In Taylor v. Comhar, Civ. 16-1218 (E.D. Pa. Aug. 30, 2021), the court dismissed a False Claims Act (FCA) action in which the government declined to intervene. The relator, a licensed professional nurse named Sarah Taylor, alleged that treatment facilities for disabled individuals fraudulently billed Medicare and Medicaid for substandard care. In dismissing the …
Fifth Circuit Reverses Lower Court Denial of Rule 41 Motion When Government Seized Attorney-Client Privileged Seized Material
In Harbor Healthcare Systems LP v. United States, No. 19-20624 (July 15, 2021), the Fifth Circuit reversed a decision by the District Court for the Southern District of Texas denying a Rule 41(g) motion for return of property. The Court held that the “district court erred in its assessment of the pre-indictment harm resulting …
COVID-19 Telehealth Fraud Indictment
Telemedicine has been growing over the last several years, and COVID-19 has accelerated that growth. Several provisions in the CARES Act relaxed telemedicine rules. In addition to the CARES Act, there have been many other legislative and policy changes on both the national and state levels. However, providers should recognize that these policy changes …
Supreme Court Clarifies the Term “Exceeds Authorized Access” Under the Computer Fraud and Abuse Act
In Van Buren v. United States, the Court held that an individual “exceeds authorized access” under the Computer Fraud and Abuse Act of 1986 (CFAA), 18 U. S. C. §1030(a)(2), when he accesses a computer with authorization but then obtains information located in areas of the computer that are off-limits to him. The Court …
Department of Justice (DOJ) Announces Task Force to Combat COVID-19 Fraud
On May 17, 2021, United States Attorney General Merrick Garland established the COVID-19 Fraud Enforcement Task Force. The Task Force will marshal the resources of the DOJ with government agencies to enhance enforcement efforts against COVID-19 fraud. https://www.justice.gov/opa/pr/attorney-general-announces-task-force-combat-covid-19-fraud. The Task Force will help the DOJ with work that is already underway by performing the …
Fifth Circuit Reverses Office Manager’s Conviction for Failure to Prove Willfulness under Healthcare Fraud and Anti-Kickback Statutes
In United States v. Nora, 18-31078 (5th Cir. Feb. 24, 2021), the Fifth Circuit reversed a conviction and 40-month sentence in a healthcare fraud case. The jury found Nora guilty of conspiracy to commit healthcare fraud, healthcare fraud, and conspiracy to violate the anti-kickback statute. Twenty-one defendants were indicted, and five individuals went to …
First Paycheck Protection Program False Claims Act Settlement
In January 2021, the Eastern District of California settled the first Paycheck Protection Program (PPP) False Claims Act (FCA) case. In the settlement agreement, SlideBelts, Inc. and its president and CEO, Brigham Taylor, agreed to pay the United States $100,000 after the company repaid a $350,000 PPP loan. The case arose from a false …
HHS-OIG Issues Special Fraud Alert Regarding Speaker Programs
In November 2020, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) published a Special Fraud Alert regarding speaker program suspect factors. SFA speaker programs_11.13 v2 (hhs.gov). In the last three years, drug and device companies have reported paying nearly $2 billion to healthcare providers for speaker-related services. Both HHS-OIG and …
How Borrowers Can Protect Themselves from Paycheck Protection Program Fraud Prosecutions
COVID-19 has had an unprecedented impact on the national economy, prompting government economic stimulus of historic proportions. The Coronavirus Aid, Relief, and Economic Security (CARES) Act provided monetary aid relief to millions of Americans and included the Paycheck Protection Program (PPP) forgivable loans. With over $600 billion pumped into the economy in 2020 and …
Motion to Dismiss Granted in False Claims Act Case Based on Public Disclosure Bar
A California federal district court granted a motion to dismiss in a False Claims Act (“FCA”) case based upon the FCA public disclosure bar. United States of America, et. al. v. Shamir USA, Inc., 2:18-cv-09426-RGK-PLA, 2020 WL 6152466. The public disclosure bar prohibits a relator from bringing a FCA case based on a fraud …