Litigation

The U.S. Department of Justice recently announced a settlement with Patients Choice Laboratories (“PCL”), a diagnostic laboratory headquartered in Indianapolis, Indiana, under which PCL will pay over $9.6 million to resolve allegations that it violated the federal False Claims Act (FCA) and Anti-Kickback Statute (AKS). The government alleged that the lab knowingly submitted claims to…

Westside Behavioral Care Inc., a Colorado mental health clinic, recently sued Kaiser Foundation Health Plan of Colorado for prematurely terminating its participation agreement. Kaiser terminated the agreement in an effort to increase the provision of services through a less costly telehealth model.

The clinic is alleging that the early termination disrupted care for more than…

The 2025 National Health Care Fraud Takedown, announced in June, was the largest in history, with 325 defendants charged (including 96 providers) in 50 federal districts. In all, the charged schemes involved more than $14 billion in intended loss, and more than $245 million in cash, luxury vehicles, cryptocurrency and other assets were seized. These…

Ransomware cyber attacks have been a prominent threat to the healthcare industry. In this case, First Choice Dental, a large dental practice with multiple locations across Wisconsin, was targeted by hackers in October 2023. The hackers gained access to sensitive information including patient names, dates of birth, Social Security numbers, passport numbers, driver’s license numbers…

In October, two medical transportation companies were charged with or indicted for fraud in New York.   

The owner of Pearl Transit Corp. (“Pearl”), Jael Watts, was accused of running a sham transportation service that supposedly provided rides for persons with disabilities and seniors in Westchester, Putnam, Rockland, and Suffolk counties. In 2024, the…

Sligo Creek Center, a Maryland nursing home, recently appealed the constitutionality of the Centers for Medicare & Medicaid (CMS) enforcing a $1.5 million fine without a jury trial. The fine related to the facility’s failure to establish and maintain an infection control program. The appeal, currently pending in the Fourth Circuit of the…

The New York Office of the Medicaid Inspector General (OMIG) publishes audit protocols to “assist the Medicaid provider community in developing programs to evaluate compliance with Medicaid requirements under federal and state statutory and regulatory law.”1 Such protocols are “applied to a specific provider type or category of service in the course of an…

A company that runs five nursing homes in Delaware recently agreed to pay a $182,000 fine to settle an investigation for alleged HIPAA violations. The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) investigated the company, referred to collectively as the Cadia Healthcare Facilities, after it received a complaint that the…

The U.S. Attorney’s Office for the Southern District of New York announced on August 21 that Niranjan Mittal, a Brooklyn-based cardiologist, was sentenced to 37 months in federal prison. Mittal pleaded guilty to violating the federal Anti-Kickback Statute (AKS) in connection with a fraudulent scheme that lasted roughly seven years and resulted in over $40…