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
Three Individuals Sentenced for $3.5 Million COVID-19 Relief Fraud Scheme-
On February 6, three individuals were sentenced for fraudulently obtaining and misusing Paycheck Protection Program (PPP) loans that the US Small...more
Binance to Pay Historic $4 Billion Fine -
Binance Holdings Limited, the operator of the world’s largest cryptocurrency exchange, agreed to pay $4.3 billion to resolve allegations that it violated the Bank Secrecy Act (BSA)...more
12/4/2023
/ Anti-Kickback Statute ,
Anti-Money Laundering ,
Bank Secrecy Act ,
Compliance ,
Cryptocurrency ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FinCEN ,
Fines ,
Fraud ,
International Emergency Economic Powers Act (IEEPA) ,
IRS ,
Kickbacks ,
Know Your Customers ,
Medicare ,
Money Laundering ,
Money Transmitter ,
Offshore Funds ,
Tax Fraud ,
Tax Preparers ,
Willful Misconduct
Arkansas Men Convicted in $18 Million Global Investment Fraud Conspiracy -
A federal jury in the Western District of Arkansas convicted four men of conspiracy to commit wire fraud, wire fraud, and conspiracy to commit money...more
9/11/2023
/ Compliance ,
Conspiracies ,
Criminal Convictions ,
Cybersecurity ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Documentation ,
Financial Institutions ,
Fraud ,
General Services Administration (GSA) ,
Independent Investigations ,
Investment ,
IRS ,
Money Laundering ,
Penalties ,
Popular ,
Restitution ,
Settlement ,
Tax Fraud ,
Tax Returns ,
Verizon ,
Wire Fraud
Supreme Court Justices Signal Skepticism of Qui Tam Constitutionality -
On Friday, June 16, the US Supreme Court ruled that the US Department of Justice (DOJ) has the authority to dismiss qui tam suits brought under the...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
DOJ Issues Corporate Self-Disclosure Policy -
The US Department of Justice (DOJ) released a Voluntary Self-Disclosure Policy that sets a consistent standard for corporate self-disclosures for all US Attorney’s Offices. The...more
2/27/2023
/ Appeals ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health and Welfare Plans ,
Medicaid ,
Medicare ,
NBA ,
Proposed Amendments ,
Restitution ,
SCOTUS ,
Self-Disclosure Requirements ,
Whistleblowers
Top Reasons for 2022’s Downward Trend in False Claims Act Recoveries -
Following the US Department of Justice’s (DOJ) release of statistics regarding FCA settlements and judgments for the 2022 fiscal year, Law360 spoke...more
2/20/2023
/ CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fees ,
Fraud and Abuse ,
Healthcare ,
Kickbacks ,
Medicare Advantage ,
Opioid ,
Private Equity ,
Proposed Amendments ,
Qui Tam ,
Settlement ,
Stark Law ,
Telehealth ,
Whistleblowers
COVID-19 Fraud Update: DOJ Prosecutes More than 150 Defendants, 95 Criminal Cases -
Since the inception of the CARES Act, DOJ’s Fraud Section has prosecuted over 150 defendants in over 95 criminal cases. The Fraud Section...more
9/30/2022
/ CARES Act ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Economic Injury Disaster Loans ,
False Claims Act (FCA) ,
False Statements ,
Fraud ,
Genetic Testing ,
IRS ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Payroll Expenses
Jury Orders Eli Lilly To Pay $61 Million -
A federal jury in Illinois found that, beginning around 2004, drug manufacturer Eli Lilly deliberately underpaid rebates to Medicare programs by excluding retroactive drug prices...more
8/8/2022
/ Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Falsified Documents ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Fraud ,
Paycheck Protection Program (PPP) ,
Rebates ,
SBA ,
Skilled Nursing Facility ,
Wire Fraud
KBR Reaches $13 Million Settlement To Resolve Kickback Allegations -
Kellogg Brown & Root Services Inc. and three related companies (collectively “KBR”) reached a $13.67 million settlement to resolve a suit alleging...more
6/17/2022
/ Army ,
Department of Justice (DOJ) ,
Environmental Protection Agency (EPA) ,
False Claims Act (FCA) ,
FIFRA ,
Investment Fraud ,
KBR (formerly Kellogg Brown & Root) ,
Kickbacks ,
Mail Fraud ,
Money Laundering ,
Qui Tam ,
Settlement ,
Subcontracts ,
Wire Fraud
Physician Partners of America Agrees To Pay $24.5 Million To Resolve False Claims Act Allegations -
Physician Partners of America LLC (PPOA), its founder, and its former chief medical officer agreed to pay $24.5 million to...more
California Man Convicted in $27 Million PPP Fraud Scheme -
After a trial before a federal jury, a California man was convicted of bank fraud, making false statements to a financial institution, and money laundering for...more
4/1/2022
/ Bank Fraud ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False Statements ,
Financial Institutions ,
Fraud ,
Healthcare Fraud ,
IRS ,
Kickbacks ,
Medicare ,
Paycheck Protection Program (PPP)
DOJ Attorneys Comment on the Rise of Telehealth Fraud During the COVID-19 Pandemic -
During the 2022 Qui Tam Conference of the Federal Bar Association, DOJ attorneys commented on the dramatic rise in the use of remote...more
2/28/2022
/ Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
GAAP ,
Healthcare Fraud ,
IRS ,
Medicare ,
Non-GAAP Financial Measures ,
Qui Tam ,
Securities and Exchange Commission (SEC) ,
Telehealth
Former Theranos CEO Convicted of Defrauding Investors -
Elizabeth Holmes, founder and former CEO of blood testing start-up Theranos, was found guilty of one count of conspiracy and three counts of wire fraud for her...more
A group of New Jersey home health care companies (collectively, the BAYADA Companies), have agreed to pay $17 million to resolve claims that they violated the False Claims Act and Anti-Kickback Statute.
Home Health Agency...more
John Peter Smith Hospital (JPS) agreed to pay more than $3.3 million to settle allegations that it violated the False Claims Act by upcoding hundreds of claims submitted to federal healthcare programs.
Texas Hospital to...more
On June 15, 2021, the Department of Justice (DOJ) filed a False Claims Act (FCA) suit against Paksn Inc., Prema Thekkek and one of its owners, and seven skilled nursing facilities (SNFs) owned by Thekkek and/or operated by...more
6/18/2021
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Embezzlement ,
False Claims Act (FCA) ,
Foreign Agents Registration Act (FARA) ,
Fraud ,
Insider Trading ,
Kickbacks ,
Medical Directors ,
Skilled Nursing Facility ,
Wire Fraud
COVID-19 Task Force Established to Enhance Enforcement Efforts against Fraud -
On May 17, 2021, the Department of Justice and U.S. Attorney General announced the establishment of the COVID-19 Fraud Enforcement Task Force,...more
5/24/2021
/ Attorney General ,
Centers for Disease Control and Prevention (CDC) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Department of Labor (DOL) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Falsified Documents ,
Fraud ,
Health Insurance ,
Healthcare Fraud ,
Medicaid ,
OIG ,
Paycheck Protection Program (PPP) ,
SBA ,
Vaccinations ,
Wire Fraud
Where’s the Beef? Two Charged with $650 Million Cattle Ponzi Scheme -
On May 12, the Department of Justice (DOJ) announced that a federal district court in Colorado unsealed an indictment alleging that two individuals ran...more
5/17/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Consumer Financial Products ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Financial Markets ,
Healthcare Fraud ,
Investment Fraud ,
Investment Funds ,
Mergers ,
Misrepresentation ,
Pharmaceutical Industry ,
Ponzi Scheme ,
Public Comment ,
Securities and Exchange Commission (SEC) ,
State and Local Government ,
Stock Prices
Pharmaceutical Company Agrees to Pay $12.6 Million to Settle FCA Allegations Involving Kickbacks -
On Tuesday, the Department of Justice announced a $12.6 million settlement with Incyte Corporation, a Delaware...more
5/10/2021
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Frivolous Lawsuits ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Money Laundering ,
Settlement ,
Telemarketing ,
TRICARE
Court Rules Prescription Drug Event and Enrollee Encounter Data Are 'Claims for Payment' Under the False Claims Act -
US District Judge Noel L. Hillman approved a whistleblower’s request to file a Fourth Amended Complaint...more
4/26/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Fair Market Value ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Mail Fraud ,
Medicaid ,
Medicare Part A ,
Medicare Part D ,
Oil & Gas ,
Securities Fraud ,
Whistleblowers ,
Wire Fraud
Urgent Care Provider and Management Company to pay $22.5 Million to End FCA Claims -
South Carolina urgent care providers agreed to pay $22.5 million to resolve False Claims Act claims filed by two former employees. The...more
4/19/2021
/ Corporate Integrity Agreement ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Medicaid ,
Medicare ,
Money Laundering ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Settlement ,
TRICARE ,
Whistleblowers ,
Wire Fraud
Sixth Circuit Splits with Tenth, Holds False Claims Act Anti-Retaliation Provision Extends to Post-Employment Retaliation -
On March 31, 2021, the US Court of Appeals for the Sixth Circuit addressed an issue of first...more
Senior DOJ Official Michael Granston Discusses COVID Relief Enforcement, Granston Memo, and other FCA Issues -
Michael Granston, the Deputy Assistant Attorney General of the DOJ Civil Division, sat down this week with Jody...more
3/29/2021
/ Conflicts of Interest ,
Consumer Protection Laws ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraudulent Procurement ,
Kickbacks ,
Manufacturers ,
Medical Devices ,
OIG ,
Private Equity Funds ,
Relief Measures ,
The Granston Memo ,
Turkey ,
USAID