Constantine Cannon Client Secures Record $90 Million False Claims Act Whistleblower Settlement with Sutter Health

Sutter Health settles closely watched whistleblower lawsuit alleging it violated the False Claims Act by submitting inaccurate and unsupported medical information on tens of thousands of patients enrolled in Medicare Advantage. SAN FRANCISCO, CA (August 30, 2021) – Constantine Cannon, together with co-counsel Keller Grover and Kleiman Rajaram, announce the landmark $90 million False Claims Act settlement with Sutter Health on behalf of their whistleblower client, Kathy Ormsby, over allegations...

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

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 medical gloves, but failed to...

Payments News Update – August 26, 2021

Legal and Regulatory Developments SPOTLIGHT: Outgoing NY Governor Signs Bill to Limit Overdraft Practices at State-Chartered Banks Banking Dive – August 20, 2021 New York Gov. Andrew Cuomo signed a bill Thursday aimed at helping consumers avoid bank overdraft fees. The law requires New York-regulated banks to process checks in the order they are received, or from smallest to largest, to prevent customers from racking up fees for overdrawing their accounts....

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

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 fraud scheme. The “Video Doctor” Kickback Scheme Creaghan Harry, of...

Private-Equity Red Flags Signal Potential False Claims Act Liability

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 supporting these facts against PE...

Payments News Update – May 14, 2021

Legal and Regulatory Developments SPOTLIGHT: A Fed Report on Debit Costs Could Fuel a Movement to Reduce a Decade-Old Fee Cap Digital Transactions News – May 10, 2021 Pressure may be building on the Federal Reserve to take action on a debit card interchange-fee regulation that it has left intact for 10 years despite sweeping changes in the payments business, including an onrush of e-commerce transactions over the past year....

Payments News Update – May 6, 2021

Legal and Regulatory Developments SPOTLIGHT: Retail Organizations Sue Fed Over Debit Law Enforcement Retail Dive – April 30, 2021 Two retail associations sued the Federal Reserve Board of Governors April 29 over what they claim is a failure by the federal agency to properly enforce a federal law that caps the fees that can be charged on debit transactions. The North Dakota Retail Association and the North Dakota Petroleum Marketers...

Payments News Update – April 22, 2021

Legal and Regulatory Developments SPOTLIGHT: At Congressional Hearing, Panelists Question Why Crypto and Fintech Firms Need Bank Licenses The Block – April 15, 2021 Congress collected feedback from legal minds on how fintech firms may use or abuse banking licenses. The hearing, entitled “Banking Innovation or Regulatory Evasion? Exploring Trends in Financial Institution Charters,” included former Comptroller of the Currency Brian Brooks Many panelists condemned the OCC for “overreaching” in...

Payments News Update – April 16, 2021

Legal and Regulatory Developments SPOTLIGHT: Insider's Report On Payments: Interchange in the Crosshairs The Green Sheet – April 12, 2021 The major card brands are on the hot seat. Under pressure from Sen. Dick Durbin, D-Ill.,Visa and Mastercard postponed for a year interchange rate changes that were slated for April 2021. This followed news that the financial software giant Intuit is suing the two brands in federal court, alleging price...

Bristol-Myers Squibb Settlement Highlights a Common-Sense Law: The Medicaid Drug Rebate Program

Drug prices are out of control.  They now account for roughly 10% of our healthcare spending and America’s per capita outlay has nearly doubled over the past two decades.  For the least fortunate among us, many of these medications have become out of reach altogether. While new proposals are regularly made, one approach that often gets overlooked is simply enforcing the laws already on the books. That is just what...