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...
Catch of the Week: 13 Conspirators Busted in $100 Million No-Fault Insurance Fraud
Posted 01/14/22
The U.S. Attorney this week announced the arrest of doctors, businesspeople, an attorney, a New York police officer, and several others in one of the largest no-fault automobile insurance fraud takedowns in history.
The investigation leading to their arrest was conducted by the U.S. Attorney’s Office for the Southern District of New York, the FBI, and the Westchester County District Attorney’s Office. The...
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...
2021 was another banner year for whistleblowers, who once again collectively recovered billions of dollars for the government and hundreds of millions of dollars in whistleblower rewards under the various government whistleblower programs. This includes awards under the qui tam provisions of the federal False Claims Act and various state False Claims Act programs. It includes awards under the Dodd-Frank SEC...
For those like your correspondents who spend their days deepintheweedsofcomplexMedicarefraud, it’s a delight when something refreshingly simple comes along. Thanks to Billy Joe Taylor of Arkansas, we can relax this Friday with a cool glass of straightforward Medicare fraud. For allegedly making $100 million in claims to CMS for tests that were not ordered or ever performed, he is our Catch of the...
Catch of the Week: Fraudulent Sleep Tests in Fresno
Posted 10/29/21
Fraud permeates through all aspects of America’s healthcare system- from hospitals to big pharma to chiropractors. This week’s catch of the week focuses on another part of the system, sleep clinics. As increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders, the significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous...
Catch of the Week: Laboratory and Two Founders Will Pay up to $16M Over Fraudulent Billing for Urine Drug Testing
Posted 10/22/21
Clinical laboratory MD Labs Inc., and co-founders and owners, Denis Grizelj and Matthew Rutledge, settled charges the lab falsely billed Medicare, Medicaid, and other federal payors for pricey and unnecessary urine drug tests. Over a four-year period, the lab regularly ran two different drug tests at once and then sent results from both tests to the ordering healthcare physician simultaneously, according to the...
Catch of the Week: Private Equity Firm and Former Executives of a Mental Health Center Reach $25 Million Medicaid Settlement
Posted 10/15/21
In recent years there has been a proliferation of private equity firms taking oversight of healthcare entities. These private equity firms have increased their exposure to False Claims Act liability by playing active roles in the operation of healthcare entities, and multiple settlements have been reached over the last two years (on kickbacks and promotion of unapproved use of drug-device systems on pediatric...
Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme
Posted 09/3/21
Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.
Healthcare fraudsters have a track record of exploiting health crises for personal gain. The COVID-19 pandemic created new telemedicine opportunities for patients to receive care without having to see doctors in person. As expected, fraudsters seized on...
Unnecessary procedures have long plagued the U.S. healthcare system, costing taxpayers billions and subjecting thousands of patients to invasive procedures that sometimes do more harm than good. For decades, various government actors have acknowledged the problem.
Why then is it so difficult to prevent unnecessary procedures in the U.S.?
Reporter Chris Outcalt recently pondered in a piece for The Atlantic. The...