Medical Device Manufacturer THD Pays $700,000 to Resolve FCA Allegations -
On September 6, the US Attorney’s Office for the District of Maryland announced that THD America, Inc., and its parent company, THD SpA of Italy,...more
9/16/2024
/ False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Health Insurance ,
Healthcare Fraud ,
Manufacturers ,
Medicaid ,
Medical Billing Codes ,
Medical Devices ,
Medicare ,
Reimbursements ,
Securities and Exchange Commission (SEC)
Federal Court Permits Investors to Resume Kickback Suit Against Teva -
After a two-year long stay, on August 30, Judge Karen S. Marston of the US District Court for the Eastern District of Pennsylvania ruled that investors...more
9/9/2024
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Investors ,
Kickbacks ,
Medicaid ,
Medicare ,
Permits ,
Reimbursements ,
Settlement
DOJ Launches Corporate Whistleblower Awards Pilot Program -
On August 1, the US Department of Justice (DOJ) announced the details of its new Corporate Whistleblower Awards Pilot Program. According to the DOJ, the...more
8/12/2024
/ Bribery ,
Controlled Substances Act ,
DEA ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
False Claims Act (FCA) ,
FinCEN ,
Foreign Corrupt Practices Act (FCPA) ,
Health Insurance ,
Healthcare Fraud ,
Internal Reporting ,
Kickbacks ,
Opioid ,
Pilot Programs ,
Securities and Exchange Commission (SEC) ,
Whistleblower Awards ,
Whistleblowers ,
Wire Fraud
Welcome to the Summer 2024 issue of “FCA Enforcement & Compliance Digest,” our quarterly newsletter in which we compile essential updates on False Claims Act (FCA) enforcement trends, litigation, agency guidance, and...more
7/31/2024
/ Anti-Kickback Statute ,
Beneficiaries ,
Bring Your Own Device (BYOD) ,
But For Causation ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement ,
Fair Market Value ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Oral Argument ,
Physician Compensation Arrangements ,
Policies and Procedures ,
Portability ,
Settlement ,
Stark Law ,
TRICARE ,
Valuation
Federal Court Dismisses $680 Million FCA Suit -
On July 23, a Maryland federal judge, Ellen L. Hollander, dismissed a $680 million False Claims Act (FCA) suit that was previously revived by the US Supreme Court. The suit...more
Health Care Fraud and Money Laundering of $18 Million Leads to Prison Sentence for New York Pharmacy Owners -
Two pharmacy owners from New York have been sentenced for using their pharmacies to submit fraudulent claims to...more
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
6/17/2024
/ Chronic Care Managment (CCM) ,
Coronavirus/COVID-19 ,
Damages ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
TRICARE ,
Uninsured Patients
District Court Declines to Stay Case Pending Resolution of FCA Causation Standard Issue Before Court of Appeals -
Earlier this week, a Massachusetts federal judge denied a motion to stay proceedings filed by Medtronic,...more
6/10/2024
/ Anti-Kickback Statute ,
Appeals ,
Causation ,
Criminal Convictions ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Mail Fraud ,
Ponzi Scheme
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
6/3/2024
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Insurance Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
OIG ,
Qui Tam ,
Reimbursements ,
Settlement ,
Stark Law ,
Whistleblowers
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
5/28/2024
/ Biomedical Companies ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement ,
Enforcement Actions ,
Fraud ,
Healthcare Fraud ,
Medicare ,
National Security ,
Self-Disclosure Requirements ,
Voluntary Disclosure
Testing Facility Settles $2.5 Million Anti-Kickback Lawsuit -
On May 15, the US Attorneys for the Southern District of New York announced that they had settled their civil fraud lawsuit against Balance Diagnostics USA,...more
Big Baby’s Big Foul: Former NBA Star Glen 'Big Baby' Davis Sentenced to 40 Months for Healthcare Fraud Scheme -
On May 9, former Boston Celtics forward Glen “Big Baby” Davis was sentenced to 40 months in prison following...more
5/13/2024
/ Anti-Kickback Statute ,
CIMA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Hospice ,
Kickbacks ,
Medicare ,
NBA ,
Wire Fraud
DOJ Secures Plea in $50 Million Medicare Fraud and Kickback Scheme -
On April 26, the US Department of Justice (DOJ) announced that Manishkumar Patel pleaded guilty to charges related to a $50 million health care fraud and...more
5/6/2024
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Guilty Pleas ,
Healthcare Fraud ,
HRSA ,
Kickbacks ,
Medicare Fraud ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Retaliation ,
Telemarketing ,
Whistleblowers ,
Wire Fraud
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
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
3/25/2024
/ CARES Act ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
NBA ,
Paycheck Protection Program (PPP) ,
SBA ,
Staffing Agencies ,
Telemedicine ,
Wire Fraud
On March 12, the Second Circuit affirmed in part and reversed in part a district court dismissal of False Claims Act (FCA) claims predicated on alleged Anti-Kickback Statute (AKS) violations. Adam Hart brought the claims...more
Telemedicine Owner Pleads Guilty to $136 Million Medicare Fraud -
A licensed nurse practitioner in New Jersey, Jean Wilson, pleaded guilty to conspiracy to commit health care fraud and wire fraud. According to court...more
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
3/11/2024
/ Anti-Kickback Statute ,
Criminal Investigations ,
Department of Justice (DOJ) ,
Drug Testing ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Fines ,
Fraud ,
Guilty Pleas ,
Healthcare Fraud ,
IRS ,
Medicaid ,
Medicare Fraud ,
Opioid ,
Sentencing ,
Settlement ,
Tax Evasion ,
TRICARE
Department of Justice Designates First Chief AI Officer -
On February 22, the US Department of Justice (DOJ) designated Jonathan Mayer as the DOJ’s first “Chief Science Technology Advisor and Chief Artificial Intelligence...more
Owner of Telemedicine Companies Settles $110 Million Health Care Fraud Claim -
Steven Richardson, the owner of telemedicine companies Expansion Media, LLC and Hybrid Management Group LLC, agreed to settle allegations that...more
2/26/2024
/ Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Indictments ,
Kickbacks ,
Medicare ,
Settlement ,
Telemedicine
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
2/19/2024
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
False Billing ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Insurance Fraud ,
Mail Fraud ,
Medical Equipment ,
Medicare ,
Paycheck Protection Program (PPP) ,
Scams ,
Sentencing ,
TRICARE ,
Wire Fraud
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
2/5/2024
/ CARES Act ,
Coronavirus/COVID-19 ,
Email ,
Fraud ,
Healthcare Fraud ,
Home Health Care ,
Identity Theft ,
Income Taxes ,
IRS ,
Medicare Fraud ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Sentencing ,
Social Security ,
Tax Fraud ,
Wire Fraud ,
Witness Tampering
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
1/22/2024
/ Anti-Kickback Statute ,
Civil Monetary Penalty ,
Controlled Substances Act ,
Damages ,
False Claims Act (FCA) ,
FDCPA ,
Fraud ,
Healthcare Fraud ,
NBA ,
Paycheck Protection Program (PPP) ,
Reimbursements ,
Wire Fraud
Clinical Laboratory and CEO To Pay Over $13 Million to Settle False Claims Act Allegations -
A New Jersey-based laboratory, RDx Bioscience Inc. (RDX), and its owner and CEO, Eric Leykin, agreed to pay $10,315,023 to the US...more
1/15/2024
/ CEOs ,
Clinical Laboratories ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
FBI ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Reimbursements ,
Settlement ,
Whistleblowers
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
12/27/2023
/ Compensation ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Insurance Fraud ,
Medicare ,
Money Laundering ,
OIG ,
Securities Fraud ,
Sentencing ,
Special Purpose Acquisition Companies (SPACs) ,
Wire Fraud