News & Analysis as of

Healthcare Fraud

Rivkin Radler LLP

Drug Testing Lab to Pay $27 Million to Resolve FCA Claims

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One of the nation’s largest urine drug testing laboratories recently settled with the federal government by paying $27 million to resolve alleged violations of the federal False Claims Act (FCA) and state statutes. Precision...more

Goldberg Segalla

Healthcare Insurers Take Note: New Federal Whistleblower Program is Coming for You

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Late this past summer, the Department of Justice (DOJ) launched a new initiative to crackdown on corporate misconduct. Beginning August 1, whistleblowers can submit original information to the DOJ regarding various types of...more

ArentFox Schiff

Investigations Newsletter: Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties

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Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties - A Connecticut Superior Court judge found Assured Rx, LLC, a Florida-based pharmacy, liable for violating the Connecticut...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - October 2024

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Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Rivkin Radler LLP

Eight Charged in $68 Million Brooklyn Medicaid Fraud Scheme

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Eight individuals associated with two Brooklyn social adult day care centers and a home health care intermediary have been charged in an alleged $68 million Medicaid fraud scheme. The defendants, including owners and staff...more

Rivkin Radler LLP

$68 Million CDPAP Fraud Indictment Unsealed Amidst Industry Changes

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On October 9, 2024, the United States Attorney’s office in the Eastern District of New York unsealed an indictment alleging that eight defendants defrauded Medicaid of approximately $68 million. The alleged scheme involved...more

Seyfarth Shaw LLP

Federal District Court Finds False Claims Act Qui Tam Provision Unconstitutional

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In a landmark decision, the United States District Court for the Middle District of Florida, in United States ex rel. Zafirov v. Florida Medical Associates, LLC, held that the False Claims Act’s (FCA) qui tam provision –...more

Husch Blackwell LLP

False Claims Act Insights - Reality Checks: How to Approach Healthcare Transactions Without Triggering FCA Liability

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Host Jonathan Porter is joined by Husch Blackwell partner Hal Katz to discuss healthcare transactions in the context of the False Claims Act (FCA) and other regulatory frameworks applicable to the healthcare industry. As...more

Troutman Pepper

Precision Toxicology Agrees to Pay $27M Over Drug Testing and Kickback Allegations

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On October 15, Maryland Attorney General Anthony G. Brown announced that his office reached a $27 million settlement with Precision Toxicology to resolve allegations that it submitted false claims to government health...more

Rivkin Radler LLP

CA Physician and Practice Resolve FCA Allegations for $3.8 Million

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The U.S. Attorney’s Office for the Southern District of California announced on October 11 that Dr. Janette Gray and her former medical practice, The Center for Health & Wellbeing in San Diego, resolved False Claims Act (FCA)...more

The Volkov Law Group

Teva Pharmaceuticals Pays $450 Million to Resolve Anti-Kickback and False Claims Act Violations

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Teva Pharmaceuticals USA Inc. (Teva USA) and Teva Neuroscience Inc. (“Teva”) agreed to pay $450 million to resolve two matters that allege Teva violated the Anti-Kickback Statute (AKS) and the False Claims Act (FCA). Teva is...more

Dorsey & Whitney LLP

Choose Your Words Wisely: Hearsay Rules, Conspiracy, and Healthcare Fraud

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The day-to-day operations of healthcare and the Rules of Evidence might seem unrelated, but in today’s enforcement environment, legal and compliance professionals can find, in evidentiary rules, best practices for creating a...more

McCarter & English, LLP

Is the Qui Tam A Sham?: Federal Judge Finds Qui Tam Enforcement of False Claims Act Unconstitutional

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A recent federal court decision has the potential to significantly impact the future of False Claims Act (FCA) lawsuits initiated by whistleblowers and to upend the FCA. In United States of America ex rel. Clarissa Zafirov v....more

Cranfill Sumner LLP

Breaking Precedent: Florida Court Declares False Claims Act Qui Tam Provisions Unconstitutional

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On September 30, 2024, Judge Kathryn Mizelle of the U.S. District Court for the Middle District of Florida issued a noteworthy decision in United States ex rel. Zafirov v. Florida Medical Associates, LLC, holding that the qui...more

Akerman LLP - Health Law Rx

Zafirov Decision Sets Stage for Appellate Showdown Over Constitutionality of FCA’s Qui Tam Provision

For the first time ever, a judge has ruled that the qui tam provision of the False Claims Act (FCA), which whistleblowers have used to recover $52 billion on behalf of the government since 1986, is unconstitutional....more

Polsinelli

Supreme Court Declines to Hear “Willfulness” Case

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On Monday, October 7, 2024, the U.S. Supreme Court declined to consider a petition for certiorari in United States ex rel. Hart v. McKesson Corp., Case No. 23-1293, where relator, Adam Hart (“Relator”), sought review of a...more

Benesch

Third-Party Co-Pay Assistance Program Kickback Scheme Results in $450 Million DOJ Settlement

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Teva Pharmaceuticals, the largest generic drug manufacturer in the United States, has agreed to pay $450 million to resolve allegations of violating the False Claims Act and Anti-Kickback Statute arising from purported...more

ArentFox Schiff

Investigations Newsletter: US Supreme Court Declines to Consider AKS ‘Willfulness’ Question

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US Supreme Court Declines to Consider AKS ‘Willfulness’ Question - On October 7, the US Supreme Court denied a petition in which a whistleblower asked the Court to decide whether a “willful” act under the federal...more

Cozen O'Connor

The State AG Report – 10.10.2024

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Here are curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •GOP AGs Urge Congress to Tune In and Support AM Radio in...more

Wiley Rein LLP

Ding-Dong the Qui Tam Relator Is Dead? Novel FCA Decision Could Change How False Claims Are Prosecuted

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Years from now, might we cite a recent Middle District of Florida decision as the beginning of the end of the False Claim Act’s (FCA) qui tam provision in its current form? In granting the defendants’ motion for judgment on...more

Stevens & Lee

Intent Required Under the Anti-Kickback Statute: Supreme Court Lets Stand Second Circuit’s Decision in the McKesson Case

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On Oct. 7, the U.S. Supreme Court denied a petition for review and let stand a widely watched Second Circuit Court of Appeals decision in which the court ruled that the term “willfully” as used in the Anti-Kickback Statute...more

Vinson & Elkins LLP

Supreme Court Declines to Revisit Limitations on Anti-Kickback Statute: What This Means for Enforcement of Corruption, Kickbacks...

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On October 7, 2024, the U.S. Supreme Court declined to hear a case concerning the “willfulness” element of the Anti-Kickback Statute (the “AKS”). This decision leaves intact a recent Second Circuit holding, which established...more

Faegre Drinker Biddle & Reath LLP

DOJ Targets Telemedicine Companies for Additional False Claims Act Recoveries

Telemedicine, which has been a fertile source of criminal prosecutions for federal prosecutors in recent years, is increasingly generating federal False Claims Act cases. This development is hardly surprising as the U.S....more

Rivkin Radler LLP

Lab Owner Pleads Guilty to COVID-19 Testing Fraud Scheme

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On October 1, the U.S. Attorney’s Office for the Northern District of Illinois announced that Zishan Alvi, the owner of a Chicago laboratory, pleaded guilty to one count of wire fraud for his role in a COVID-19 testing fraud...more

Husch Blackwell LLP

Florida Federal Court Strikes Down False Claims Act Qui Tam Provisions as Unconstitutional

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A federal judge in Florida issued a ruling this week holding that the qui tam provisions of the False Claims Act (FCA) are unconstitutional. In the lawsuit, a relator named Clarissa Zafirov accused the defendants of violating...more

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