Tagged: healthcare fraud

Checking in on Criminal Healthcare Fraud Prosecutions

For criminal defense practitioners, it is easy to lose perspective when focused on FCPA, export control/sanctions and AML prosecutions.  In the healthcare fraud area, prosecutors continue to aggressively enforce anti-kickback and fraud statutes through criminal prosecutions. The Justice Department has made its priority in this area clear – by dedicating law enforcement resources and prosecutors to investigating and prosecuting healthcare fraud schemes.  As government participation...

False Claims Act 2018 Year in Review – Making Sense of the DOJ Fraud Statistics

Jessica Sanderson, Of Counsel, The Volkov Law Group, joins us for her initial posting on the False Claims Act. Jessica can be reached at jsanderson@volkovlaw.com. On December 21, 2018, the Department of Justice (“DOJ”) released its Fraud statistics showing $2.8 billion recovery under the False Claims Act (“FCA”) for 2018.[1] While this number is staggering, fiscal year 2018 FCA recoveries were down more than ½...

Episode 52 — The False Claims Act and Healthcare Fraud

The federal government continues to push aggressive False Claims Act enforcement cases against healthcare companies, including hospitals, skilled nursing facilities, hospices and other healthcare providers.  The Justice Department has employed the False Claims Act to target companies in the opioid industry as a response to the opioid crisis in our country. Healthcare companies have to implement effective ethics and compliance controls to protect against fraud...

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

Despite the controversial impact of the Supreme Court’s Escobar decision, the Justice Department’s False Claims Act prosecutions and settlements are continuing at a consistent rate – heading towards another multi-billion dollar year of FCA recoveries. Some examples of these prosecutions and settlements will demonstrate my overall point – FCA risks are significant and healthcare providers, especially hospitals, have to devote time and attention to oversight...

Hospital Official and Three Dentists Convicted for Kickback and Bribery in RICO Criminal Case (Part II of IV)

The Justice Department has continued to pursue healthcare fraud and bribery criminal prosecutions.  Healthcare fraud remains a high priority for criminal enforcement. With the pervasive problem of fraud and bribery, the healthcare industry continues to suffer from corrupt officials and physicians.  Government regulation of the healthcare industry provides many opportunities and incentives for industry participants to cheat the system. In a recent case, the Justice...

Webinar: Healthcare Providers — The Need to Enhance Your Ethics and Compliance Program

Webinar: Healthcare Providers — The Need to Enhance Your Ethics and Compliance Program Tuesday, April 10, 2018, 12 Noon EST Sign Up Here Healthcare providers continue to face significant enforcement risks. Federal and state regulation of healthcare providers creates numerous risks, including the possibility of criminal fraud prosecutions. False Claims Act prosecutions continue to threaten healthcare providers with potential parallel criminal and civil proceedings. In...

ArthroCare CEO Reconvicted for Fraud

The healthcare industry continues to be a frequent target for criminal prosecutions. More importantly, federal prosecutors are ready, willing and able to bring criminal cases against C-Suite actors involved in healthcare fraud cases. Sometimes prosecutors win their cases, and sometimes they lose. That is just the nature of the beast. ArthroCare stands as yet another example of the destruction of a company resulting from C-Suite...

CCOs and the C-Suite

Let’s start out with something ironic – the C-Suite typically resists the need for ethics and compliance training, as well as other compliance controls, claiming that they know everything about ethics and compliance. Unfortunately, when a member or members of the C-Suite commit misconduct, the consequences can be devastating for the company. We all know high-profile instances of C-Suite misconduct involving bribery, fraud, and theft....

Check Up on Healthcare Fraud Prosecutions

Chief compliance officers face an overwhelming level of risk in the healthcare sector. I do not mean to belittle the risks of corruption, AML, sanctions and other risks typically associated with global companies. Healthcare companies face an extraordinary mix of risks, including fraud, data security, bribery/anti-kickback, and Stark Law violations. The False Claims Act statute is a prosecutor’s dream, and organizations and individuals face extraordinary...

Compliance Reminder — DOJ Announces Largest Healthcare Fraud Takedown

Jacqui Merrill, an Associate at The Volkov Law Group, rejoins us for a posting on DOJ’s largest healthcare fraud takedown.  Jacqui’s profile is here and she can be reached at jmerrill@volkovlaw.com. On Wednesday, June 22, 2016, the DOJ announced the largest nationwide heath care fraud takedown in history, which resulted in criminal and civil charges against 301 individuals for alleged participation in health care fraud...