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Three States Impose Profit Limits on Nursing Homes

Posted 10/29/21

New York, New Jersey, and Massachusetts have just sent a clear message to nursing home operators: patient care must be prioritized over profits. Each state is introducing rules requiring nursing homes to spend a specific portion of their total revenue on direct patient care. In New York, it will be at least 70%, in Massachusetts at least 75%, and in New Jersey at least 90%. The three states are also limiting...

Tagged in: COVID-19, Healthcare Fraud, Provider Fraud, SNF,

Catch of the Week: Florida Man Charged with Stealing Over $12 Million in Funds Slated for PPE

Posted 08/27/21

person handcuffed with hands on stack of papers with briefcase

DOJ continues to make good on its promise to root out fraud in pandemic relief. This week, a Florida resident Brian Sperber was indicted for defrauding hospitals and medical institutions out of more than $12 million dollars by falsely promising to deliver personal protective equipment to those purchasers. Sperber and his co-conspirators, who ran medical supply and logistics companies, took orders for N95 masks and...

Tagged in: Catch of the Week, COVID-19, Criminal Proceedings,

Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme

Posted 08/20/21

Doctor on computer with patient discussing medicine

Underscoring the fraud risks associated with the government’s continued expansion and loosening of restrictions on telehealth, the U.S. Department of Justice recently announced that a grand jury in New Jersey has returned a superseding indictment against the Florida owner of multiple telemedicine companies, referred to by DOJ prosecutors as the Video Doctor Network, for allegedly participating in a massive Medicare...

Tagged in: Catch of the Week, COVID-19, FCA Federal, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medical Devices and DME, Medicare, Money Laundering, Whistleblower Rewards,

Partner Mary Inman Speaks about Research Fraud with Science Whistleblower Dr. Elisabeth Bik at the HCCA’s Research Compliance Conference

Posted 07/23/21

On June 16, 2021, Constantine Cannon partner Mary Inman spoke at the Health Care Compliance Association’s (HCCA) Research Compliance Conference on the topic of ‘The Vital Role of Whistleblower Scientists in Exposing Fraudulent Research During the Pandemic.’ Mary was joined by co-panelist Dr. Elisabeth Bik, the Founder and Editor of the Science Integrity Digest, a blog about scientific integrity aimed at...

Tagged in: COVID-19, Grant and Research Fraud, Importance of Whistleblowers, Other Government Health Programs, Whistleblower Evidence,

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,

Private-Equity Red Flags Signal Potential False Claims Act Liability

Posted 05/21/21

Private equity (PE) firms that manage healthcare entities have further reason to take note of the growing record of exposure for False Claims Act (FCA) liability.

Martino-Fleming Case

In the latest shot across the bow, the PE firm, a majority shareholder of a for-profit mental-health provider, knew about the false claims and played a sufficiently active role in operations potentially to have caused them. Evidence...

Tagged in: COVID-19, Defendants, FCA Federal, Financial and Investment Fraud, Healthcare Fraud, Importance of Whistleblowers, Provider Fraud, SNF,

As COVID-19 Stimulus Funds Flow, DOJ Puts Fraudsters on Notice and Calls Whistleblowers “Essential”

Posted 04/2/21

On March 11th, President Biden signed The American Rescue Plan Act of 2021 (ARPA), a sweeping economic stimulus plan that will pump $1.9 trillion into the US economy. In addition to direct relief to Americans, ARPA includes record-setting government spending in numerous areas to speed recovery from the economic and health effects of the COVID-19 pandemic and the ongoing recession. As we have previously written,...

Tagged in: COVID-19, FCA Federal, FIRREA, Government Loan Programs, Government Procurement Fraud, Government Programs Fraud, Importance of Whistleblowers,

March Madness: AstraZeneca Fudges the Clinical Trial Results for Its COVID-19 Vaccine

Posted 03/26/21

In case you haven’t been following the NCAA Men’s Basketball Tournament (or even if you have), you might be surprised to learn that the University of Hartford is poised to win it all this year—except for the fact that it lost in the first round of the tournament to Baylor University, 79-55, and has been eliminated from the competition. Likewise, in case you haven’t been following the results of COVID-19...

Tagged in: COVID-19, FDA Fraud, Financial and Investment Fraud, Government Programs Fraud, Grant and Research Fraud, Healthcare Fraud, Pharma Fraud,

COVID Frauds of the Week: DOJ Continues to Crack Down on PPP Fraudsters

Posted 03/19/21

As of this week, the Small Business Administration has disbursed over $700 billion in Paycheck Protection Program (PPP) loans to small businesses and non-profits. There are over $100 billion in remaining appropriations, with additional appropriations likely to follow thereafter. With numbers like these, the program has become a magnet for fraudsters seeking to profit from the pandemic. The DOJ has been actively going...

Tagged in: Catch of the Week, COVID-19, Financial and Investment Fraud, Financial Institution Fraud, Government Programs Fraud, Money Laundering,

DOJ Previews False Claims Act Enforcement Priorities for 2021

Posted 03/5/21

Department of Justice Seal on the United States Flag

The False Claims Act is the federal government's primary enforcement tool to combat fraud against the public. Every year the government recovers billions of dollars under the statute, primarily with the help of whistleblowers. Under the so-called qui tam provisions of the act, whistleblowers are authorized to act as private attorneys general and bring lawsuits on behalf of the government and recover a portion of...

Tagged in: COVID-19, Cybersecurity and Data Breaches, Electronic Health Records, FCA Federal, Government Procurement Fraud, Government Programs Fraud, Healthcare Fraud, Home Health and Hospice, Importance of Whistleblowers, Pharma Fraud, SNF,

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Three States Impose Profit Limits on Nursing Homes

Catch of the Week: Florida Man Charged with Stealing Over $12 Million in Funds Slated for PPE

Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme

Partner Mary Inman Speaks about Research Fraud with Science Whistleblower Dr. Elisabeth Bik at the HCCA’s Research Compliance Conference

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

Private-Equity Red Flags Signal Potential False Claims Act Liability

Martino-Fleming Case

As COVID-19 Stimulus Funds Flow, DOJ Puts Fraudsters on Notice and Calls Whistleblowers “Essential”

March Madness: AstraZeneca Fudges the Clinical Trial Results for Its COVID-19 Vaccine

COVID Frauds of the Week: DOJ Continues to Crack Down on PPP Fraudsters

DOJ Previews False Claims Act Enforcement Priorities for 2021

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