Federal Judge Affirms $487 Million Judgment Against Medical Device Distributor for FCA Violations -
On May 12, 2023, US District Judge Wilhelmina M. Wright of the District of Minnesota affirmed the entry of a $487 million...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
Recent Interview With FCA Plaintiff Bar Attorneys Offers Key Insight into Trends in Anti-Kickback Litigation -
During a recent interview commemorating the 50th anniversary of the enactment of the Anti-Kickback Statute, two...more
Anticipated Landmark Supreme Court Decision May Be Anything But On -
April 18, 2023, the US Supreme Court heard oral arguments in a set of highly anticipated cases regarding the scienter—or knowledge—provision of the False...more
4/24/2023
/ Appeals ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Oral Argument ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
Restitution ,
SCOTUS
Two Men Sentenced for $1.6 Million COVID-19 Fraud Scheme -
On Monday, April 10, two brothers were sentenced for their participation in a COVID-19 fraud scheme. The scheme involved fraudulent applications for $1.6 million...more
Supreme Court to Hear US Government in FCA Scienter Oral Argument -
On March 20, 2023, the US Supreme Court agreed to allow the federal government to participate in oral argument in the Supreme Court’s review of the...more
3/27/2023
/ Bribery ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Generic Drugs ,
Insurance Fraud ,
Medicaid ,
Medicare ,
Oral Argument ,
Scienter ,
SCOTUS ,
Securities and Exchange Commission (SEC)
DOJ Files FCA Complaint Against Major Pharmacy Retailer Based on Alleged Violations of Controlled Substances Act -
On March 13, 2023, the Department of Justice (DOJ) announced that it filed a complaint in intervention...more
3/20/2023
/ Cannabis-Related Businesses (CRBs) ,
Controlled Substances Act ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Workers ,
Home Health Care ,
Investment ,
Nurses ,
Pharmaceutical Industry ,
Pharmacies ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Sherman Act ,
Staffing Agencies ,
Wage-Fixing
SCOTUS Denies Cert In Cases Addressing FCA Pleadings Requirements -
On Monday, October 17, 2022, the US Supreme Court rejected three petitions asking the Court to resolve a circuit split regarding the Rule 9(b)...more
10/21/2022
/ CIGNA ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Kickbacks ,
Medicare ,
Medicare Advantage ,
SCOTUS ,
Solicitor General ,
TRICARE ,
Whistleblowers
OIG Warns That Proposed Drug Discounts May Warrant Sanctions -
On October 5, the US Department of Health and Human Services’ Office of Inspector General (OIG) issued an advisory opinion assessing a proposal that involved...more
10/10/2022
/ Anti-Competitive ,
Anti-Kickback Statute ,
Bid Rigging ,
Bribery ,
Caltrans ,
Contractors ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
Discounts ,
Drug Pricing ,
Economic Injury Disaster Loans ,
False Statements ,
Fraud and Abuse ,
Healthcare Fraud ,
IRS ,
Medicare ,
Medicare Part D ,
OIG ,
Sanctions ,
Tyson Foods ,
Wire Fraud
DC Circuit Adopts Pro Tanto Approach to False Claims Act Settlement Offsets -
In an opinion issued on August 30, 2022, the US Court of Appeals for the DC Circuit held in United States v. Honeywell International, Inc., ---...more
Lens Manufacturer Agrees To Pay $16.4 Million To Resolve Alleged Violations of the False Claims Act and Anti-Kickback Statute -
Essilor International, Essilor of America, Inc., Essilor Laboratories of America Inc., and...more
Ramesh “Sunny” Balwani, Former Theranos President and COO, Found Guilty on All Twelve Fraud Counts in High-Profile Trial -
On July 7, 2022, a federal jury in the Northern District of California found Ramesh “Sunny”...more
7/11/2022
/ Administrative Law Judge (ALJ) ,
Appeals ,
Corruption ,
Criminal Conspiracy ,
Criminal Convictions ,
Cyber Crimes ,
Cybersecurity ,
Department of Justice (DOJ) ,
En Banc Review ,
Enforcement ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Securities and Exchange Commission (SEC) ,
Settlement ,
Theranos ,
Unconstitutional Condition ,
Wire Fraud
SCOTUS Raises the Bar for Proof of Intent Under the Controlled Substances Act -
This week, the US Supreme Court issued a ruling in Ruan v. United States requiring subjective intent of wrongdoing in order to convict...more
7/1/2022
/ Controlled Substances Act ,
Criminal Investigations ,
Department of Justice (DOJ) ,
Fraud ,
Kickbacks ,
NBA ,
Proof of Intent ,
Reimbursements ,
SCOTUS ,
Settlement ,
Stark Law
On May 17, 2022, the US Court of Appeals for the DC Circuit issued an opinion in a False Claims Act suit, narrowly interpreting the so-called “government-action bar.” The government-action bar, 31 USC § 3730(e)(3), forecloses...more
Federal Contractors Beware: Sixth Circuit Recognizes False Claims Act Exposure Based on Allegedly Inflated Labor Cost Estimates Leading To Firm-Fixed-Price Contract.
On May 16, 2022, the US Court of Appeals for the Sixth...more
DOJ and SEC Bring Charges Against Executive in Alleged $62 Million Global Crypto Investment Fraud Scheme -
On May 6, 2022, the Department of Justice (DOJ) announced that a federal district court in the Southern District of...more
Hearing Aid Company Agrees To Pay $34.37 Million To Settle Claims That It Submitted False Claims to the Federal Employees Health Benefits Program -
On Friday, April 29th, DOJ announced a $34.37 million settlement with...more
DOJ and Treasury Announce Multilateral Russian Oligarch Task Force Called “REPO” -
On March 16, 2022, Attorney General Merrick Garland and Secretary of the Treasury Janet Yellen met with representatives from Australia,...more
Headlines that Matter for Companies and Executives in Regulated Industries.
DOJ Civil Cyber-fraud Initiative Obtains First Settlement -
The Department of Justice announced on Tuesday, March 8th, that Comprehensive...more
3/11/2022
/ Department of Energy (DOE) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Pharmaceutical Industry ,
Settlement ,
Subcontractors
On February 1, 2022, a federal court in California issued the first major ruling in a False Claims Act case testing the Department of Justice’s newly minted Civil Cyber-Fraud Initiative, notching a win for the government. In...more
On January 14, 2022, a federal court in the Northern District of California endorsed the SEC's novel "shadow trading" theory of insider trading. In SEC v. Panuwat, No. 3:21-cv-06322-WHO (N.D. Cal. Jan. 14, 2022), the Court...more
Lab Owner Pleads Guilty to $6.9 Million Medicare Fraud Scheme Involving Kickbacks and Bribery -
On January 13, 2022, the Department of Justice (DOJ) announced that a Florida man pled guilty in the Southern District of...more
1/24/2022
/ Bribery ,
Coronavirus/COVID-19 ,
DEA ,
Department of Defense (DOD) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
FBI ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Virus Testing
Sixth Circuit Rules That Statute of Limitations for FCA Retaliation Claims Is Triggered by Decision To Terminate, Not Notice of Termination -
On Wednesday, January 12, 2022, the Sixth Circuit held in El-Khalil v. Oakwood...more
The concept of materiality is critical in criminal fraud and false statement cases, as well as civil fraud cases, because it is what distinguishes harmless misrepresentations from consequential ones.
A misrepresentation is...more
DOJ Files Complaint in AWP False Claims Act Suit Against Pharmaceutical Ingredient Seller -
On November 8, 2021, the Department of Justice (DOJ) announced that it intervened in a qui tam suit and filed a False Claims Act...more
11/15/2021
/ Anti-Kickback Statute ,
Bribery ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FBI ,
Fraud ,
Medical Devices ,
Medicare ,
Pharmaceutical Industry ,
Qui Tam ,
TRICARE ,
Whistleblowers