In a series of recent legal challenges initiated by the pharmaceutical industry against the US Department of Health and Human Services Office of the Inspector General (OIG), manufacturers have contested the OIG’s...more
With the change of administrations typically comes a flurry of activity across all government agencies, and the same can be expected with the official start of the Biden Administration now well underway. What should...more
2/1/2021
/ Biden Administration ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Executive Orders ,
Final Rules ,
Government Agencies ,
Healthcare Fraud ,
Healthcare Reform ,
Medicare ,
Medicare Part D ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Proposed Rules ,
Reimbursements
Nine Individuals Charged in $24 Million Paycheck Protection Program Fraud Scheme -
In one of the largest COVID-relief fraud cases to date, nine Ohio and Florida individuals are alleged to have conspired to obtain...more
8/17/2020
/ Bank Fraud ,
CARES Act ,
Coronavirus/COVID-19 ,
False Statements ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Loan Applications ,
Money Laundering ,
Paycheck Protection Program (PPP) ,
Wire Fraud
In the DOJ’s first-ever criminal action against an electronic health records vendor, San Francisco-based Practice Fusion Inc. agreed to pay $145 million to resolve allegations that it received kickbacks from pharmaceutical...more
2/3/2020
/ Anti-Kickback Statute ,
Criminal Penalties ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Fraud ,
Investigations ,
Kickbacks ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Software ,
Whistleblowers
Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme -
Two individuals pled guilty in Pennsylvania federal court to conspiracy to defraud the Pennsylvania Medicaid program and commit...more
1/24/2020
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Home Health Agencies ,
OIG ,
Whistleblowers
DOJ News -
Manufacturer to Pay Over $37.5 Million to Resolve False Claims Act Allegations -
On January 15, 2015, the DOJ announced that ResMed Corp., a manufacturer of durable medical equipment, agreed to pay over...more
1/20/2020
/ Anti-Kickback Statute ,
Clinical Trials ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Indictments ,
Misrepresentation ,
Physicians ,
Qui Tam ,
Settlement ,
Tax Deductions ,
Tax Fraud ,
Tax Returns ,
Whistleblowers
Ten Former NFL Players Charged with Defrauding League's Health Care Benefits Plan -
On December 12, the DOJ unsealed two indictments charging ten retired NFL players with defrauding the league's retiree health care...more
12/18/2019
/ Administrative Monetary Penalties ,
Athletes ,
Corporate Monitoring ,
Criminal Conspiracy ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Ericsson ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Healthcare Fraud ,
Indictments ,
IRS ,
Medical Equipment ,
NFL ,
Offshore Funds ,
Price Manipulation ,
Prison ,
Pump and Dump ,
Restitution ,
Sentencing ,
Sports ,
Tax Avoidance ,
Tax Fraud
Defense Vehicle Manufacturer Accused of Defrauding the Government by $1.2 Billion -
On Tuesday, December 3, the United States District Court for the District of Columbia unsealed a six-year-old False Claims Act complaint...more
12/9/2019
/ Anti-Kickback Statute ,
Clinical Laboratory Testing ,
Criminal Prosecution ,
Defense Sector ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
Guilty Pleas ,
Healthcare Fraud ,
Manufacturers ,
Medicaid ,
Medicare ,
Settlement ,
Stark Law ,
TRICARE ,
United Auto Workers
Compound Ingredient Supplier to Pay Over $22 Million to Resolve Allegations Brought Under Qui Tam Provisions of FCA -
On November 7, 2019, the Department of Justice (DOJ) announced that Fagron Holding USA LLC (Fagron) had...more
11/18/2019
/ Alstom ,
Civil Monetary Penalty ,
Corporate Officers ,
Criminal Convictions ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Healthcare Fraud ,
Insider Trading ,
Medicare ,
Qui Tam ,
TRICARE ,
Whistleblowers
Kickback Allegations Settled for $20.25 Million -
Sanford Health, Sanford Medical Center, and Sanford Clinic (collectively, Sanford), a South Dakota health system, will pay $20.25 million to settle allegations that they...more
DOJ Issues Guidance on Ability-to-Pay in False Claims Act Cases -
On October 8, 2019, Assistant Attorney General Brian Benczkowski announced new guidance for federal prosecutors evaluating whether a corporation is unable...more
10/21/2019
/ Corporate Criminal Fines ,
Corporate Misconduct ,
Criminal Investigations ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Sentencing Guidelines ,
Healthcare Facilities ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
New Guidance ,
Prescription Drugs
Medical Device Exec Sentenced to 42 Months in Prison for $4.6 Million Kickback Scheme, Co-Conspirator Awaits Sentencing -
On August 29, the Department of Justice announced that a Tennessee health care executive, Brenda...more
9/9/2019
/ Anti-Kickback Statute ,
Bribery ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
Healthcare Fraud ,
Kickbacks ,
Medical Devices ,
Medicare ,
Pharmacies ,
Prison ,
SBA ,
TRICARE
Doctors and Alabama Cardiac Center to Pay $1.1 Million to Resolve Kickback Allegations -
On August 27, the US Attorney’s Office for the Western District of Washington announced a $1.1 million settlement with three...more
8/30/2019
/ Anti-Kickback Statute ,
Debtors ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medicaid ,
OIG ,
Qui Tam ,
Safe Harbors
Telemarketing Business Agrees to Pay $2.5 Million to Settle FCA Allegations of Telemedicine Scheme -
The US Attorney’s Office for the Middle District of Florida, in collaboration with the US Attorney’s Office for the...more
8/12/2019
/ Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Indictments ,
Kickbacks ,
Medicare ,
Physicians ,
Settlement ,
Telemarketing
Patient Recruiter Convicted in $1.3 Million Kickback Conspiracy Scheme -
After a six-day trial, a federal jury in Detroit found a patient recruiter guilty of one count of conspiracy to pay and receive health care...more
8/5/2019
/ Aiding and Abetting ,
Blue Book ,
Civil Monetary Penalty ,
Criminal Conspiracy ,
Criminal Convictions ,
Criminal Prosecution ,
False Claims Act (FCA) ,
Federal Contractors ,
Foreclosure Sales ,
Health Care Providers ,
Healthcare Fraud ,
Home Health Agencies ,
Kickbacks ,
Medicare ,
Mortgage Lenders ,
Public Contracts ,
Settlement ,
Wire Fraud
Podiatrist Sentenced to Prison for Fraudulent Billing Scheme -
On July 19, 2019, a New York podiatrist was sentenced to 366 days in prison, assessed a $50,000 fine, ordered to pay $869,651 in restitution and forfeit...more
7/29/2019
/ Anti-Kickback Statute ,
Criminal Convictions ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medical Devices ,
Medicare ,
Pharmacies ,
Physicians ,
Prescription Drugs