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Legal Insights and Perspectives for the Healthcare Industry

Trending in 2024: What Does the HCFAC Report Signal About Federal Enforcement Mechanisms?

By Jacob J. Harper , Scott A. Memmott , and Jonathan P. York
// February 09, 2024
The Health Care Fraud and Abuse Control Program (HCFAC), an annual report jointly issued by the US Department of Justice (DOJ) and Department of Health and Human Services (HHS), can be helpful in predicting DOJ and HHS priorities for the coming year. In the FY 2022 HCFAC, DOJ and HHS not only highlighted a series of fraud and abuse enforcement wins, but also indicated increased activity by and with the US Food and Drug Administration (FDA) and the DOJ Consumer Protection Branch (CPB). This increase in activity from these regulatory agencies should be of interest to stakeholders in the pharmaceutical and medical device sectors.
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Topics: DOJ, Enforcement, Healthcare Fraud, HHS

Florida Healthcare Director Charged in Fraud Case Against CMS

By Michael J. Madderra , Scott A. Memmott , and Howard J. Young
// January 12, 2024
Continuing its recent slate of high-profile indictments, convictions, and plea agreements involving healthcare executives who have violated federal healthcare laws, the US Department of Justice (DOJ) recently announced charges against a healthcare executive for her role in a Medicare fraud scheme.
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Topics: DOJ, Healthcare Fraud

Texas Attorney Convicted of Conspiracy with Clients to Commit Healthcare Fraud

By Howard J. Young , Scott A. Memmott , and Michael J. Madderra
// August 15, 2023
In the second blog post of our series on healthcare chief compliance officers and lawyers accused of “going bad,” we discuss Texas attorney Peter J. Bennett (licensed since 2007) who was charged in the Eastern District of Texas in February 2022 (and in a December 2022 superseding indictment) with conspiracy to commit money laundering, conspiracy to operate an unlicensed money transmitting business, and two counts of perjury in relation to an illegal kickback-for-referral scheme. Bennett was convicted of all counts after a five-day jury trial on July 14, 2023 and is now awaiting sentencing.
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Topics: DOJ, Healthcare Fraud

False Claims Act Breakups Are Harder to Do in the District of Massachusetts

By Jonathan P. York and Scott A. Memmott
// June 28, 2023
As we at Morgan Lewis pride ourselves on excellent client service, we feel it is our duty to provide critical dispatches from the romantic world of healthcare fraud. Specifically, we want to highlight developments in the District of Massachusetts that may make the prospects of an amicable breakup in a federal civil False Claims Act (FCA) case with Boston federal prosecutors more remote.
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Topics: Enforcement, False Claims Act, Healthcare Fraud

Chief Compliance Officer Convicted in Healthcare Fraud Case

By Howard J. Young , Scott A. Memmott , and Michael J. Madderra
// June 21, 2023
The US Department of Justice (DOJ) announced on June 8, 2023 that Steven King, a compliance executive of pharmacy holding company A1C Holdings LLC, was convicted of defrauding Medicare out of more than $50 million in a scheme involving dispensing medically unnecessary lidocaine and diabetic testing materials.
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Topics: DOJ, Healthcare Fraud, Medicare

LawFlash: A Fraud Section Year in Review for a Year Like No Other

By Sandra Moser and Erica A. Jaffe
// March 04, 2021
On the heels of the US Department of Justice’s (DOJ’s) Criminal Division Fraud Section releasing its annual Year in Review, our white collar team published a LawFlash discussing the report, which highlights DOJ’s sustained aggressive enforcement efforts despite the COVID-19 pandemic.
Topics: COVID-19, DOJ, Healthcare Fraud, Paycheck Protection Program

Tele-Tuesday: OIG Clarifies Stance on Telehealth Fraud Scrutiny

By Jacob J. Harper
// March 02, 2021
The US Department of Health and Human Services Office of Inspector General (OIG), the Department of Justice (DOJ), and other federal regulators have grown increasingly concerned about the use of telehealth technologies by perpetrators of various fraud schemes. While this is in part due to the meteoric rise in use of telehealth services during the past year and the need to quickly formalize permanent policy around the technology, the federal government’s concern extends well before the COVID-19 public health emergency (PHE).
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Topics: COVID-19, DOJ, Healthcare Fraud, OIG, Telehealth

Tele-Tuesday: DOJ National Healthcare Fraud Takedown Targets Telehealth – But Should DOJ’s Focus Be Elsewhere?

By Jacob J. Harper and Scott A. Memmott
// October 20, 2020
DOJ recently announced a massive coordinated effort with other federal agencies to charge 345 defendants allegedly responsible for over $6 billion in fraud. DOJ, OIG, FBI, DEA, and various US Attorneys’ Offices in 51 federal districts teamed up to unveil charges against more than 100 doctors, nurses, and licensed clinical personnel.
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Topics: DOJ, Government Investigations, Healthcare Fraud, Telehealth
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