Fraud and Abuse

In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar and John Queenan will discuss the seventh required elements of an Effective Compliance Program: Responding to Compliance Issues.

Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar and Health Services practice groups. John is a

On May 2, the U.S. Attorney’s Office for the Eastern District of Pennsylvania announced that the United States has filed a complaint under the False Claims Act (FCA) against James McGuckin, an interventional radiologist. The complaint alleges that McGuckin and his affiliated entities billed Medicare and the Federal Employees Health Benefits Program for more than

The U.S Attorney’s Office for the District of Connecticut announced on May 9 that Yale New Haven Health Services Corp. and Northeast Medical Group, Inc. have paid $560,718.48 to resolve federal and state False Claims Act (FCA) allegations. The hospital system allegedly submitted claims to Medicare and Medicaid for services provided by mid-level providers

In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar and Mary Aperance will discuss the fifth and sixth required elements of an Effective Compliance Program. They will discuss:

  • Disciplinary Standards
  • Auditing and Monitoring

Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar and Health

Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding New Jersey state and local health benefits programs and other insurers. Sher and a co-conspirator recruited state

Transportation fraud isn’t new, but it’s new to Rivkin Rounds. The U.S. Attorney’s Office for the Southern District of New York recently announced that Yonkers resident Julio Alvarado was sentenced to 95 months in prison for leading a scheme that billed Medicaid for fraudulent transportation claims. From 2017 to 2020, KJ Transportation C Services Inc.

To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence Alexander, were sentenced to prison for their roles in a Medicare fraud scheme. Zusmer, a chiropractor, and Alexander, an orthopedic surgeon

The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16 million in cash and other proceeds from the schemes, which resulted in more than $490 million in false

On the heels of New York’s Office of the Medicaid Inspector General (OMIG) releasing updated compliance requirements, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) announced today that it will also be updating and modifying its voluntary compliance guidance documents.

The OIG’s stated purpose for the modifications is to improve