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Top Ten Financial and Healthcare Fraud Prison Sentences of 2021

Posted 01/28/22

Individuals involved in financial and healthcare fraud schemes face not just civil liability, but also criminal penalties – including prison time. In 2021, the Department of Justice obtained substantial prison sentences in a myriad of cases involving healthcare and financial frauds, many of which involved convictions of the type of fraudulent schemes that whistleblowers report. Whistleblowers play an essential role...

Tagged in: Compounding Pharmacy Fraud, COVID-19, Criminal Proceedings, Education Fraud, Financial and Investment Fraud, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medicare, Money Laundering, Ponzi Schemes, Securities Fraud, Top 10,

Top Ten Healthcare Fraud Recoveries of 2021

Posted 01/11/22

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2021 stemmed from healthcare fraud matters. Most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. The majority of the recoveries on this list involve allegations of violations of the Anti-Kickback Statute, a federal law that...

Tagged in: Anti-Kickback and Stark, Chiropractic, Criminal Proceedings, FCA Federal, Healthcare Fraud, Improper Medical Personnel, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medical Devices and DME, Medicare, Pharma Fraud, Provider Fraud, Top 10,

Catch of the Week: Jury Finds Teva Pharmaceuticals Liable for Contributing to Opioid-Related Deaths in New York State

Posted 01/7/22

In a significant development in the ongoing effort to assess blame and responsibility for the opioid epidemic, which has led to the deaths of hundreds of thousands of individuals and ravaged communities throughout the United States, on December 30^th, after a six-month trial, a New York jury found that Teva Pharmaceuticals USA, Inc. (“Teva”) and its affiliates, including Anda Inc., created a “public nuisance”...

Tagged in: Catch of the Week, Healthcare Fraud, Pharma Fraud,

Catch of the Week: Pharmacy Owner Convicted in $174 Million Telehealth Fraud That Targeted Consumers and PBMs

Posted 12/10/21

In yet another example of how unscrupulous providers can take advantage of the benefits of telehealth (or telemedicine) to commit healthcare fraud, on December 2, 2021, a federal jury in Tennessee convicted Peter Bolos, the owner and operator of Synergy Pharmacy, located in Florida, of 22 criminal counts, including violating the Food, Drug and Cosmetic Act (FDCA) by introducing a misbranded drug into interstate...

Tagged in: Catch of the Week, Criminal Proceedings, Drug Switching, Healthcare Fraud, Medicaid, Pharma Fraud, Provider Fraud,

Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Posted 11/15/21

Person Handing Hundred Dollar Bill to Another Person

The Department of Justice regularly highlights the areas of fraudulent conduct it intends to target as enforcement priorities. These identified enforcement priorities tend to cover burgeoning areas of fraud or particular misbehavior especially ripe or prevalent because of the particular times we live in. As might be expected, DOJ's current listing of priorities includes fraud related to the pandemic, opioids, the

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medical Devices and DME, Pharma Fraud, Provider Fraud,

Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act

Posted 08/19/21

Red and yellow pills scattered on hundred dollar bills

Last week, the Seventh Circuit Court of Appeals, the federal appellate court for Illinois, Indiana, and Wisconsin decided U.S. ex rel. Yarberry v. Supervalu, an important decision that may lead more unscrupulous government contractors to help themselves to public funds to which they are not entitled. Unless the Supreme Court or Congress steps in to correct the Seventh Circuit’s errors, the government may have...

Tagged in: Contract Non-Compliance, Court Decision, Drug and DME Pricing, FCA Federal, Government Procurement Fraud, Healthcare Fraud, Medicaid, Medicare, Pharma Fraud, Pricing Fraud, Whistleblower Case,

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Posted 07/9/21

The Food and Drug Administration (FDA) is supposed to protect American consumers from unscrupulous private actors—charlatans, snake-oil salesmen, and the like—seeking to profit by selling unproven medical “cures,” treatments, and devices to the public. Emerging during the era of the robber barons as part of Theodore Roosevelt’s efforts to “civilize capitalism,” the FDA has prevented untold harm to...

Tagged in: FCA Federal, FDA Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicare, Pharma Fraud,

Book Review: “Empire of Pain: The Secret History of the Sackler Dynasty,” by Patrick Radden Keefe

Posted 06/3/21

Last October, Purdue Pharma, the inventor, manufacturer, and marketer of Oxycontin, the drug at the center of the opioid crisis, reached a massive healthcare fraud settlement with the Department of Justice. The Department advertised the settlement as an $8.3 billion dollar recovery, which would make it one of the largest healthcare fraud settlements in history. In his book Empire of Pain, Patrick Radden Keefe explores...

Tagged in: Importance of Whistleblowers, Pharma Fraud, Whistleblower Bookshelf,

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Posted 05/28/21

Hey, fraudsters, did you hear? There was a global pandemic, so the government pumped trillions of dollars into the economy. Probably a good time to get a piece of the cut, you ask? They’ll never find out, right? So many ways to grift! Well, not so much. From the start, the cops on the beat, led by the United States Department of Justice, have screamed from the rooftops: “Don’t do it. We WILL...

Tagged in: COVID-19, Criminal Proceedings, FCA Federal, Financial and Investment Fraud, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Laboratory and IDTF, Lack of Medical Necessity, Market Manipulation and Trading Violations, Medical Billing Fraud, Misrepresentations, Pharma Fraud, Securities Fraud,

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted 05/7/21

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

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Top Ten Financial and Healthcare Fraud Prison Sentences of 2021

Top Ten Healthcare Fraud Recoveries of 2021

Catch of the Week: Jury Finds Teva Pharmaceuticals Liable for Contributing to Opioid-Related Deaths in New York State

Catch of the Week: Pharmacy Owner Convicted in $174 Million Telehealth Fraud That Targeted Consumers and PBMs

Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Book Review: “Empire of Pain: The Secret History of the Sackler Dynasty,” by Patrick Radden Keefe

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

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