In an unusual criminal prosecution, the Chesapeake Regional Medical Center (CRMC), a hospital in Chesapeake, Virginia, was indicted last week by a federal grand jury in Virginia for conspiring to defraud the United States and...more
Kenneth Fishberger, a Long Island internist with nearly 50 years of medical experience, recently pleaded guilty to conspiracy to commit healthcare fraud. Prosecutors revealed that from 2013 to 2019, Fishberger ordered...more
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
On June 27, U.S. Attorney General Merrick Garland announced the results of a two-week nationwide law enforcement action by the Department of Justice (DOJ) in 32 federal districts against 193 defendants for their participation...more
A New York acupuncturist recently admitted to billing Amtrak’s health care benefit plan for services that were never provided and were medically unnecessary. From January 2019 through June 2022, Punson Figueroa of Long Island...more
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
North Carolina AG Josh Stein settled with Med First Immediate Care and Family Practice, P.A. to resolve False Claims Act allegations that the clinic operated as a “pill mill” for opioid prescriptions....more
As someone who cares about their health, you listen when your doctor recommends a procedure. But how can you be sure that your doctor’s suggestions are based on your own best interests rather than their own? Recent reports...more
Last summer the Supreme Court overturned Roe v. Wade, the landmark ruling that established the constitutional right to abortion. On August 25, 2022, Texas’ Human Life Protection Act of 2021 (“HLPA” or the “Act”), colloquially...more
On May 2, the U.S. Attorney’s Office for the Eastern District of Pennsylvania announced that the United States has filed a complaint under the False Claims Act (FCA) against James McGuckin, an interventional radiologist. The...more
Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding...more
Pregnant Employees Were Denied Accommodations and Required to Submit to Unnecessary Medical Examinations- CHICAGO – Symphony Deerbrook, LLC will pay $400,000 and furnish other relief to settle a pregnancy discrimination...more
Medicaid providers and suppliers have likely discovered this the hard way. A provider’s or supplier’s enrollment in the Medicaid program may be insufficient to assure that their provision of a covered and medically necessary...more
In recent years, there have been only a handful of corporate integrity agreements (“CIAs”) and integrity agreements (“IAs”) that have included a “conditional exclusion release” of the Office of the Inspector General for the...more
The U.S. Department of Justice (DOJ) announced on October 18 that Oklahoma-based Carter Healthcare LLC and its affiliates, plus two executives, agreed to pay a total of over $30 million to resolve two separate qui tam cases....more
The U.S. Attorney for the District of New Jersey and New York Attorney General Letitia James both announced on October 6 that pediatric dentist Barry L. Jacobson, his management company, and 13 affiliated pediatric dentistry...more
Here are this week’s curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •James Leads Coalition of AGs Winning...more
In 2020, we published an eAlert titled “Telehealth in a Changing World - Trending Risks and How to Minimize Potential Exposure.” As we predicted would happen, the government has become acutely focused on telehealth fraud....more
On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth...more
Earlier this month, Snap Diagnostics LLC and two of its executives entered into a nearly $4 million settlement with the United States to settle two qui tam lawsuits. Snap agreed to pay the government $3.5 million with the two...more
Looking for compliance training and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance training, including updates on the latest news in regulatory...more
Report on Medicare Compliance 31, no. 14 (April 18, 2022) - Michigan gynecologic oncologist Vinay Malviya, M.D., has agreed to pay $775,000 to settle false claims allegations in connection with medically unnecessary...more
On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more
Nevada AG Aaron Ford and the U.S. DOJ reached a settlement with healthcare provider Lipshutz & Wills Medical Group, LLP d/b/a Monos Health (“Monos”) to resolve allegations that it improperly billed Medicaid, Medicare, and...more
Defendants Cannot Move for Compassionate Release Based Solely on Post-Sentencing Cooperation- United States v. Claude (October 27, 2021), No. 20-3563- BACKGROUND- Defendant sought compassionate release to reduce his...more