The Health Law Firm

APRIL 22, 2013

She made more than $400,000 in false claims between January 2008 and June 2011. Edna Lorraine Watkins, the owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has been sentenced to six years in prison for defrauding Medicaid, according to the Florida Office of the Attorney General (AG). Watkins was sentenced on April 2, 2013.

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Health Law Advisor

FEBRUARY 3, 2022

FY 2021 was also a record-shattering year for DOJ as it relates to health care fraud enforcement; over $5 billion (90% of the total) was obtained from cases pursued against individuals and entities in the health care and life sciences industries. With collections amounting to $5.6 billion received in FY 2020.

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Fraud COVID-19 Governance Medicare 52

The Health Law Firm

APRIL 20, 2016

The verdict comes from a complex scheme in which referring physicians received substantial kickbacks for services over a three-year period from 2008 to 2011. Details of the Complex Fraud Scheme. Indest III, J.D., Board Certified by The Florida Bar in Health Law On April 14, 2016, a jury in California awarded Aetna Inc. more than $37.4

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The Health Law Firm

AUGUST 31, 2016

After the 2008 financial crisis, the US Congress passed the Dodd-Frank Wall Street Reform and Protection (Dodd-Frank) Act to combat financial fraud in our capital markets. The health insurance company paid the penalty without admitting or denying the SEC’s allegations. The Dodd-Frank Whistleblower Program. 111-203, 124 Stat.

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Healthcare Law Blog

DECEMBER 12, 2022

Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. Although the PHE and its telehealth flexibilities currently remain in effect, the DOJ has started to investigate allegations of fraud and violations of the Controlled Substances Act.

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COVID-19 Fraud Telemedicine Public Health 52

HIPAA Journal

MARCH 20, 2025

OCR Settlements and Fines Over the Years Further information on HIPAA fines and settlements can be viewed on our HIPAA violation fines page, which details all HIPAA violation fines imposed by OCR since 2008. 35,000 Settlement 2009 CVS Pharmacy Inc.

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HIPAA Ransomware Compliance Hospitals 111

Health Care Law Brief

FEBRUARY 7, 2022

It is unclear, however, whether this new regulatory framework will ultimately benefit requestors. at 1368 (emphasis added). However, OIG’s sentiment may presume too much. First, OIG appears to presuppose that any conduct under investigation by DOJ—by virtue of it being under investigation—is problematic.

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Health Care Law Brief

APRIL 11, 2022

For example, in October, 2008 , the OIG allowed a non-profit organization that provides outpatient treatment services for patients with psychoactive substance abuse dependence to offer incentives in the form of $5–$10 gift cards to motivate those patients to adhere to their treatment plans, which include urine drug screening and counseling sessions.

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AIHC

NOVEMBER 29, 2023

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. Those providers who were not prepared to manage the new reimbursement often resorted to “enhancing” revenue through “creative” means.

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AIHC

NOVEMBER 29, 2023

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. Those providers who were not prepared to manage the new reimbursement often resorted to “enhancing” revenue through “creative” means.

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Healthcare IT Today

JUNE 29, 2023

Medicare Payment Resources CMS implemented an Ambulatory Payment Classification-based payment methodology in 2008. They follow Medicare reimbursement policies, coding and documentation guidelines, HIPAA compliance, fraud, and abuse prevention, prior authorization, and state-specific regulations.

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Compliance Medicare Medicare Medical Billing 52

Hall Render

NOVEMBER 25, 2024

Previously, OIG released voluntary compliance program guidance (“CPG”) for nursing facilities in 2000 and supplemented the CPG in 2008. The CPG was designed to encourage nursing facilities to develop and implement internal monitoring controls to assure adherence to applicable statutes, regulations and compliance program requirements.

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Nurses Compliance Compliance Officers Medicare 40

Health Law Advisor

MARCH 7, 2023

Background on the Ryan Haight Act The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (the “Ryan Haight Act”) made certain amendments to the CSA which established controls on the remote prescribing of controlled substances. 18 U.S.C. § Will DEA suggest through its guidance any guardrails for the industry to consider?

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Telemedicine COVID-19 FDA Compliance 52

Health Law Advisor

FEBRUARY 10, 2023

Lowest Total Recoveries Since 2008 Record-Shattering Number of New Cases Filed Health Care and Life Sciences Cases Continue to Dominate On February 7, 2023, the U.S. The total recoveries in fraud cases brought with respect to the health care and life sciences industries fell to the lowest level since 2009. Last year, $1.2

Fraud 52

Fraud COVID-19 Governance Medicaid 52

Health Law Advisor

MARCH 1, 2023

Last July, the Department of Health and Human Services’ Office of Inspector General (“OIG”) published a Special Fraud Alert detailing high-risk activities conducted by telehealth providers and has, to date, indicted 31 telehealth providers alleging various health care fraud and abuse schemes.

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Telemedicine COVID-19 Fraud Licensing 52

Hall Render

JUNE 30, 2023

NATIONAL 3 big noncompete ban wins for physicians 5 systems join $50M poverty and cancer program AHA advises Congress how to advance MACRA payment models Amazon delays virtual care service’s unveiling after senators raised privacy concerns At AHA Hill briefing, hospital leaders say site-neutral payment cuts jeopardize access to care for patients and (..)

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Drug & Device Law

MARCH 15, 2024

312, 318 (2008)). Turning to the last count of the amended complaint, the Court dismissed the plaintiff’s false representation claims under the good, old fashioned Rule 9(b) fraud analysis. at *3 (citing Riegel v. Medtronic, Inc. , The Court got it right again, and its straightforward application of established law is refreshing.

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Drug & Device Law

DECEMBER 21, 2023

The logic of the consumer fraud claim made no sense. Letting plaintiffs use RICO (or the False Claims Act) to bring fraud on the FDA claims (preemption only applies to state law) is a distinct minority position, but the Ninth Circuit has. Remember Riegel ( 2008+1 )? The penalty did not hold up, but the duty did.

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Drug & Device Law

DECEMBER 4, 2023

Basically, CPAP II purported to do precisely what Buckman itself prohibited: using express preemption to limit the “ordinary working” of implied preemption of fraud on the FDA claims. 2008) (applying the rule; rejecting distinction that “this is a ‘no warning’ case as opposed to an inadequate warning case”), aff’d , 321 F. Sinclair v.

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Drug & Device Law

SEPTEMBER 18, 2023

312 (2008). So, if a plaintiff contends that a defendant abused the ASR program, that is a Buckman -preempted fraud on the FDA claim. Conversely, violation claims involving the ASR program are paradigmatic examples of agency fraud/private FDCA enforcement that are impliedly preempted by Buckman. 2d 381 (Pa. Medtronic, Inc. ,

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Drug & Device Law

JULY 18, 2023

312 (2008). But calling it design defect based on a failure to disclose doesn’t change the fact that this is really a fraud-on-the-FDA claim which is impliedly preempted by Buckman. That claim is expressly preempted by Riegel v. Medtronic, Inc. ,

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Drug & Device Law

MAY 4, 2023

The intersection between these statutes, or the more complete “FDA defense” provisions in Michigan and Texas, and Buckman ’s prohibition on fraud-on-the-FDA claims has been the subject of variable treatment from courts. 440 (2008), in the face of a contrary ruling from the Sixth Circuit in Garcia v. Warner-Lambert & Co. ,

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Drug & Device Law

JANUARY 30, 2023

440 (2008) Buckman was not cited at all in the Merck Sharp & Dohme Corp. 470 (1996), was decided – removing express preemption as a defense for manufacturers of §510(k) products So defendants moved on fraud on the FDA under an implied preemption theory and won. Plaintiffs Legal Committee , 531 U.S. Kent , 552 U.S. Albrecht , 139 S.

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FDA Fraud Governance Medicare 72

Drug & Device Law

DECEMBER 30, 2022

312 (2008)—that plaintiffs could assert “parallel claims” that were neither expressly preempted by the provisions of the MDA nor impliedly preempted under Buckman. An unfortunate fiction developed post- Buckman —particularly after Riegel v. Medtronic, Inc.

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Drug & Device Law

OCTOBER 10, 2022

3 (2008), the court explained that “the word ‘includes,’ when used in a statute, ‘is usually a term of enlargement, and not of limitation.’” Pfizer, Inc. , 2022) (presuming that commission based compensation violates the AKS, while affirming dismissal for failure to plead fraud with the requisite particularity); United States v.

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Medicare Medicare FDA Prescription Drug Pricing 52

Drug & Device Law

MAY 5, 2022

Stated differently, the rebuttal provision makes allegations and evidence of fraud on the FDA a prerequisite to state-law liability. But state-law claims that rest on alleged fraud on the FDA are contrary to Buckman Co. 440 (2008)). Plaintiffs’ Legal Committee , 531 U.S. 21 U.S.C. § McNeil Consumer & Specialty Pharms.,

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