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Read Criminal Law updates, alerts, news, and legal analysis from leading lawyers and law firms:

Physicians in the Bulls-eye

by BakerHostetler on

Several recently reported cases highlight the growing risk physicians face if they succumb to competitive pressures, especially offers of remuneration from labs, pharmacies, home health agencies and other providers to whom...more

This Month in Corruption: Improper Billing, Double Dipping, Disability Faking

by PretiFlaherty on

A Dream Most Improper. On September 4, announcements came from the offices of the U.S. Attorney for Massachusetts and the Massachusetts Attorney General that Dental Dreams, a national dental chain with locations in...more

Aegerion Settles Criminal and Civil Probe of Promotional Practices, REMS and HIPAA Compliance, and Patient Assistance Programs

On September 22, 2017, Aegerion Pharmaceuticals resolved a wide-ranging probe by the Department of Justice (DOJ) regarding the company’s U.S. commercial activities relating to Juxtapid, a lipid-lowering agent for the...more

FinCEN Issues Advisory on Widespread Public Corruption in Venezuela

by Dechert LLP on

The Financial Crimes Enforcement Network (FinCEN) released an advisory on September 20, 2017, to alert financial institutions of widespread public corruption in Venezuela and the methods Venezuelan senior political figures...more

Consultant found guilty of illegal kickbacks by “referring” doctors’ patients to another medical provider in exchange for...

by Dorsey & Whitney LLP on

Under 42 U.S.C. § 1320a-7b(b)(1)(A) it is a felony for a physician to solicit or receive a kickback “in return for referring” a Medicaid or Medicare patient to another medical provider. But as a recent decision by the Eighth...more

Bad News for Whistleblowers: Defendant Pleads Guilty

by Faegre Baker Daniels on

At first glance, it looks nonsensical. How could it be bad news for False Claims Act whistleblowers that the defendant pleaded guilty to violating that statute—to committing the very Medicare fraud the whistleblowers alleged?...more

Yates Memo's Influence Felt in DOJ Health Care Enforcement

by Jones Day on

In September 2015, Deputy Attorney General Sally Yates issued a memorandum titled "Individual Accountability for Corporate Wrongdoing." In it, she stressed that one of the most effective ways to combat corporate misconduct is...more

This Month in Corruption: Ex-Manager of Two Towns Pleads Guilty to Variety of Crimes

by PretiFlaherty on

On Thursday, July 20, Andrew Bisignani pleaded guilty in Essex Superior Court to procurement fraud, destroying public records, municipal bid-rigging and other crimes related to his service, from January 1, 2009 to June 30,...more

US Attorney Announces Settlement with Florida Condominium Complex Over Alleged FHA Reverse Mortgage Fraud

by Goodwin on

On July 20, 2017, acting United States Attorney Stephen Muldrow announced a civil settlement with the owner of a Florida condominium complex over fraudulent reverse mortgage transactions. Defendant had been accused of...more

Client Alert: Feds Shine a Light on Medicare Advantage Plans and Physicians Related to Risk Adjustment Practices

Although the sufficiency of medical records documentation supporting beneficiary diagnoses for Medicare Advantage (MA) risk adjustment has been on the OIG’s work plan since 2013, the Department of Justice has upped the ante...more

The Lowdown On Takedowns

by Ifrah PLLC on

Attorney General Jeff Sessions and a battery of other federal law enforcement officials today announced the “largest health care fraud takedown” in U.S. history, with 412 charged defendants, including 56 doctors, accused of...more

Twelve-Year Sentence for Medicaid Diaper Scam

by Faegre Baker Daniels on

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas...more

This Month in Corruption: Bilking of Disabled Veterans a Notable Low

by PretiFlaherty on

Ex-Cop Guilty of Misusing Funds for Disabled Veterans. On May 16, Glenn P. Pearson, a former sergeant in the Whitman Police Department, pleaded guilty in connection with the misappropriation of funds from accounts owned by...more

Seven Takeaways from the ABA National Institute On Health Care Fraud

On May 17, 2017 the American Bar Association convened its 27th National Institute on Health Care Fraud. I have attended many of the past annual meetings, and always enjoy the presentations and the opportunity to network with...more

Energy & Process Corp. Settles Whistleblower Action Related to Construction of Nuclear Waste Treatment Facility

by Dorsey & Whitney LLP on

On Monday, April 24, the U.S. Department of Justice announced that Energy & Process Corp. agreed to pay $4.6 million to settle False Claims Act allegations concerning the construction of a large nuclear waste treatment...more

Can Overpayments Create Criminal Liability?

by Ruder Ware on

We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges...more

Fighting fraud and corruption: increasing the government’s powers of detection

by Dentons on

On 30 March 2017, the Australian Parliament introduced the Crimes Legislation Amendment (Powers, Offences and Other Measures) Bill 2017 into the Legislative Assembly. The Bill aims to provide a range of amendments to improve...more

A “Change of Heart” in a Health Care Fraud Prosecution - Inconsistent angiogram interpretations establish reasonable doubt in...

On March 7, 2017, the U.S. District Court for the Eastern District of Kentucky reversed the October 27, 2016 criminal jury verdict against Kentucky cardiologist Dr. Richard E. Paulus, and acquitted him on all counts of health...more

Three Recent Fraud Cases Involving Dermatologists Illustrate Primary Compliance Risks in Dermatology Practices

by Ruder Ware on

Three relatively recent cases involving dermatology billing practices illustrate some of the main compliance risks faced by dermatology practices...more

This Month in Corruption: Smuggled Drugs, Bogus Billing, Tampered Equipment

by PretiFlaherty on

Wrong Way to Keep Prisoners in Line. The office of William D. Weinreb, acting U.S. Attorney for the District of Massachusetts, announced March 3 that two former corrections officers at the Essex County Correctional facility...more

Mintz Levin Health Care Qui Tam Update: Recently Unsealed Whistleblower Cases

Featured Unsealed Cases United States ex rel. Thomas v. Best Choice Home Health Care Agency, Inc., No. 2:13-cv-02209 (D. Kan.) - Complaint Filed: May 6, 2013 - Complaint Unsealed: October 24, 2016...more

President’s Budget Blueprint Increases Funds For Health Care Fraud Enforcement

The President has released a “budget blueprint” for fiscal year 2018. Although there are many aspects of the budget blueprint to digest, several budget items signal that government health care fraud enforcement remains a...more

Pharmaceutical Manufacturers and Healthcare Leaders cite Fraud and Abuse Laws as Obstacle to Value-Based Arrangements

As the healthcare industry moves towards value-based purchasing, pay-for-performance, and other payment reform models, industry leaders have identified federal fraud and abuse laws as a barrier to full implementation of such...more

Health Care FCA Decisions Applied to Criminal Case

by Bryan Cave on

False Claims Act (“FCA”) cases involving medical necessity continue to receive great attention. A March 7, 2017 opinion that overruled a jury’s criminal fraud conviction of a cardiologist demonstrates the broader implications...more

A Parallel Universe: Navigating Discovery in Concurrent Civil and Criminal Proceedings

by Ward and Smith, P.A. on

As criminal law has expanded into almost every sector of the American economy, one byproduct is the rise of "parallel proceedings"—lawsuits that proceed concurrently in criminal and civil court based on largely the same...more

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