Law Brief®: Steve Polyakov and Richard Schoenstein Explore Healthcare Agreements
On Demand Insurance is Here But Will it Stay?
The North Carolina Department of Insurance (NCDOI), in partnership with the Farm Bureau’s Special Investigations Unit, recently announced a fraud investigation that led to the arrest of a roofing professional on multiple...more
As a part of our quarterly practice group update, we are pleased to produce our latest installation with examples of our continued success in fraud litigation. This is now our fourth year of this publication, which amazes me...more
Fraudulent transactions involving vacant properties are on the rise and are a significant source of claims for title insurance companies. While seller impersonation fraud may involve any type of real property, it is more...more
China has intensified regulatory oversight of excessive prescription practices, as evidenced by the recent notice issued by the National Healthcare Security Administration (NHSA) and the implementation of the Insurance Fraud...more
Join Goldberg Segalla partner Dan Strick and attorney Andrew Simmers for a look into emerging risks presented by generative artificial intelligence. Dan and Andrew will discuss AI-related claims, how current policies apply,...more
MONY Life Ins. Co. v. Perez, 146 F.4th 1018 (11th Cir. 2025) - The insurer sought to recover nearly $449,000 it had paid to ophthalmologist Dr. Bernard Perez, alleging he misrepresented his disability and committed fraud. A...more
The U.S. Attorney’s Office for the Southern District of New York announced on August 21 that Niranjan Mittal, a Brooklyn-based cardiologist, was sentenced to 37 months in federal prison. Mittal pleaded guilty to violating the...more
FINRA only brings disciplinary actions against registered representatives (RRs) for their securities business, right? Wrong! FINRA often brings cases against RRs for conduct not related to their securities business....more
China’s Supreme People’s Court is stepping up enforcement against medical insurance fraud, with severe penalties and a focus on protecting public healthcare funds. Recent cases show fraud schemes ranging from hospital-level...more
Umpire Not Immune from Insurer’s Suit for Undisclosed Conflicts - A toilet supply line leak damaged Rike’s home. She submitted a claim to her property insurer and demanded an appraisal. Rike and the insurer selected their...more
The U.S. Court of Appeals for the Ninth Circuit has held that a laboratory owner’s payments to marketing intermediaries violated the Eliminating Kickbacks in Recovery Act (EKRA)—in its first interpretation of the statute...more
On June 30, 2025, New York Attorney General (AG) Letitia James announced new lawsuits, criminal charges, and settlements with 25 New York transportation companies related to alleged schemes to defraud Medicaid of millions....more
In May, California’s attorney general (AG) charged a local dermatologist with more than 20 counts of fraud after uncovering a scheme that allegedly resulted in the state’s Medicaid program paying out over $1.3 million for...more
Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more
Car accidents are an unfortunate reality on the roads of Tallahassee, Florida. With thousands of vehicles traversing the city daily, collisions are bound to occur. Determining fault and liability in these incidents is often a...more
It’s apt to name a blog post after one of history’s great action movies when the case involves a “conceptual artillery duel” that “ends in a draw,” and that is exactly how U.S. District Judge Gerald Austin McHugh Jr. of the...more
The U.S. Department of Justice’s (DOJ) Criminal Division launched its Corporate Whistleblower Awards Pilot Program (“Criminal Whistleblower Program”) in August of 2024 to encourage tips for various types of fraud, including...more
On Monday, January 6, 2025, Governor Walz issued the first Executive Order of 2025, EO 25-01, which creates a centralized state fraud investigations unit administered and overseen by the Minnesota Bureau of Criminal...more
Gov’t Emps. Ins. Co. v. Mount Prospect Chiropractic Ctr., P.A., 98 F.4th 463 (3d Cir. 2024) - The court found that nothing in the text or legislative history of New Jersey’s Insurance Fraud Prevent Act (IFPA) explicitly or...more
The IRS Whistleblower Program helps boost the “fair and effective enforcement of our nation’s tax laws and the success of our voluntary tax system.” The IRS Whistleblower Program is dependent on people who become aware of tax...more
UCHealth Settles FCA Violations for $23 Million - On November 12, the US Department of Justice (DOJ) announced that University of Colorado Health (UCHealth) agreed to resolve allegations that it violated the False Claims...more
In Meyer v. Massachusetts Mutual Life Insurance Co., the U.S. District Court for the District of Colorado entered summary judgment for an insurer after video evidence showed that the insured was not entitled to the benefits...more
The unpublished case of Settler v. Auto-Owners Ins. Co., 2023 WL 5157685, illustrates the impact of evolving case law and changes in insurance fraud litigation in the state of Michigan. In Settler, the plaintiff was injured...more
No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more
In Seitz v. Marcum LLP, 2024 N.Y. Slip Op. 51141(U) (Sup. Ct., N.Y. County Aug. 30, 2024) (here), Justice Robert R. Reed of the New York County Commercial Division addressed the doctrine of in pari delicto, which “bars a...more