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Catch of the Week

This archive includes posts from our “Catch of the Week” series, in which the Whistleblower Insider blog highlights particular government enforcement actions.  Return to:

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

Posted  01/7/22
spilt pills
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 30th, 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,

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Catch of the Week: Privatized Military Housing Contractor Pays Over $65 Million to Resolve Criminal and False Claims Act Allegations

Posted  12/23/21
Government contractors are held to high standards in the performance of their contracts or services because of the direct impact to government services and taxpayer dollars at stake. Often fraud related to government contractors can negatively impact U.S. servicemembers or public servants who diligently serve our country. This week we focus on the over $65 million judgment and settlement reached between the...

Tagged in: Catch of the Week, Contract Non-Compliance, Criminal Proceedings, Defense Contract Fraud, FCA Federal, Government Procurement Fraud,

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

Posted  12/10/21
Pharmacists discussing medication
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,

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Catch of the Week: Archdiocese of New Orleans pays $1 million to Resolve Katrina-Related Allegations, Highlighting Importance of Enforcement in Disaster Recovery Fraud

Posted  11/19/21
New Orleans Jackson Square
We’ve covered this before: natural disasters and fraud against the government often go hand in hand. The government, through agencies and programs such the FEMA and the federally-backed flood and crop insurance programs, can distribute enormous sums of money very quickly in the wake of hurricanes, floods, tornadoes, and the like. Distributing lots of money quickly after natural disasters gets immediate help to...

Tagged in: Catch of the Week, Certifications, FCA Federal, Flood Insurance, Government Programs Fraud,

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Catch of the Week: Classic Medicare Fraud

Posted  11/5/21
medicare dollars
For those like your correspondents who spend their days deep in the weeds of complex Medicare fraud, 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...

Tagged in: Catch of the Week, COVID-19, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Provider Fraud,

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Catch of the Week: Fraudulent Sleep Tests in Fresno

Posted  10/29/21
bed with pillow and sheets scattered
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...

Tagged in: Catch of the Week, Healthcare Fraud, Improper Medical Facility, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Medicare, Provider Fraud,

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Catch of the Week: Laboratory and Two Founders Will Pay up to $16M Over Fraudulent Billing for Urine Drug Testing

Posted  10/22/21
Person wearing lab coat in laboratory
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...

Tagged in: Catch of the Week, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medicare, Provider Fraud, Whistleblower Case,

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Catch of the Week: Private Equity Firm and Former Executives of a Mental Health Center Reach $25 Million Medicaid Settlement

Posted  10/15/21
dollar bill with Medicaid text ripped through
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...

Tagged in: Catch of the Week, Defendants, FCA State, Healthcare Fraud, Improper Medical Personnel, Medicaid, Provider Fraud,

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Catch of the Week: 18 Former N.B.A. Players Charged in Healthcare Fraud Scheme

Posted  10/8/21
Former professional basketball players, including Terence Williams, "Big Baby" Glen Davis, Sebastian Telfair, and Tony Allen, have been indicted for submitting fraudulent claims for reimbursement of medical and dental services not actually rendered. From 2017 through last year, defendants' scheme caused the N.B.A. Players' Health and Welfare Benefit Plan ("the Plan") to pay out nearly $4 million in false claims....

Tagged in: Catch of the Week, Criminal Proceedings, Healthcare Fraud, Private Insurance Whistleblower Reward Programs,

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Catch of the Week: In hot water again, now for fleecing customers in foreign currency transactions, Wells Fargo pays $72m in fines and restitution

Posted  09/29/21
Wells Fargo Bank Banners on Side of Building
Earlier this week, the Department of Justice settled an important case in which Wells Fargo Bank agreed to pay over $70 million in penalties and restitution to defrauded bank customers. Wells Fargo admitted that it defrauded 771 customers, mostly small businesses, who used the bank’s foreign exchange services when they needed to send money overseas or receive money from abroad. Rather than charging standard fees for...

Tagged in: Catch of the Week, Financial and Investment Fraud, Financial Institution Fraud, FIRREA,

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