Alleged violations of the federal Anti-Kickback Statute (AKS) are more and more often at the heart of actions involving accusations of health insurance fraud brought under the False Claims Act (FCA). Consider, for example, the amended complaint that was just filed by the U.S. Justice Department to add six physicians as defendants to the original

The Justice Department recently reported obtaining more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2021. https://www.justice.gov/opa/pr/justice-department-s-false-claims-act-settlements-and-judgments-exceed-56-billion-fiscal-year. This is the largest annual total in False Claims Act (FCA) history since 2014, no doubt spurred in part by fraud related to COVID-19. This

The terrible, terrible losses associated with the opioid epidemic are almost too horrifying to describe. Statistics alone cannot explain its scope, but it is important to note that, last year alone, over 100,000 Americans died from drug overdoses across the country. Strikingly, the increase in overdose numbers during the COVID-19 pandemic took place in all

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

In March 2020, as the COVID-19 pandemic was first beginning to take hold, the New York State Department of Financial Services (DFS) issued a report on insurance fraud that highlighted the fact that suspected no-fault automobile insurance fraud accounted for 59 percent of the 25,985 insurance fraud reports that the DFS’s Insurance Frauds Bureau received

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

The report detailing new filings and recoveries under the False Claims Act (FCA) during the 2020 fiscal year that was just released by the U.S. Department of Justice (DOJ) suggests, at first glance, a diminished role for one of the federal government’s strongest anti-fraud tools. Delving more deeply into the details, however, demonstrates the continuing

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