

Bradley Arant Boult Cummings LLP on

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

ArentFox Schiff

Investigations Newsletter: COVID-19 Fraud Update: DOJ Prosecutes More than 150 Defendants, 95 Criminal Cases

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COVID-19 Fraud Update: DOJ Prosecutes More than 150 Defendants, 95 Criminal Cases - Since the inception of the CARES Act, DOJ’s Fraud Section has prosecuted over 150 defendants in over 95 criminal cases. The Fraud Section...more

The Volkov Law Group

DOJ Announces Two Significant Indictments Charging Individuals with Healthcare Fraud

The Volkov Law Group on

The Justice Department is continuing to use criminal enforcement as an important tool in the fight against healthcare fraud.  While the False Claims Act continues its important place in the fight against healthcare fraud, DOJ...more

Brownstein Hyatt Farber Schreck

State Lawmakers Introduce Colorado False Claims Act

Brownstein Hyatt Farber Schreck on

Within days of gaveling in the 2022 Colorado legislative session, a coalition of state leaders introduced a bill to create the Colorado False Claims Act (the “CFCA”). The brainchild of Attorney General Phil Weiser, the CFCA...more

ArentFox Schiff

Investigations Newsletter: Lab Owner Indicted For $100 Million Health Care Fraud Scheme

ArentFox Schiff on

Lab Owner Indicted For $100 Million Health Care Fraud Scheme - On November 2, 2021, a federal grand jury in the Western District of Arkansas indicted Billy Joe Taylor of Arkansas for an alleged health care fraud scheme. ...more

Rivkin Radler LLP

NYC Pharmacy Owner Charged With Healthcare Fraud

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The owner of Brooklyn Chemists in Gravesend, Brooklyn and Lucky Care Pharmacy in Flushing, Queens was recently indicted on charges of conspiracy to commit health care fraud, conspiracy to defraud the United States by paying...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 2. News Briefs: January 2020 #2

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 29, no. 2 (January 20, 2020) - - The HHS Office of Inspector General has updated its Work Plan, which includes an item on early discharges from inpatient rehabilitation facilities to home...more

ArentFox Schiff

Investigations Newsletter: Defense Vehicle Manufacturer Accused of Defrauding the Government by $1.2 Billion

ArentFox Schiff on

Defense Vehicle Manufacturer Accused of Defrauding the Government by $1.2 Billion - On Tuesday, December 3, the United States District Court for the District of Columbia unsealed a six-year-old False Claims Act complaint...more

ArentFox Schiff

Investigations Newsletter: 34 Individuals Charged in $258 Million Medicare and Medicaid Fraud Schemes

ArentFox Schiff on

34 Individuals Charged in $258 Million Medicare and Medicaid Fraud Schemes - Twenty-six individuals in the state of California, fourteen of whom were doctors or medical professionals, and eight individuals in Arizona and...more

King & Spalding

In Significant Shift, DOJ Takes Position that Affordable Care Act Is Unconstitutional

King & Spalding on

On Monday, March 25, 2019, the Department of Justice (DOJ) endorsed the decision of a district court judge in the Northern District of Texas that invalidated the entire Affordable Care Act (ACA) as unconstitutional. Texas v....more

Nelson Mullins Riley & Scarborough LLP

District Court Sentences Former Speech Therapist to an Unexpected 111 Months for Healthcare Fraud in an Upward Departure

Nelson Mullins Riley & Scarborough LLP on

On November 20, 2018, former speech therapist Gena Randolph was sentenced to 111 months in federal prison and ordered to pay $580,937.44 on convictions of criminal healthcare fraud. This sentence is noteworthy in that it fell...more

K&L Gates LLP

K&L Gates Triage: 2018 Health Care Fraud Takedown

K&L Gates LLP on

Recently, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced its largest ever national health care fraud takedown, resulting in charges against 601 diverse defendants including...more

Jackson Walker

U.S. Department of Justice Announces National Healthcare Fraud Takedown

Jackson Walker on

601 Criminal Healthcare Fraud Indictments Proves Enforcement Remains a Top Priority for Federal and State Authorities - The Department of Justice and the U.S. Department of Health and Human Services Office of Inspector...more

Robinson+Cole Health Law Diagnosis

State Enforcement Actions Demonstrate Continued Scrutiny of Health Care Fraud

Robinson+Cole Health Law Diagnosis on

A series of criminal and civil enforcement actions announced in recent weeks demonstrate the continued attention that state regulators throughout the Northeast are placing on health care fraud. ...more

Obermayer Rebmann Maxwell & Hippel LLP

Corporate Actors Held Individually Accountable in Recent False Claims Act Settlement

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The Department of Justice (“DOJ”) has sent a clear message that individuals cannot hide behind the corporate shield in its recent settlement with Med-Fast Pharmacy, Inc. and the charges brought against its associated...more

Dorsey & Whitney LLP

Consultant found guilty of illegal kickbacks by “referring” doctors’ patients to another medical provider in exchange for...

Dorsey & Whitney LLP on

Under 42 U.S.C. § 1320a-7b(b)(1)(A) it is a felony for a physician to solicit or receive a kickback “in return for referring” a Medicaid or Medicare patient to another medical provider. But as a recent decision by the Eighth...more

Faegre Drinker Biddle & Reath LLP

Twelve-Year Sentence for Medicaid Diaper Scam

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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

Fox Rothschild LLP

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

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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

Ruder Ware

Atlanta Dentist Goes to Jail for Medicaid Fraud - Do You Hear Me Now on Dental Practice Compliance?

Ruder Ware on

A few months ago, the Atlanta Journal-Constitution reported on the guilty plea of an Atlanta dentist for Medicaid fraud.  Just this week, the dentist was sentenced to serve a year and a half in federal prison....more

Carlton Fields

Health Care Fraud and Abuse in the Middle District of Florida in 2016 - a Year in Review

Carlton Fields on

The United States Attorney’s Office (USAO) for the Middle District of Florida (USAO-MDFL) prosecuted several civil health care fraud matters in 2016 and issued related press releases. A review of the USAO-MDFL’s criminal and...more

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