Litigation

The U.S. Department of Justice (DOJ) announced on October 18 that Oklahoma-based Carter Healthcare LLC and its affiliates, plus two executives, agreed to pay a total of over $30 million to resolve two separate qui tam cases. One lawsuit claimed that Carter paid remuneration to physicians in Oklahoma and Texas to induce referrals of Medicare…

The U.S. Attorney for the District of New Jersey and New York Attorney General Letitia James both announced on October 6 that pediatric dentist Barry L. Jacobson, his management company, and 13 affiliated pediatric dentistry practices agreed to pay $753,457 to resolve allegations of False Claims Act violations. Between 2011 and 2018, Jacobson and other…

On October 7, the U.S. Attorney’s Office for the District of New Jersey announced that a former physician pleaded guilty to conspiring to wrongfully disclose patients’ protected health information to a pharmaceutical sales representative. Frank Alario, who had had numerous offices in New Jersey, Manhattan and Florida, admitted to criminal HIPAA violations in connection with…

On September 15, Deputy Attorney General (“DAG”) Lisa Monaco delivered remarks announcing updated guidance on how the Department of Justice will be prioritizing and prosecuting corporate crime.  Her remarks were accompanied by a formal memo, titled “Further Revisions to Corporate Criminal Enforcement Policies Following Discussions with Corporate Crime Advisory Group” (https://www.justice.gov/opa/speech/file/1535301/download).  However inelegant…

Rivkin Radler’s Jeff Kaiser will be a panelist at the Upstate New York Health Care Fraud Symposium hosted by the United States Attorney’s Office for the Northern District of New York. Jeff’s panel is entitled “Use of the False Claims Act in Health Care Fraud Investigations and Litigation.”

The symposium will take place on Friday,…

Dental Care Alliance, LLC (DCA) agreed to settle a class action lawsuit that arose out of a 2020 cyberattack. A hearing to approve the $3 million settlement was held on September 1.

DCA, based in Sarasota, Fla., is a dental services organization that provides practice support to over 390 affiliated dental practices across the U.S.…

On August 23, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that Massachusetts-based New England Dermatology, P.C., d/b/a New England Dermatology and Laser Center (NEDLC), agreed to resolve alleged HIPAA violations for a fine of $300,640.

OCR commenced an investigation of NEDLC after the provider filed a breach report…

Rivkin Radler’s Michael Sirignano authored an article for the September 2 issue of the New York Law Journal entitled “As Telemedicine Expands, Insurance Fraud Grows.” The article discussed recent enforcement actions by the U.S. Department of Justice and the recent Special Fraud Alert issued by the U.S. Department of Health and Human Services’…

If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually provided is always a bad idea.

On August 4, the U.S. Department of Justice (DOJ) announced that Ariel Madero…

On August 15, the U.S. Department of Justice (DOJ) announced that a Long Island chiropractor pleaded guilty to healthcare fraud for billing a private insurance company over $1 million for acupuncture services that were never performed. The investigation of Peter Adamczak was a joint effort by DOJ, the New York State Inspector General, and the…