Generally, the Employee Retirement Income Security Act of 1974 (ERISA) prohibits discrimination based on a plan participant’s health status-related factor, such as a medical condition, medical history, or genetic information....more
Fourth Circuit Appeal Challenges Six-Year Sentence in $10 Million Medicaid Fraud Case -
A former physician assistant, Colby Edward Joyner, has asked the US Court of Appeals for the Fourth Circuit to overturn his six-year...more
10/14/2025
/ Appeals ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
Department of Justice (DOJ) ,
Healthcare Fraud ,
Loans ,
Medicaid ,
Popular ,
Sentencing ,
UK ,
Wire Fraud
$37 Million FCA Settlement: Semler Scientific and Bard Resolve Medicare False Claims Over FloChec/QuantaFlo -
On September 26, the US Department of Justice (DOJ) announced that Semler Scientific Inc., Bard Peripheral...more
10/7/2025
/ Corporate Integrity Agreement ,
Cybersecurity ,
Department of Defense (DOD) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medical Devices ,
Medicare ,
Popular ,
Qui Tam ,
Whistleblowers
A North Carolina federal court’s recent order granting remand in the case Nash Hospitals, Inc. v. UnitedHealthcare of North Carolina, Inc., et al., No. 5:25-CV-28-FL underscores the limits of federal question jurisdiction in...more
8/25/2025
/ Breach of Contract ,
Contract Disputes ,
Contract Interpretation ,
Health Insurance ,
Healthcare ,
Insurance Litigation ,
Jurisdiction ,
Medicare Advantage ,
Popular ,
Reimbursements ,
Remand
DOJ Reports Nearly $3 Billion in FCA Settlements, Judgments for FY 2024 -
On January 15, the US Department of Justice (DOJ) reported that settlements and judgments under the False Claims Act (FCA) totaled more than $2.9...more
1/20/2025
/ Criminal Prosecution ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Investment Fraud ,
Medicare ,
Medicare Advantage ,
Pharmaceutical Industry ,
Pharmacies ,
Settlement ,
Whistleblowers ,
Wire Fraud
Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions -
In a brief filed earlier this week, the US federal government has urged the Eleventh Circuit Court of Appeals to uphold the...more
1/13/2025
/ Anti-Kickback Statute ,
Appeals ,
Appointments Clause ,
Article III ,
Constitutional Challenges ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
Misrepresentation ,
National Institute of Health (NIH) ,
Pharmaceutical Industry ,
Qui Tam ,
SCOTUS ,
Settlement ,
Stark Law ,
Unconstitutional Condition ,
Whistleblowers
There is significant potential that the Congressional Review Act (CRA) will play a prominent role in the early weeks of the Trump Administration. Below, we will break down what the CRA is, when it applies, and how it may be...more
In a departure from past jurisprudence, a recent DC Circuit decision questioned whether the White House Council on Environmental Quality (CEQ) had the legal authority to issue key regulations under the National Environmental...more
11/26/2024
/ Administrative Procedure Act ,
Audubon Society ,
Aviation Industry ,
CEQ ,
Environmental Policies ,
Federal Aviation Administration (FAA) ,
Government Agencies ,
National Park Service ,
NEPA ,
Regulatory Agencies ,
Regulatory Authority ,
Separation of Powers ,
Statutory Authority
Owner, Operator of Texas Lab Charged for $79 Million Medical Testing Fraud Scheme -
On November 20, Osman Syed, the owner and operator of a laboratory in Texas, was charged with three counts of health care fraud,...more
11/25/2024
/ Conspiracies ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Bank Accounts ,
Fraud ,
Healthcare Fraud ,
Home Health Care ,
Kickbacks ,
Medicaid ,
Medical Testing ,
Medicare ,
Money Laundering ,
Sentencing ,
Settlement ,
Texas
UCHealth Settles FCA Violations for $23 Million -
On November 12, the US Department of Justice (DOJ) announced that University of Colorado Health (UCHealth) agreed to resolve allegations that it violated the False Claims...more
11/18/2024
/ Criminal Conspiracy ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Insurance Fraud ,
Investment Fraud ,
Medicare ,
Money Laundering ,
Pharmacist ,
Settlement ,
TRICARE ,
Wire Fraud
Florida Federal Judge Strikes Down FCA’s Qui Tam Provision as Unconstitutional -
On September 30, US District Judge Kathryn Kimball Mizelle of the Middle District of Florida held in a historic decision that the federal...more
10/7/2024
/ Anti-Kickback Statute ,
Appointments Clause ,
Criminal Convictions ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
False Statements ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Misrepresentation ,
OIG ,
Qui Tam ,
Sentencing ,
Settlement ,
Unconstitutional Condition
New York City Mayor Eric Adams Charged for Accepting Foreign Bribes -
On September 26, New York City Mayor Eric Adams was charged with conspiracy to commit wire fraud, bribery, and two counts of soliciting donations from...more
9/30/2024
/ Bribery ,
Campaign Contributions ,
Coronavirus/COVID-19 ,
Criminal Conspiracy ,
False Claims Act (FCA) ,
Foreign Entities ,
Foreign Nationals ,
Fraud ,
HRSA ,
Identity Theft ,
Kickbacks ,
Medicaid ,
Medical Billing Codes ,
Reimbursements ,
Sentencing ,
Settlement ,
Virus Testing ,
Wire Fraud
On September 9, the US Departments of Labor, Treasury, and Health and Human Services (the Departments) jointly released a final rule to ensure that group health plans comply with the Mental Health Parity and Addiction Equity...more
Precision Lens Pays $12 Million to Resolve FCA and AKS Violations -
Late last week, Precision Lens and the estate of its former principal agreed to pay $12 million to resolve allegations regarding violations of the False...more
8/5/2024
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Fraud ,
Healthcare ,
Insurance Fraud ,
Kickbacks ,
Medicare ,
Reimbursements ,
Settlement ,
Stark Law ,
Telemarketing ,
Whistleblowers
Texas Pharmaceutical Marketer Sentenced for $59 Million Medications Fraud Conspiracy -
On July 12, Quintan Cockerell, a Texas pharmaceutical marketer, was sentenced to over two years in prison and ordered to pay more than...more
7/22/2024
/ Conspiracies ,
False Claims Act (FCA) ,
Fraud ,
Hospice ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Prescription Drugs ,
Sentencing ,
Settlement
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
On March 7, Deputy Attorney General Lisa Monaco delivered the keynote remarks at the American Bar Association’s (ABA) 39th National Institute on White Collar Crime.
She noted that artificial intelligence (AI) “holds great...more
3/15/2024
/ Algorithms ,
Artificial Intelligence ,
Banking Sector ,
Compliance ,
Corporate Crimes ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Electronic Protected Health Information (ePHI) ,
Enforcement Actions ,
False Claims Act (FCA) ,
FinCEN ,
FinTech ,
Fraud ,
Healthcare ,
IRS ,
Liability ,
Machine Learning ,
Securities and Exchange Commission (SEC) ,
White Collar Crimes
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
Two Individuals Indicted for Operating $25 Million Crypto-Fraud -
On December 11, a federal court in California unsealed a superseding indictment, which charged two men with operating a $25 million cryptocurrency fraud...more
12/18/2023
/ Coronavirus/COVID-19 ,
Criminal Conspiracy ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Food and Drug Administration (FDA) ,
Fraud ,
Indictments ,
Medicaid ,
Medicare ,
Money Laundering ,
Securities Fraud ,
Wire Fraud
Hospital Executive and Three Physicians to Pay More Than $880,000 to Resolve Kickback Allegations -
On Monday, December 4, 2023, a Lexington, Texas, hospital executive and three health care providers agreed to pay more...more
12/11/2023
/ Clinical Laboratory Testing ,
Conspiracies ,
Controlled Substances ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Facilities ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Settlement ,
TRICARE ,
Wire Fraud
Lab Owner Sentenced to Over 16 Years for Health Care Fraud, Money Laundering -
On September 26, 2023, a US District Judge for the Western District of North Carolina sentenced a Charlotte lab owner, Donald Booker, to over...more
10/2/2023
/ Criminal Convictions ,
Department of Justice (DOJ) ,
Gift-Cards ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare Fraud ,
Money Laundering ,
Sentencing ,
Wire Fraud ,
Witness Tampering
Government Brings FCA Action Against Laboratory Companies -
On July 18, 2023, the US Department of Justice (DOJ) announced it has filed a complaint against multiple laboratory companies and their owner, Patrick...more
7/24/2023
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Electronic Protected Health Information (ePHI) ,
False Claims Act (FCA) ,
Health Care Providers ,
Kickbacks ,
Laboratories ,
Medicare ,
Medicare Fraud ,
Virus Testing
New FCA Filings Point to Future Path Forward For Companies -
The US Supreme Court recently ruled in United States ex rel. Proctor v. Safeway Inc. and United States ex rel. Schutte, et al. v. SuperValu Inc. et al. that...more
Nurse Pleads Guilty to Health Care Fraud, Distributing Controlled Substances -
On May 9, 2023, an advanced practice registered nurse pleaded guilty to unlawfully distributing controlled substances and committing health...more