Archive

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Posted 09/3/21

telemedicine doctor on computer with patient

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...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Contract Non-Compliance, FCA Federal, Government Programs Fraud, Healthcare Fraud, Improper Medical Facility, Lack of Medical Necessity, Provider Fraud,

Managed Care Risk Adjustment Enforcement Continues with Sutter Health Settlement: Constantine Cannon Client Secures Largest Ever Medicare Advantage Settlement by a Hospital

Posted 08/30/21

Sutter Health will pay the Government $90 million under the False Claims Act for allegedly submitting inaccurate and unsupported medical information on tens of thousands of patients. The settlement in a case brought by a whistleblower represented by Constantine Cannon, together with co-counsel Keller Grover and Kleiman Rajaram, is the largest Medicare Advantage FCA settlement against a hospital system, and the...

Tagged in: CC Lawyers, FCA Federal, Healthcare Fraud, Managed Care, Provider Fraud, Risk Adjustment Fraud, Whistleblower Case,

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,

P-Stim Fraud: A New DOJ Enforcement Priority?

Posted 04/23/21

The Department of Justice regularly publicizes its fraud prevention and False Claims Act enforcement priorities. These announced priorities typically focus on broad issues that affect the lives of millions of Americans – COVID-19 fraud, the opioid crisis, and the rapid expansion of telehealth. In addition, we keep an eye on DOJ enforcement actions, and these can reveal emerging trends, often in narrow areas. One...

Tagged in: Chiropractic, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Provider Fraud,

Disturbing New Evidence Suggests Fraud Underlies Five-Star Ratings for Some Nursing Homes

Posted 03/19/21

Nurse helping elder man walking in rehab facility

Twelve years after the implementation of the nursing-home star-ratings system, a disturbing New York Times exposé and a lawsuit by California against Brookdale Senior Living reveals how the ratings are manipulated to the detriment of families in their time of crisis. The NYT’s investigation and California’s allegations in combination paint the troubling picture of profits tied to higher star ratings, and...

Tagged in: FCA Federal, Financial and Investment Fraud, Healthcare Fraud, Home Health and Hospice, Importance of Whistleblowers, Provider Fraud, SNF,

Constantine Cannon and AARP Foundation Represent Advocacy Groups on behalf of Nursing-Home Patients to Ensure Facility Accountability

Posted 01/22/21

Constantine Cannon LLP proudly joins the AARP Foundation in representing the National Consumer Voice for Quality Long-Term Care and California Advocates for Nursing Home Reform in a lawsuit seeking to roll back a directive undercutting accountability for nursing homes that violate federal standards. The federal Nursing Home Reform Act of 1987 allows states to recommend to CMS that a non-compliant facility pay civil...

Tagged in: CC Lawyers, COVID-19, FCA Federal, Healthcare Fraud, Provider Fraud, SNF,

Top Ten State Healthcare and Financial Fraud Recoveries of 2020

Posted 01/8/21

State and local governments are on the front lines of enforcing anti-fraud laws and play a critical role in ensuring that businesses and individuals are held accountable. Whistleblowers with information about corporate misconduct involving healthcare, government procurement, financial regulation, and tax may find that state proceedings offer them the best option. More than 30 states have False Claims Acts that...

Tagged in: Auto Safety, Drug and DME Pricing, FCA State, Financial and Investment Fraud, Government Procurement Fraud, Government Programs Fraud, Healthcare Fraud, Medical Billing Fraud, Pharma Fraud, Provider Fraud, Tax Fraud, Top 10,

Top Ten Healthcare Fraud Recoveries of 2020

Posted 01/5/21

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2019 stemmed from healthcare fraud matters, and with the Biden administration eyeing a bigger role for the federal government in our healthcare system, this trend is likely to accelerate. Most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, FCPA, Government Programs Fraud, Healthcare Fraud, Home Health and Hospice, Medicaid, Medicare, Pharma Fraud, Provider Fraud, Top 10,

Constantine Cannon Settles Case Alleging Kickbacks to Multi-Practice Physicians’ Group for Referrals to Wholly Owned Ambulatory Surgery Center – Whistleblower Was Former CEO

Posted 10/9/20

Constantine Cannon, on behalf of whistleblower Jeffery Neuberger, has settled a False Claims Act action against Mid Dakota Clinic and a related entity. Mr. Neuberger, the former CEO of the medical group, filed his case in 2017 alleging a scheme in violation of the Anti-Kickback Statute (AKS) between the medical group and its wholly owned ambulatory surgery center (ASC). At issue was a financial arrangement whereby...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Provider Fraud, Whistleblower Rewards,

Catch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown

Posted 10/2/20

Paper Ripped Uncovering Medical Necessity Wording

In the largest health care fraud and opioid enforcement action in the Justice Department’s history, 345 defendants—including more than 100 doctors, nurses, and other medical professionals—face charges for submitting over $6 billion in false or fraudulent claims to federal and private insurers. Defendants stand accused of submitting $4.5 billion in fraudulent claims linked to telemedicine, $845 million...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Pharma Fraud, Provider Fraud,

Contact

Click here for a confidential contact or call:

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

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.

Managed Care Risk Adjustment Enforcement Continues with Sutter Health Settlement: Constantine Cannon Client Secures Largest Ever Medicare Advantage Settlement by a Hospital

Private-Equity Red Flags Signal Potential False Claims Act Liability

Martino-Fleming Case

P-Stim Fraud: A New DOJ Enforcement Priority?

Disturbing New Evidence Suggests Fraud Underlies Five-Star Ratings for Some Nursing Homes

Constantine Cannon and AARP Foundation Represent Advocacy Groups on behalf of Nursing-Home Patients to Ensure Facility Accountability

Top Ten State Healthcare and Financial Fraud Recoveries of 2020

Top Ten Healthcare Fraud Recoveries of 2020

Constantine Cannon Settles Case Alleging Kickbacks to Multi-Practice Physicians’ Group for Referrals to Wholly Owned Ambulatory Surgery Center – Whistleblower Was Former CEO

Catch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: