Your prescribed dose of health law news
The U.S. Court of Appeals for the Seventh Circuit recently rejected an effort by the federal government to extend the federal Anti-Kickback Statute (AKS) to a marketing company in the absence of influence by the company over decision makers.
Mark Sorensen, the owner of SyMed Inc., a durable medical equipment (DME) distributor, had been convicted…
On May 1, a whistleblower filed a complaint under the federal False Claims Act (FCA) against Aetna, Elevance Health (formerly Anthem) and Humana alleging that the insurers paid hundreds of millions of dollars in illegal kickbacks to induce brokers including GoHealth, eHealth and SelectQuote (the “Brokers”) to steer beneficiaries to their Medicare Advantage plans. While…
The U.S. Attorney’s Office for the Eastern District of Pennsylvania announced on April 23 that Genexe, LLC (doing business as Genexe Health) and its parent company, Immerge, Inc., along with two of their executive officers/owners, Jason Green and Jason Gross, collectively agreed to pay $6 million to settle claims that they violated the False Claims…
A Florida jury recently found two laboratory co-owners of Innovative Genomics LLC (“IGX”) not guilty in connection with an allegedly fraudulent COVID-19 testing scheme.
The Government alleged that from November 2019 through June 2023, the co-owners conspired to defraud Medicare and the Health Resources and Services Administration COVID-19 Uninsured Program by billing healthcare benefit plans…
An article in the March 10 issue of Part B News, “In trend, court limits drug rebate AKS charges to easier ‘but-for’ standard,” discussed a recent ruling on the False Claims Act (FCA) implications of the federal Anti-Kickback Statute (AKS). Rivkin Radler’s Jeff Kaiser was quoted in the article.
“Every time a…
Conspiracies to rip off the Medicare system are prevalent due to the vast amounts of money flowing through the program. On February 25, Sherif Khalil of Redondo Beach, California man was convicted by a federal jury in Detroit for stealing $4 million from the Medicare program.
Khalil conspired with others to generate orders for medically…
In recent months, Executive Orders issued by the current Administration regarding gender-affirming care of minors have been the subject of much debate and litigation. The crux of these lawsuits is largely two Executive Orders: Executive Order 14187 (Protecting Children From Chemical and Surgical Mutilation) and Executive Order 14168 (Defending Women From Gender Ideology Extremism and…
Healthcare fraud is prevalent within state Medicaid programs due to the massive amounts of money flowing through the system. In Louisiana, the Estate of Yolanda Burnom and her former company, Community Healthcare Solutions, LLC, recently agreed to pay $4.6 million to settle a False Claims Act lawsuit.
The allegations included providing incentives to Medicaid beneficiaries…
The U.S. Department of Justice (DOJ) announced on February 18 that Health Net Federal Services, LLC and its corporate parent, Centene Corporation, agreed to pay $11,253,400 to resolve False Claims Act (FCA) claims. Health Net, a federal contractor responsible for administering TRICARE, allegedly falsely certified compliance with cybersecurity requirements in its contract with the U.S.
DMERx, an online DME platform, served as the basis for a massive fraud against Medicare and other insurers. Gregory Schreck, a Kansas man who was the vice president of DMERx, orchestrated a sophisticated fraud scheme to bill Medicare and other insurers over $1 billion, resulting in payments of over $350 million. The scheme used DMERx’s…
