Three Men Sentenced for $54 Million TRICARE Fraud Scheme -
Three men were sentenced in connection with a $54 million bribery and kickback scheme involving TRICARE, a federal program that provides health insurance benefits...more
11/20/2023
/ Bribery ,
Department of Justice (DOJ) ,
False Statements ,
Fraud ,
Health Insurance ,
Healthcare Fraud ,
Kickbacks ,
Money Laundering ,
Pyramid Schemes ,
Reimbursements ,
TRICARE ,
Wire Fraud
Nevada Man Sentenced to 51 Months Imprisonment for Prize-Notification Fraud Scheme -
Earlier this week, a Nevada man was sentenced to 51 months in prison for perpetrating a prize-notification scheme that defrauded...more
Medical Marketer Convicted of $55 Million Fraud Scheme -
Late last week, a federal jury in the Northern District of Texas convicted Quintan Cockerell for his role in a $55 million fraud conspiracy involving TRICARE, a...more
11/6/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Fraud ,
Kickbacks ,
Medicaid ,
Medicaid Drug Rebate Program ,
Reimbursements ,
Settlement ,
TRICARE
DOJ’s First Criminal Securities Fraud Prosecution Related to COVID-19 Results in Eight-Year Sentence -
Mark Schena, the former president of Arrayit Corporation, a Silicon Valley-based medical technology company, was...more
10/23/2023
/ Conspiracies ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Emergency Use Authorization (EUA) ,
False Claims Act (FCA) ,
False Statements ,
Food and Drug Administration (FDA) ,
Healthcare Fraud ,
Investors ,
Kickbacks ,
Medicaid ,
Medical Technology Companies ,
Medicare Fraud ,
Restitution ,
Securities Fraud ,
Sentencing ,
Settlement ,
TRICARE ,
Wire Fraud
FTX Founder’s Fraud Trial Continues in Manhattan Court -
The criminal trial of Sam Bankman-Fried continued this week in Manhattan where the FTX founder faces several charges, including fraud, conspiracy, and money...more
Federal Judge Rules Government Must Demonstrate “But-For” Causation for Anti-Kickback Statute Claims -
On September 27, 2023, Chief Judge Dennis Saylor of the US District Court for the District of Massachusetts ruled that...more
10/9/2023
/ Anti-Kickback Statute ,
But For Causation ,
Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Home Health Care ,
Medicare ,
Medicare Fraud ,
Money Laundering ,
Settlement ,
Summary Judgment ,
Unjust Enrichment ,
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
Engineering Company Agrees to Pay $4.4 Million to Settle FCA -
On Friday, September 15, 2023, the US Department of Justice (DOJ) announced a settlement agreement with Navmar Applied Sciences Corporation, a...more
9/25/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Acquisition Regulations (FAR) ,
Federal Health Care Programs (FHCP) ,
Healthcare Fraud ,
Identity Theft ,
Kickbacks ,
Settlement ,
U.S. Navy ,
Whistleblowers
Co-Founder of Fraudulent Cryptocurrency Sentenced to 20 Years in Prison -
Karl Sebastian Greenwood, a citizen of Sweden and the United Kingdom and co-founder of the cryptocurrency OneCoin, was sentenced to 20 years in...more
9/18/2023
/ Blockchain ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Embezzlement ,
Fraud ,
Identity Theft ,
Misrepresentation ,
MLM Industry ,
Nonprofits ,
Sentencing
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
Medical Supplier Agrees to Pay $29 Million for FCA Violations -
Earlier this month, the US Department of Justice (DOJ) and medical supplier Lincare Holdings Inc. reached an agreement to settle claims that Lincare violated...more
9/5/2023
/ Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Kickbacks ,
Medical Supplies ,
Medicare ,
OIG ,
Reimbursements ,
Settlement Agreements ,
Suppliers ,
Universal Health Services Inc v United States ex rel Escobar
DOJ Announced Results of Nationwide COVID-19 Fraud Enforcement -
On Wednesday, August 23, 2023, the US Department of Justice (DOJ) announced the results of a coordinated, nationwide enforcement action to combat COVID-19...more
8/28/2023
/ Beneficiaries ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
Department of Justice (DOJ) ,
Enforcement ,
Fraud ,
Kickbacks ,
Medicare Fraud ,
Money Laundering ,
OIG ,
Public Health Emergency ,
Sanction Violations
Walgreens Medicaid Fraud Case Kicked Back to Trial Court -
On August 15, 2023, the US Court of Appeals for the Fourth Circuit issued an opinion reversing a district judge’s dismissal of False Claims Act (FCA) claims...more
8/21/2023
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicaid Act ,
Medicare ,
Money Laundering ,
Reimbursements ,
Trial Court Orders ,
Virus Testing ,
Walgreens
Former NBA Player Sentenced to 10 Years in Prison for Health Care Fraud -
Terrence Williams, a former NBA player, was sentenced to 10 years in prison for his participation in a scheme to defraud the NBA’s Health and...more
8/14/2023
/ Bitcoin ,
Coronavirus/COVID-19 ,
Cryptocurrency ,
False Advertising ,
Federal Trade Commission (FTC) ,
Healthcare Fraud ,
Kickbacks ,
Misleading Statements ,
Money Laundering ,
NBA ,
Penalties ,
Reimbursements ,
Sentencing ,
Theft ,
Unfair or Deceptive Trade Practices
Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment -
Defunct BestCare Laboratory Services LLC and its founder will pay $5.7 million to settle an outstanding 2018 False Claims Act...more
8/7/2023
/ Beneficiaries ,
Blue Cross ,
Blue Shield ,
DEA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Medicare ,
Mileage Reimbursement ,
Nursing Homes ,
Pharmacies ,
Restitution ,
Settlement
DOJ Enters Into DPAs with Former Deerfield Traders and CMS Consultant -
On July 24, 2023, the US Department of Justice (DOJ) entered into deferred prosecution agreements with Theodore Huber and Robert Olan, former traders...more
7/31/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Clinical Laboratory Testing ,
Conflicts of Interest ,
Criminal Conspiracy ,
Criminal Convictions ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Insider Trading ,
Investment Adviser ,
Kelly v United States ,
Kickbacks ,
Physicians ,
SCOTUS ,
Securities and Exchange Commission (SEC) ,
Settlement ,
Special Purpose Acquisition Companies (SPACs)
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
$140 Million Healthcare Fraud Case to Be Retried -
On June 27, a Houston federal district court judge indicated that a $140 million healthcare fraud case, which ended in mistrial in December 2022 due to allegations of...more
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
On June 16, 2023, in United States, ex rel. Polansky v. Executive Health Resources, Inc., the US Supreme Court addressed the government’s authority to dismiss a qui tam False Claims Act (FCA) suit over a relator’s objection...more
6/22/2023
/ Article II ,
Constitutional Challenges ,
Corporate Misconduct ,
Dismissals ,
False Claims Act (FCA) ,
Federal Rules of Civil Procedure ,
Fraud ,
Healthcare ,
Inpatient Billing ,
Investigations ,
Qui Tam ,
Relators ,
SCOTUS ,
United States ex rel Polansky v Executive Health Resources Inc ,
Whistleblowers
Recent Filings Shed Light on DOJ’s View of Supreme Court’s Recent FCA Ruling -
On June 1, 2023, the US Supreme Court explained that an assessment of a defendant’s subjective beliefs — rather than what an objectively...more
6/19/2023
/ Chief Compliance Officers ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
IRS ,
Medicare ,
Opioid ,
Pharmacies ,
Pharmacist ,
Scienter ,
SCOTUS ,
Tax Fraud ,
Wire Fraud
Court Unseals Charges Alleging Nearly $15 Million in Fraudulent PPP Loans -
Earlier this week, federal prosecutors in the Southern District of New York announced the unsealing of a criminal complaint charging six...more
6/12/2023
/ Criminal Conspiracy ,
False Claims Act (FCA) ,
Falsified Documents ,
Financial Institutions ,
Fraud ,
IRS ,
Kickbacks ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
SCOTUS ,
Sentencing ,
Tax Returns ,
US ex rel Tracy Schutte et al v SuperValu Inc et al ,
Wire Fraud
Supreme Court FCA Scienter Ruling Revives Fraud Lawsuits Against Safeway and SuperValu On Thursday, the US Supreme Court issued its highly anticipated ruling regarding the threshold of liability under the False Claims Act...more
6/5/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Oral Argument ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Reasonable Interpretations ,
Safeco ,
Safeco Insurance Co of America v Burr ,
Scienter ,
SCOTUS ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
Surgeon To Pay Up to $43 Million for FCA Fraud -
A Michigan vascular surgeon, Vasso Godiali, was sentenced to 80 months in prison for defrauding health care programs in connection with his submission of false claims for...more
5/30/2023
/ Blue Cross ,
Blue Shield ,
Coronavirus/COVID-19 ,
Criminal Convictions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare ,
Investors ,
Medicaid ,
Medicare ,
Paycheck Protection Program (PPP) ,
Wire Fraud