As physician practices are in the midst of calculating and distributing 2022 year-end bonuses to physician employees and profits to owners, practices providing Designated Health Services ("DHS"), such as laboratory testing, diagnostic radiology... Read More
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
As a result of the increased marketing by payors of over-the-counter (“OTC”) cards to plan members, pharmacists are being placed in jeopardy by patients who do not know, or appreciate, the legal complexities around proper use of these cards. The... Read More
On September 23, 2022, the Fourth Circuit issued a per curiam opinion upholding the dismissal of a 2014 qui tam suit against Forest Laboratories, LLC while vacating both the district court and subsequent Fourth Circuit panel opinions. Although the... Read More
Earlier this month, the DOJ announced that a pharmacy owner pleaded guilty to conspiracy to commit health care fraud for his involvement in an $8.3 million scheme. The individual was an owner of three pharmacies that paid kickbacks to telemarketers... 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
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
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
The government increasingly has its sights set on various healthcare frauds that result in major financial losses to its healthcare programs such as Medicare, Medicaid, and TRICARE. Recently, the expanded enforcement efforts have included the foot... Read More
On April 20, 2022, the Department of Justice (DOJ) announced criminal charges against twenty-one (21) defendants in nine federal courts across the country for their roles in Coronavirus-related healthcare fraud schemes that resulted in more than... Read More
