On February 22, 2023, the U.S. Department of Justice (“DOJ”) issued a corporate Voluntary Self-Disclosure policy (the “Policy”) that applies to all United States Attorney’s Offices (“USAOs”), effective immediately. The articulated goal... Read More
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A motion to dismiss that has been pending since last year was recently decided in the matter of U.S. ex rel. Teresa Ross v. Independent Health Association, et al. The decision may very well be a bellwether for future Medicare Advantage (“MA”)... Read More
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Having served for nearly a decade as a federal prosecutor with the Department of Justice (“DOJ”), I always understood that whether a violation of the Anti-Kickback Statute (“AKS”) will result in criminal charges versus a civil lawsuit for... Read More
Articles | Chain Pharmacies | Community, Retail Pharmacies | Digital Pharmacies | Federal and State Fraud and Abuse Counseling | Federal and State Fraud and Abuse Counseling | Fertility Pharmacies | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | White Collar Criminal Defense & Government Investigations | White Collar Defense and Government Investigation

America spends more on prescription drugs than any other country in the world. Although most patients have some form of insurance to help offset the costs of their prescriptions, 28% of Americans currently take a prescription medication that is not... Read More
Articles | Federal and State Fraud and Abuse Counseling | Review of Promotional and Advertising Materials | Start-Up Healthcare and Life Sciences Companies

All members of the health care industry have a legal and ethical duty to deal with the Federal health care programs (e.g., Medicare, Medicaid, and Tricare) with integrity. In keeping with this duty, practitioners are expected to employ measures to... Read More
Articles | Federal and State Fraud and Abuse Counseling | Healthcare | Healthcare Law | Healthcare Practice Compliance | White Collar Defense and Government Investigation

Earlier this week the Second Circuit affirmed a lower court’s holding which found that drug manufacturer Pfizer Inc.’s practice of providing copay assistance to Medicare beneficiaries violated the Federal Anti-Kickback Statute (“AKS”).... Read More
Articles | Federal and State Fraud and Abuse Counseling | Federal and State Fraud and Abuse Counseling | Healthcare Practice Compliance | Medical Practice Representation | Professional Practice Representation | White Collar Criminal Defense & Government Investigations | White Collar Defense and Government Investigation

The Department of Justice ("DOJ") indicted a North Carolina physician assistant last month on criminal charges in a genetic testing scheme that resulted in the submission of more than $10 million in fraudulent claims to Medicare. The indictment... Read More
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On June 29, 2022, the Department of Justice (“DOJ”) announced the formation of the New England Prescription Opioid (NEPO) Strike Force. This strike force will investigate and vigorously prosecute healthcare providers involved in healthcare fraud... Read More
All types of single and multi-specialty medical practice groups | Articles | Chain Pharmacies | Community Oncology Practices & Other Dispensing Physician Practices | Community, Retail Pharmacies | Digital Pharmacies | Dispensing Physician Practices and Dispensing Physicians | Federal and State Fraud and Abuse Counseling | Federal and State Fraud and Abuse Counseling | Fertility Pharmacies | Healthcare Practice Compliance | Hospitals and Healthcare Systems | Long-Term Care Pharmacies | Medical Practice Representation | Pain Management Compliance | Physician Dispensing | Physician Dispensing | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Provider Relationship | Regulatory Compliance, including FDA, DEA and HIPAA | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | Urologist | White Collar Criminal Defense & Government Investigations | White Collar Defense and Government Investigation

According to the DOJ’s indictment, Ms. Lavache prescribed DME for Medicare beneficiaries without conducting any consultations with the said beneficiaries. As a result, she allegedly caused the submission of false claims to Medicare totaling... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Federal and State Fraud and Abuse Counseling | Healthcare Practice Compliance | Medical Practice Representation | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Provider Relationship | Telehealth and Telemedicine | Telehealth and Telemedicine | White Collar Criminal Defense & Government Investigations | White Collar Defense and Government Investigation

In a recent trend, compounding pharmacies have been receiving notices of audit from the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services (“HHS”). In the notice, OIG requests that the pharmacies submit... Read More
Antitrust Review and Compliance | Articles | Federal and State Fraud and Abuse Counseling | Federal and State Fraud and Abuse Counseling | Regulatory Compliance, including FDA, DEA and HIPAA | Traditional Compounding Pharmacies (503A) | White Collar Criminal Defense & Government Investigations