Federal Government’s Increasing Focus on Healthcare Providers Who Receive Private Funds

By Sarah Wirskye - On

There is a common misconception that if a healthcare provider only accepts private funds, they are immune from federal prosecution. While there is no denying that a provider who receives substantial reimbursement from federal payors is more likely to find him/herself under federal scrutiny, there has been increasing focus on providers who received little …

Don’t Commit Fraud in Texas!

By Sarah Wirskye - On

In January 2020, the United States Sentencing Commission (USSC) released the Inter-District Differences in Federal Sentencing Patterns, which examines sentencing practices across districts in the post-Booker era, between 2005 and 2017. The report can be found at https://www.ussc.gov/sites/default/files/pdf/research-and-publications/research-publications/2020/20200122_Inter-District-Report.pdf. The USSC’s analysis found that consistent with the Commission’s 2012 Booker Report, sentencing outcomes continue to …

Department of Justice Files PPP Fraud Case in Texas

By Sarah Wirskye - On

The government is continuing to investigate individuals who submitted fraudulent applications for funds under the Paycheck Protection Program (PPP) of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.  The Eastern District of Texas recently charged Samuel Yates (Yates) with wire fraud, bank fraud, making false statements to a financial institution, and making false …

DOJ Files First Paycheck Protection Program Criminal Case

By Sarah Wirskye - On

The Department of Justice (DOJ) has already begun investigating companies who applied for loans under the Paycheck Protection Program (PPP) under the CARES Act. Assistant Attorney General Brian Benczkowski recently announced that the DOJ would file criminal charges against those who provided misleading information to obtain government funds under the CARES Act. Individuals charged …

Coronavirus Fraud Investigations

By Sarah Wirskye - On

There has been a slew of legislation and government payments related to COVID-19. Consequently, there are sure to be many investigations regarding alleged fraudulent activity and we are already seeing some of them. These prosecutions will likely fall in the following four primary areas: (1) healthcare fraud and kickbacks; (2) government contractor fraud; (3) …

CMS Issues Coronavirus Guidance for Healthcare Providers

By Sarah Wirskye - On

The Centers for Medicare and Medicaid Services (CMS) issued guidance for certain healthcare providers regarding coronavirus. The healthcare providers include nursing homes, home health agencies, dialysis facilities, hospices, hospitals and others. The guidance varies by specific area, but generally focuses on limiting transmission based on restricting visitation, social distancing, sanitization and monitoring. The hospital …

Department of Justice Provides Keynote Remarks on False Claims Act

By Sarah Wirskye - On

On January 27, 2020 Deputy Associate Attorney General Stephen Cox provided keynote remarks at the 2020 Advanced Forum on False Claims and Qui Tam Enforcement. He began by discussing enforcement and recent cases, emphasizing that enforcing the False Claims Act (FCA) is a top priority for the Department of Justice (DOJ). In the past …

Insys Therapeutics Defendants Sentenced

By Sarah Wirskye - On

In May 2019, a Boston jury convicted five Insys Therapeutics executives on federal racketeering charges for bribing doctors to prescribe opioid painkillers to patients who did not need them and defrauding Medicare, private insurance and patients, under conspiracy to commit mail fraud, wire fraud and anti-kickback statutes. However, there have been some recent, favorable …

Mixed Verdict in Compounding Pharmacy Case

By Sarah Wirskye - On

After a six-week trial, a federal, Dallas jury returned a mixed verdict in a trial involving a compounding pharmacy which allegedly made kickback payments to doctors and others. Overall, the verdict was a victory for a defense with only one trial defendant being convicted on any charges. The Allegations Defendants were charged with conspiracy …