The U.S. Department of Justice announced on July 24 that Admera Health LLC, a New Jersey-based biopharmaceutical research and clinical laboratory testing company, agreed to pay $5,389,648 to resolve kickback allegations...more
The U.S. Department of Justice recently announced that Silver Lake Hospital, a long-term care hospital in Newark, New Jersey, and some of its investors agreed to pay $30.6 million to settle claims that they violated the False...more
The U.S Attorney’s Office for the District of Connecticut announced on May 9 that Yale New Haven Health Services Corp. and Northeast Medical Group, Inc. have paid $560,718.48 to resolve federal and state False Claims Act...more
The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay...more
The U.S. Attorney for the District of Connecticut recently announced that Michael Lonski, a Greenwich psychologist, pleaded guilty to healthcare fraud. Lonski admitted to billing insurers for services that were not rendered,...more
The U.S. Department of Justice (DOJ) announced on January 20 that DePuy Synthes, a subsidiary of Johnson & Johnson, agreed to pay $9.75 million to resolve allegations that it entered into a kickback scheme with an unnamed...more
The U.S. Attorney for the Eastern District of New York recently announced that Morris Barnard, a Great Neck gastroenterologist, was sentenced to 30 months in jail for billing Medicare for procedures he never performed....more
Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases....more
10/28/2022
/ Anti-Kickback Statute ,
Bribery ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Price Inflation ,
Telemarketing
The U.S. Department of Justice (DOJ) announced on October 18 that Oklahoma-based Carter Healthcare LLC and its affiliates, plus two executives, agreed to pay a total of over $30 million to resolve two separate qui tam cases....more
The U.S. Attorney for the District of New Jersey and New York Attorney General Letitia James both announced on October 6 that pediatric dentist Barry L. Jacobson, his management company, and 13 affiliated pediatric dentistry...more
On August 23, the U.S. Department of Justice announced that Dallas-based optical lens manufacturer Essilor International and its affiliates agreed to pay $16.4 million to settle alleged violations of the federal Anti-Kickback...more
The U.S. Department of Justice (DOJ) recently announced that Reliance Medical Systems LLC, a Utah-based distributor of spinal implant devices, two of its individual owners, and two of its physician-owned distributorships...more
A New York woman was sentenced last month to 78 months in prison for defrauding healthcare programs, including obtaining more than $6.5 million from Medicare Part D plans and Medicaid drug plans....more
The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures...more
The U.S. Department of Justice recently announced that CareCloud Health, a Florida-based developer of electronic health records software, agreed to pay $3.8 million to resolve a whistleblower’s allegations that it paid...more
The U.S. Department of Justice recently announced that Bristol-Myers Squibb (BMS) agreed to pay $75 million, plus interest, to resolve allegations that it knowingly underpaid rebates owed under the Medicaid Drug Rebate...more
The U.S. Department of Justice (DOJ) announced on January 28 that athenahealth Inc., a Massachusetts-based electronic health records (EHR) technology vendor, has agreed to pay $18.25 million to resolve allegations that it...more
The U.S. Department of Justice announced on November 20 that Doctor’s Choice Home Care, Inc. agreed to pay $3,856,000 to resolve allegations that the agency paid illegal kickbacks to physicians for referring patients. The...more
The U.S. Department of Justice (DOJ) announced on October 29 that Medtronic USA Inc. agreed to pay $8.1 million to settle allegations that it violated the False Claims Act (FCA) and federal Anti-Kickback Statute by paying...more
11/13/2020
/ Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medical Devices ,
Medicare
On September 23, the U.S. Department of Justice announced that pharmaceutical company Gilead Sciences, Inc. agreed to pay $97 million to resolve claims that it illegally used a foundation as a conduit to pay the copays of...more
Teva Pharmaceuticals USA Inc. is in the crosshairs of the U.S. Department of Justice (DOJ) on two separate matters. On August 18, the DOJ announced that it filed a lawsuit against Teva and an affiliate, Teva Neuroscience...more
8/27/2020
/ Co-payments ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FBI ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Pharmaceutical Industry ,
Prescription Drugs ,
Price-Fixing ,
Private Foundations ,
Settlement
The U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) have released the 2019 annual report for their Health Care Fraud and Abuse Control Program. The government recovered almost $3.6 billion,...more
7/23/2020
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
False Claims Act (FCA) ,
FBI ,
Fraud ,
Genetic Testing ,
Healthcare Fraud ,
Home Health Care ,
Medicaid ,
Medical Devices ,
Medicare ,
Prescription Drugs ,
Telehealth
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits...more
6/29/2020
/ False Billing ,
False Claims Act (FCA) ,
Home Health Agencies ,
Hospice ,
Medicaid ,
Medicare ,
New York ,
Nonprofits ,
Nurses ,
Patient Referrals ,
State and Local Government ,
Whistleblower Awards ,
Whistleblowers