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
On February 17, Daniel Russo, a Long Island resident, pleaded guilty in federal court in Brooklyn to multiple charges in connection with illegally distributing oxycodone. Russo faces decades in federal prison when he is...more
As many of our readers are no doubt already aware, the U.S. Department of Health and Human Services announced on February 9 that the COVID-19 public health emergency (PHE) will end on May 11. The announcement gave payers,...more
The U.S. Department of Justice (DOJ) announced on January 25 that 25 defendants have been indicted in Florida for their involvement in the sale of more than 7,600 fraudulent diplomas, and fake transcripts, from three...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
I don’t know how to say it any more clearly. Somehow, medical and dental practices continue to get roped into responding to negative patient reviews on Yelp, Google, or elsewhere online, and posting any identifying...more
On January 11, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally renewed the federal COVID-19 public health emergency (PHE) for another 90 days. The PHE, which originally went into effect on...more
On December 23, the U.S. Congress passed the “Consolidated Appropriations Act, 2023,” the omnibus budget bill for fiscal year 2023 (HR 2617). The bill includes several provisions relating to Medicare coverage of telehealth,...more
A Suffolk County, New York court held on November 16 that White’s Apothecary in East Hampton was not negligent when it filled a physician’s opioid and benzodiazepine prescriptions as ordered....more
The U.S. Attorney’s Office for the District of Connecticut announced on November 3 that Ananthakumar Thillainathan, a physician with offices in Stratford and Milford, pleaded guilty to healthcare fraud and federal kickback...more
The U.S. Department of Justice announced on November 10 that five former employees of Methodist Hospital, based in Memphis, Tennessee, were indicted by a federal grand jury for allegedly selling the names and telephone...more
The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental...more
Align Technology, the manufacturer of the Invisalign system of orthodontic braces, recently announced the release of an improved artificial intelligence-assisted smartphone app that can direct an Invisalign wearer when to...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
Home health-related fraud and dentists behaving badly (see this week’s earlier posts) have both been notable recent trends, but the U.S. Department of Justice (DOJ) has been even busier lately cracking down on fraud involving...more
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
Virtual primary care company HealthTap recently announced that it has partnered with Samsung to provide telehealth services through Samsung smart TVs. Users will be able to connect to the HealthTap platform and schedule a...more
On October 13, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally renewed the federal COVID-19 public health emergency (PHE) for another 90 days....more
On October 7, the U.S. Attorney’s Office for the District of New Jersey announced that a former physician pleaded guilty to conspiring to wrongfully disclose patients’ protected health information to a pharmaceutical sales...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
If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually...more
8/26/2022
/ Bribery ,
Criminal Conspiracy ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Nurse Practitioners ,
Telemarketing ,
Wire Fraud
On August 15, the U.S. Department of Justice (DOJ) announced that a Long Island chiropractor pleaded guilty to healthcare fraud for billing a private insurance company over $1 million for acupuncture services that were never...more