The year 2021 will be remembered for many things, of course including that, as of this writing, a total of more than 800,000 Americans have died from COVID-19 since the beginning of the pandemic. For lawyers who represent insurance companies in cases seeking to challenge fraudulent claims and other types of insurance fraud, as well

In mid-May, U.S. Attorney General Merrick Garland established the COVID-19 Fraud Enforcement Task Force. Attorney General Garland directed the task force to use the resources of the U.S. Department of Justice in partnership with agencies across government to enhance enforcement efforts against fraud related to the COVID-19 pandemic. Even by that time – more than

As the COVID-19 pandemic was taking hold last April, the Manhattan U.S. Attorney filed a lawsuit against FPR Specialty Pharmacy LLC and Mead Square Pharmacy, Inc., and their owners, Christopher Casey and William Rue, alleging that they had submitted fraudulent claims for reimbursement to federal healthcare programs for compounded prescription drugs in violation of the

Nearly a decade ago, in October 2011, Preet Bharara, then serving as U.S. Attorney for the Southern District of New York, announced pension disability fraud charges against a number of individuals associated with the Long Island Railroad (LIRR). The complaint estimated a potential loss to the Railroad Retirement Board of more than $1 billion in

Fifteen years ago, the New York Court of Appeals ruled that a violation of a licensing requirement by a medical provider rendered the provider ineligible to be reimbursed by an insurance company for no-fault claims that had been assigned to the provider by an individual allegedly involved in an automobile accident. The court recognized that one

The Fifth Amendment “not only protects the individual against being involuntarily called as a witness against himself in a criminal prosecution but also privileges him not to answer official questions put to him in any other proceeding, civil or criminal, formal or informal, where the answers might incriminate him in future criminal proceedings.” Lefkowitz v. Turley,

A case that has been appealed to the U.S. Court of Appeals for the Second Circuit, and one that has just been argued in that court, have the potential to significantly affect the ability of insurance companies to fight no-fault insurance fraud in New York.

The defendants in Government Employees Ins. Co. v. Wellmart RX,

Insurance fraud is not only a New York problem, or even solely a northeast concern. Insurance fraud is prevalent across the country. In particular, no-fault insurance fraud can be found in every state with a significant no-fault insurance program.

State legislatures have adopted a wide variety of statutes in an effort to protect consumers and

On Monday, April 1, 2019, Gov. Andrew Cuomo and the New York Legislature agreed to broad reform in the criminal justice system that will take effect on January 1, 2020. These new criminal procedure laws will completely change how individuals accused of committing crimes (referred to below as “the accused”) are treated during a criminal

Determining the appropriate standard of judicial review is the threshold issue a court decides when reviewing an adverse benefit determination under the Employee Retirement Income Security Act of 1974 (ERISA). If the court applies the arbitrary and capricious standard of review, it gives deference to the administrator’s determination. By contrast, if it reviews the determination