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Criminal Conspiracy Medicare

ArentFox Schiff

Investigations Newsletter: Biomedical Company Avoids DOJ Prosecution After First Ever Voluntary Corporate Self-Disclosure of Fraud...

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Biomedical Company Avoids DOJ Prosecution After First Ever Voluntary Corporate Self-Disclosure of Fraud Under NSD Enforcement Policy - On May 22, the US Department of Justice (DOJ) announced that it will not prosecute a...more

Benesch

From the NBA Finals to Federal Prison - “Big Baby” Sentenced to 40 months in NBA Healthcare Plan Scheme

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Former NBA player Glen “Big Baby” Davis was sentenced to 40 months in prison after being convicted for his role in a scheme to defraud the NBA healthcare plan. Davis’ sentence comes almost a year after the scheme’s...more

Rivkin Radler LLP

Owner and Medical Director of Pain Clinic Jailed for Urine Drug Testing Scheme

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On April 11, the medical director and the owner of a pain clinic in Kentucky were sentenced to prison for their roles in a scheme to defraud federal healthcare programs and commercial insurance companies for medically...more

Rivkin Radler LLP

NYC Man Pleads Guilty in $3.5 Million COVID-19 Kickback Scheme

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On February 26, David Weathers of the Bronx pleaded guilty in federal court in New Jersey for his role in a COVID-19 kickback conspiracy. The government had charged Weathers with soliciting kickbacks in return for referrals...more

ArentFox Schiff

Investigations Newsletter: Former Healthcare Executives Convicted for Health Insurance Policy Fraud Scheme

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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

Rivkin Radler LLP

Brooklyn Cardiologist Hit with Fraud Charges

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On December 14, the U.S. Attorney’s Office for the Southern District of New York and other agencies announced the indictment of Niranjan Mittal, a Brooklyn cardiologist, on multiple fraud charges. Mittal allegedly fabricated...more

ArentFox Schiff

Investigations Newsletter: Two Individuals Indicted for Operating $25 Million Crypto-Fraud

ArentFox Schiff on

Two Individuals Indicted for Operating $25 Million Crypto-Fraud - On December 11, a federal court in California unsealed a superseding indictment, which charged two men with operating a $25 million cryptocurrency fraud...more

ArentFox Schiff

Investigations Newsletter: FTX Founder’s Fraud Trial Continues in Manhattan Court

ArentFox Schiff on

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

ArentFox Schiff

Investigations Newsletter: Court Unseals Charges Alleging Nearly $15 Million in Fraudulent PPP Loans

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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

Rivkin Radler LLP

Fraud Week: More Non-Existent Services

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If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually...more

Rivkin Radler LLP

Private Insurers Must Watch Out for Medical Equipment Fraud

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Healthcare fraud related to durable medical equipment (DME) is extremely costly to insurers yet often continues without criminal or civil consequences. Fraudulent schemes by DME supply companies vary in complexity but...more

ArentFox Schiff

Investigations Newsletter: Dozens Charged in $1.2 Billion Nationwide Telemedicine and DME Fraud Scheme

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On July 20, 2022, the Justice Department announced that it brought criminal charges against 36 defendants in 13 federal districts across the country, charging more than $1.2 billion in alleged telemedicine, cardiovascular and...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 9. News Briefs: March 2022

Report on Medicare Compliance 31, no. 9 (March 14, 2022) - A federal jury on March 8 convicted New Jersey rheumatologist Alice Chu for defrauding Medicare and other health insurance programs, the Department of Justice...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 22. News Briefs: June 2021

Report on Medicare Compliance 30, no. 22 (June 14, 2021) - CMS’ supplemental medical review contractor (SMRC) is now doing postpayment reviews of Medicare claims for electrodiagnostic (EDX) testing axial muscles and...more

Holland & Knight LLP

Healthcare Law Update: April 2021

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William F. Gould In United States v. Merino, No. 19-50291, 2021 WL 754589 (9th Cir. Feb. 26, 2021), the court of appeals reversed the conviction of Marina Merino of conspiracy to commit healthcare fraud in violation of 18...more

Rivkin Radler LLP

NYC Pharmacy Owner Charged With Healthcare Fraud

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The owner of Brooklyn Chemists in Gravesend, Brooklyn and Lucky Care Pharmacy in Flushing, Queens was recently indicted on charges of conspiracy to commit health care fraud, conspiracy to defraud the United States by paying...more

ArentFox Schiff

Investigations Newsletter: Pharmacy Owner and Accountant Indicted in $134m Health Care Fraud Scheme

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Pharmacy Owner and Accountant Indicted in $134m Health Care Fraud Scheme - Mohamed Mokbel and Fathy Elsafty, of Houston, Texas, were arrested on charges of money laundering, health care fraud, and conspiracy to commit...more

ArentFox Schiff

Investigations Newsletter: HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute

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HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute - On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services (HHS) published...more

The Volkov Law Group

Teva Pharma Charged with Antitrust Conspiracy in Generic Pharmaceuticals Industry

The Volkov Law Group on

Teva, the global pharmaceutical giant, was indicted last week as part of DOJ’s expanding criminal conspiracy investigation focused on illegal price-fixing and customer allocations....more

Mintz - Health Care Viewpoints

DOJ Announces Criminal Charges against Lab Executive Accused of Fraudulently Promoting COVID-19 Tests

The Department of Justice (DOJ) has announced its first criminal securities fraud prosecution related to COVID-19, and it involves health care fraud as well. Mark Schena, president of Arrayit Corporation, a publicly traded...more

ArentFox Schiff

Investigations Newsletter: Elder Care Companies Agree to Pay $15.5 Million to Resolve False Claims Act Allegations

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Headlines that Matter for Companies and Executives in Regulated Industries - Health Care Enforcement News - Elder Care Companies Agree to Pay $15.5 Million to Resolve False Claims Act Allegations - The Department...more

ArentFox Schiff

Four Physicians Found Guilty for Role in $150 Million Medicare Fraud Scheme

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Headlines that Matter for Companies and Executives in Regulated Industries - DOJ News - Four Physicians Found Guilty for Role in $150 Million Medicare Fraud Scheme - Following a four-week trial, a federal jury in...more

The Volkov Law Group

Two Charitable Foundations Pay $6 Million for Anti-Kickback Violations

The Volkov Law Group on

Two charitable foundations that helped patients pay for drug co-payments settled anti-kickback charges for $6 million.  The Patient Access Network Foundation (PANF) agreed to pay $4 million and Good Days agreed to pay $2...more

ArentFox Schiff

Investigations Newsletter: 34 Individuals Charged in $258 Million Medicare and Medicaid Fraud Schemes

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34 Individuals Charged in $258 Million Medicare and Medicaid Fraud Schemes - Twenty-six individuals in the state of California, fourteen of whom were doctors or medical professionals, and eight individuals in Arizona and...more

ArentFox Schiff

Investigations Newsletter - Medical Device Exec Sentenced to 42 Months in Prison for $4.6 Million Kickback Scheme, Co-Conspirator...

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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

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