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DOJ Announces National Health Care Fraud Enforcement Actions Result in Charges Involving over $1.4 Billion in Alleged Losses

On September 17, 2021, the Department of Justice announced in a PRESS RELEASE that criminal charges had been brought against 138 defendants, including 42 doctors, nurses and other licensed medical professionals. These charges spanned 31 federal districts across the U.S. for alleged participation in various health care fraud schemes that resulted in approximately $1.4 billion in alleged losses. Watch Assistant Attorney General Kenneth A. Polite Jr.’s remarks on health care fraud enforcement actions HERE. The largest amount of the alleged fraud charged related to schemes… Read More »DOJ Announces National Health Care Fraud Enforcement Actions Result in Charges Involving over $1.4 Billion in Alleged Losses

DOJ Publishes Health Care Fraud and Abuse Control Program Annual Report FY 2020

This month, the 120-page Annual Report of the Departments of Health and Human Services and Justice Health Care Fraud and Abuse Control Program FY 2020 was published. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a nationalHealth Care Fraud and Abuse Control Program (HCFAC or the Program) under the jointdirection of the Attorney General and the Secretary of the Department of Health and HumanServices (HHS), acting through the Inspector General, designed to coordinate federal, state, andlocal law enforcement activities with respect to… Read More »DOJ Publishes Health Care Fraud and Abuse Control Program Annual Report FY 2020

DOJ Announces Coordinated Law Enforcement Action to Combat Health Care Fraud Related to COVID-19, Including Two South Florida Kickback Schemes

Today, Wednesday, May 26, 2021, the Department of Justice announced criminal charges against a telemedicine company executive, physician, marketers, and medical business owners for COVID-19 related fraud schemes. More specifically, the DOJ announced criminal charges against 14 defendants, including 11 newly-charged defendants and three who were charged in superseding indictments, in seven federal districts across the United States for their alleged participation in various health care fraud schemes that exploited the COVID-19 pandemic and resulted in over $143 million in false billings. Included in those… Read More »DOJ Announces Coordinated Law Enforcement Action to Combat Health Care Fraud Related to COVID-19, Including Two South Florida Kickback Schemes

SavaSeniorCare LLC Agrees to Pay $11.2 Million to Resolve False Claims Act Allegations

On Friday, May 21, 2021, the DOJ announced in a press release that Georgie-based, SavaSeniorCare LLC and its related entities (“Sava”) agreed to pay $11.2 million, plus additional amounts if certain financial contingencies occur, to resolve civil allegations that Sava violated the False Claims Act. A copy of the Settlement Agreement* is here -> Sava, through its subsidiaries, provides skilled nursing services and rehabilitation therapy services, including physical, occupational, and speech therapy, to patients at numerous skilled nursing facilities (“SNFs”) nationwide, and bills the Medicare… Read More »SavaSeniorCare LLC Agrees to Pay $11.2 Million to Resolve False Claims Act Allegations

U.S. Attorney General Merrick B. Garland Announces Task Force to Combat COVID-19 Fraud

On May 17, 2021, the Department of Justice, Office of Public Affairs, ANNOUNCED that the Attorney General directed the establishment of the COVID-19 Fraud Enforcement Task Force to marshal the resources of the DOJ to enhance enforcement efforts against COVID-19 related fraud. The Task Force FACT SHEET and AG Memorandum makes clear that “The Department of Justice will use every available federal tool – including criminal, civil, and administrative actions – to combat and prevent COVID-19 related fraud. We look forward to working with our… Read More »U.S. Attorney General Merrick B. Garland Announces Task Force to Combat COVID-19 Fraud

South Carolina’s Largest Urgent Care Provider and its Management Company to Pay $22.5 Million to Settle Civil Allegations of Healthcare Fraud in Violation of the False Claims Act

On April 8, 2021, the DOJ announced in a PRESS RELEASE that Doctors Care, P.A. – South Carolina’s largest urgent care provider network – and its management company, UCI Medical Affiliates of South Carolina, Inc. (“UCI”), will pay $25 million to resolve* civil allegations of healthcare fraud in violation of the False Claims Act. Relators initiated the FCA action on August 8, 2017 with the filing of their original complaint. On September 18, 2017, Relators filed their Amended Complaint for False Claims Act Violations, a… Read More »South Carolina’s Largest Urgent Care Provider and its Management Company to Pay $22.5 Million to Settle Civil Allegations of Healthcare Fraud in Violation of the False Claims Act

North Carolina Pain Management Company to Pay $789,292.95 to Resolve Civil Allegations of False Claims for Urine Drug Testing

On April 16, 2021, the DOJ announced in a PRESS RELEASE that Preferred Pain Management & Spine Care, P.A. (“PPM”) and its owner, Dr. David Spivey, have agreed to pay $789,292.95 to resolve civil allegations that PPM violated the False Claims Act by billing Medicare, Medicaid, and other federal health care programs for medically unnecessary urine drug testing (“UDT”). The Relator/Whistleblower will receive $118,911.12 as her share of the federal recovery in this case. According to the Qui Tam Relator’s Complaint filed on January 22,… Read More »North Carolina Pain Management Company to Pay $789,292.95 to Resolve Civil Allegations of False Claims for Urine Drug Testing

Bristol-Myers Squibb to Pay $75 Million to Resolve False Claims Act Allegations of Underpayment of Drug Rebates Owed Through Medicaid.

On April 1, 2021, the DOJ announced in a PRESS RELEASE that Bristol-Myers Squibb (“BMS”) had agreed to pay the United States and participating states a total of $75 Million, plus interest, to resolve allegations that it knowingly underpaid rebates owned under the Medicaid Drug Rebate Program (“MDRP”)*. Relator, Ronald Streck, initiated the current civil lawsuit in the Eastern District of Pennsylvania, under the whistleblower provisions of the False Claims Act, as well at multiple state false claims acts. The government declined intervention of this… Read More »Bristol-Myers Squibb to Pay $75 Million to Resolve False Claims Act Allegations of Underpayment of Drug Rebates Owed Through Medicaid.

Owners and Former Employee of Health Care Company Face Federal Charges for Allegedly Paying Kickbacks to Homeless Patients and Fraudulently Billing Medicaid

On April 2, 2021, the DOJ announced in a PRESS RELEASE that a federal criminal complaint was filed charging a husband and wife of Silver Spring, Maryland, (and their employee) with health care kickbacks and conspiracy to receive unlawful kickbacks, in connection with their company, Holy Health Care, Services, LLC (“Holy Health”). The criminal complaint is sealed, but the Affidavit in Support of Criminal Complaint and Arrest Warrants is below: According to the Affidavit, Julius Bakari owns and operates Holy Health, and is also the… Read More »Owners and Former Employee of Health Care Company Face Federal Charges for Allegedly Paying Kickbacks to Homeless Patients and Fraudulently Billing Medicaid