We have previously discussed the California Insurance Frauds Prevention Act (IFPA)–a state antifraud statute that, while modeled on the False Claims Act (FCA), is unique in targeting fraud in the commercial health insurance space.
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Recent DOJ Indictment Involving Done Global Telehealth Prescriptions
I was quoted in a Law360 Healthcare Authority article examining the recent indictment against two executives of Done Global Inc. accused of defrauding government programs by improperly providing Adderall via telehealth visits.
Causation Split: First Circuit Pauses Teva Appeal; Regeneron Appeal Going Forward
False Claims Act (FCA) practitioners have been closely watching cases in which courts address the causation requirement in FCA actions based on Anti-Kickback Statute (AKS) violations.
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COVID-19 Relief Enforcement Actions Highlight Ongoing Risk
The Department of Justice (DOJ) continues to demonstrate its sustained interest in COVID-19 relief fraud as an enforcement priority and we can expect to see persistent enforcement in this area.
The Tale of an AKS Self-Disclosure
Last week, the Department of Justice (DOJ) announced a $12 million settlement with spinal device manufacturer, Innovasis Inc. (Innovasis) and senior executives Brent Felix and Garth Felix related to allegations that they violated the False Claims Act (FCA) by paying
FCA Statute of Limitations Triggered by Notice to DOJ Only, Court Rules
In a recent order denying dismissal in United States v. NH Learning Solutions Corp. (NHLS), the U.S. District Court for the Eastern District of Michigan weighed in on a False Claims Act (FCA) issue that has divided courts, ruling that
Settlement Roundup: Heart-Valve Replacements, Federal Research Grants, and Clinical Laboratory Marketing
The Department of Justice (DOJ) recently announced settlements involving alleged noncompliance with Medicare billing requirements for heart-valve replacement surgeries, false statements in federal funding research grants, and physician kickback schemes for clinical laboratories. The settlements show DOJ’s continued scrutiny in
Seventh Circuit Upholds FCA Judgment Against Constitutional Challenge, Avoids Causation Circuit Split
On May 2, the U.S. Court of Appeals for the Seventh Circuit affirmed a False Claims Act (FCA) trial verdict in part, holding that the judgment was not constitutionally excessive under the Eighth Amendment.
False Claims Act Settlements to Know from Q1 2024
Despite the recent downward trend in DOJ healthcare industry settlements, the first quarter of 2024 saw many noteworthy False Claims Act (FCA) and civil healthcare fraud settlements related to alleged kickbacks, medically unnecessary services and equipment, pharmaceutical issues and Controlled