Major healthcare and hospital systems are the latest victims in the growing trend amongst insurers and payors who are refusing to reimburse health care providers for their services. Most recently, Valley Health System (“Valley”) filed suit... Read More
Recently, the State of New Jersey, Office of the Attorney General, Division of Consumer Affairs (“DCA”) has issued a “SCAM ALERT” with the following, warning all licensed professionals that: “Individuals impersonating New Jersey Division... Read More
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
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
In May, we warned former members of Affiliated Physicians and Employers Master Trust d/b/a Members Health Plan NJ (“APEMT Trust” or the “Trust”) that the Trust was preparing to sue them for outstanding assessments allegedly owed, plus a... Read More
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
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
Earlier this week, the U.S. Supreme Court ruled that to secure convictions under the federal Controlled Substances Act (“CSA”) for excessive prescribing of controlled substances, including opioids, prosecutors must prove beyond a reasonable... Read More
Two practices in Connecticut recently settled large six-figure lawsuits with federal and state agencies resolving allegations of improperly employing an individual who was excluded from all federal healthcare programs. In both instances, the... Read More
Last week, the United States Department of Justice (“DOJ”) announced that a Georgia marketer pled guilty for his role in a conspiracy to violate the Federal Anti-Kickback Statute and commit health care fraud. The marketer was charged with taking... Read More
