Litigation

Rivkin Radler’s Michael Sirignano authored a recent article for the New York Law Journal entitled “The Anti-Kickback Statute’s Role in Health Insurance Fraud Cases.” The article discussed recent lawsuits against physicians, laboratories, hospitals, and a large pharmaceutical company, McKesson Corporation, under the False Claims Act and federal Anti-Kickback Statute.

On May 27, the U.S. District Court for the Northern District of California refused to dismiss a lawsuit[1] brought against Envision Healthcare Corp. alleging violations of California’s corporate practice of medicine (CPOM) prohibition, as well as state fee-splitting and kickback prohibitions. The action was brought by the American Academy of Emergency Medicine Physician Group…

A New York woman was sentenced last month to 78 months in prison for defrauding healthcare programs, including obtaining more than $6.5 million from Medicare Part D plans and Medicaid drug plans.

Queens resident Aleah Mohammed owned five pharmacies, four of which operated under variations of the name “Superdrugs.” Between 2015 and 2020, the pharmacies…

On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal programs and thefts from federally funded pandemic assistance programs.

Some of the defendants, in California, New York and Maryland, allegedly obtained…

The U.S. Department of Justice (DOJ) recently intervened in an action filed in Texas against two laboratory CEOs, one hospital CEO, and numerous other executives, employees, and recruiters, seeking civil penalties and treble damages for violations of the False Claims Act. The DOJ’s complaint, which was unsealed on April 4, also alleges that the fraudulent…

This is outside our usual catchment area, but interesting nonetheless. The Indiana Supreme Court ruled on March 8 that the state’s Medical Malpractice Act (MMA) does not apply to claims for indemnification filed by one medical provider against another. The decision allows a contract claim by a hospital system against an outside radiology group to…

Rivkin Radler’s Eric Strober will be a panelist at the CLM Focus conference, taking place June 15-16 in Nashville, TN. His program, entitled “Medical Malpractice: Unique Issues in the Defense of Non-MD Healthcare Providers in the Homecare Setting,” will cover the various kinds of claims that are made against non-doctor professionals in the home care…

The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures over seven years, and for fraudulently obtaining two business loans under the CARES Act’s Paycheck Protection Program (PPP) in the early…