Law Brief®: Steve Polyakov and Richard Schoenstein Explore Healthcare Agreements
On Demand Insurance is Here But Will it Stay?
Last month, the U.S. District Court for the District of New Jersey held that a private company, Allstate Insurance Company, could proceed with its whistleblower action against a clinical laboratory, Phoenix Toxicology and Lab...more
On April 11, 2024, a jury convicted Northern Kentucky Center for Pain Clinic owner Dr. Timothy Ehn (who was not a medical doctor) and medical director, Dr. William Lawrence Seifert, for their roles in a scheme that defrauded...more
A Long Island man who impersonated the general counsel of the NFL and an NBA player as part of his scheme for multiple frauds will now serve jail time. Sentenced in federal court in Central Islip, Matthew James used...more
Gov’t Emps. Ins. Co. v. Koppel, No. 2:21-cv-03413-MEF-JRA, 2023 U.S. Dist. LEXIS 151531, (D.N.J. Aug. 28, 2023) - The insurance carrier brought a civil action against various medical providers, asserting an illegal kickback...more
Although this blog focuses mainly on the federal False Claims Act (FCA), other antifraud statutes feature in the qui tam relator and government enforcement toolkit. Key among them: the California Insurance Frauds Prevention...more
On the latest Law Brief® episode, Steve Polyakov, Partner and Chair of the Healthcare and Pharmacy Law Practice, joins Host Richard Schoenstein to explore New York corporate regulations that prohibit non-physicians from...more
The United States Court of Appeals for the Third Circuit ruled last week that whistleblower relators need not show “objective falsity” to prove their claims, and that a dispute among physician experts about a clinical...more
Report on Patient Privacy Volume 19, Number 11. November 2019 - “Deep fake” radiology scans - with altered results falsely showing either fake cancerous nodes or a clear scan where the patient actually has cancer - are...more
On September 9, in a setback for AseraCare but an overall win for hospice providers, the Eleventh Circuit affirmed a Northern District of Alabama decision to grant a new trial in a False Claims Act (FCA) case against...more
In a long-awaited decision, the Eleventh Circuit concurred with the lower court’s standard for determining falsity under the False Claims Act (FCA) — reasonable disagreement between medical experts alone is not enough to...more
More than two years after the Northern District of Alabama granted summary judgment in a False Claims Act (FCA) case in favor of AseraCare Inc., holding that “contradiction based on clinical judgment or opinion alone cannot...more
What happens when a whistle blower provides detailed information about a burly Texan — with convictions for felony theft and felony injury of a child — and a burgeoning scam to rip off health insurers for $25 million? Pretty...more
In a complaint filed yesterday, the State of California sued AbbVie, Inc. based on an alleged kickback scheme in connection with AbbVie’s Humira® (adalimumab). The complaint alleges that AbbVie violated the Insurance Frauds...more
Allstate Insurance has won a judgment of nearly $4 million against a NY lawyer and Calif. consultant who guided a NJ chiropractor in structuring a medical practice designed to appear to meet the requirements of the state...more
Recent changes to our health care system have been at the forefront of the American news cycle for several years. But certain aspects have not received adequate attention. One example is the scrutiny federal and state...more