There has been a significant increase in investigations and cases involving skin substitutes utilized in wound care. As it frequently does, the Government is focusing on these high reimbursement products. These cases and requests have been administrative, civil, and criminal matters. Based on current investigative activity, additional cases will surely follow. Administrative Cases and …

President-elect Trump has repeatedly stated that he will increase tariffs. While it is unclear to what extent, while campaigning he proposed a 10% to 20% tariff on all imports and an additional 60% or more on goods from China. (https://www.msn.com/en-us/money/markets/trade-sector-eyes-a-new-wave-of-tariffs-under-trump/ar-AA1tDjhv?ocid=BingNewsSerp). More recently he said he would impose a 25% tariff on all goods from …

On August 1, 2024, the Department of Justice launched their Corporate Whistleblower Awards Pilot Program (Program) to find and prosecute corporate crime. A whistleblower who provides the Criminal Division with original and truthful information about corporate misconduct that results in forfeiture may be eligible for an award under the Program. The information must relate …

On April 17, 2024, the bipartisan United States Sentencing Commission voted unanimously to prohibit conduct for which a defendant was acquitted in federal court from being used to calculate a sentence range under the United States Sentencing Guidelines (USSG).  The Commission also passed additional reforms, including those that bring uniformity to sentencing for certain …

The United States Sentencing Commission is making sentencing data available through the Judiciary Sentencing Information (JSIN) platform. The JSIN platform is an online sentencing data resource specifically developed with the needs of judges in mind. The platform provides online access to sentencing data for arguably similarly situated defendants. Judiciary Sentencing Information | United States …

In October 2023, the HHS-OIG issued its annual report on the Health Care Fraud and Abuse Control Program for fiscal year 2022 (Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022 (hhs.gov). This comprehensive document delves into Program and Department of Justice (DOJ) activities, providing summaries of significant healthcare fraud …

In Dubin v. United States, the Supreme Court unanimously held that Dubin did not violate 18 U.S.C.A. § 1028A, when he submitted a fraudulent claim to Medicaid using a patient’s name. In holding such, the Court stated that “Section 1028A(a)(1) is violated when the defendant’s misuse of another person’s means of identification is at …

In U.S. ex rel. Shannon Martin, et al. v. Darren Hathaway, et al., No. 22-1463 (6th Cir. March 28, 2023) the court affirmed dismissal of a False Claims Act (FCA) complaint, based on its interpretation of causation and remuneration under the FCA, 31 U.S.C. §§3729-3733 and Anti-Kickback Statute (AKS), 42 U.S.C. §1320a-7b(b). The court held …

Settlements and judgments under the False Claims Act (FCA) exceeded $2.2 billion in the fiscal year ending Sept. 30, 2022. Of the approximately $2.2 billion, over $1.7 billion involved the health care industry. This included recoveries from drug and medical device manufacturers, durable medical equipment, home health and managed care providers, hospitals, pharmacies, hospice …

In December 2022, Attorney General Merrick Garland issued a new Department of Justice (DOJ) charging, pleas, and sentencing policy memorandum (Policy). While the memorandum affirms the previous DOJ guidance in the Principles of Federal Prosecution (Principles), the new Policy provides for additional prosecutorial discretion in charging, plea agreements and the sentencing process. Charging Decisions …