Title VII of the Civil Rights Act of 1964 (amended by the Civil Rights Act of 1991) prohibits employee discrimination based on race, religion, color, sex, and national origin. One of the critical elements that a plaintiff must establish is whether they are an “employee” under Title VII, as the statute protects only employees. The […]Read More
In 2016, Stop Illinois Health Care Fraud, LLC, brought a case against Asif Sayeed, Physician Care Services, S.C., Vital Home & Healthcare, Inc., and Management Principles, Inc. (MPI) under the qui tam (whistleblower) provisions of the False Claims Act (FCA), predicated on alleged violations of the Anti-Kickback Statute (AKS). The case stems from the plaintiff’s […]Read More
The Anti-Kickback Statute (AKS) is a federal law that, at its core, prohibits offering, paying, soliciting, or receiving any sort of remuneration in exchange for federal healthcare program referrals. AKS violations carry with them potential criminal penalties, including up to ten years in federal prison, as well as civil and administrative consequences, including monetary penalties […]Read More
Recent Settlement Demonstrates That Cybersecurity Vulnerability May Create False Claims Acts Exposure
The federal False Claims Act (FCA) prohibits the knowing submission of a false or fraudulent claim to the federal government. Many states have their own version of the FCA, prohibiting the same conduct in relation to state programs. Although the FCA is often associated with healthcare fraud, it applies across all sectors to any company […]Read More
Medical Assistant Files Discrimination Suit Against Hospital for Numerous Alleged Employment Violations
On July 17, 2019, Bianca Boyd, a former medical assistant at Copper University Hospital in New Jersey, sued her former employer for religious bias, as well as violations of the Americans with Disabilities Act (ADA), the Family and Medical Leave Act (FMLA), the New Jersey Law Against Discrimination, and retaliation. Ms. Boyd alleges that her […]Read More
On July 17, 2019, a federal grand jury returned an indictment against Miami-Luken, Inc., a pharmaceutical distributor. The indictment has garnered attention due to the named defendants and the allegations. Besides Miami-Luken, the indictment named individually (1) Anthony Rattini, President of Miami-Luken; (2) James Barclay, Compliance Officer of Miami-Luken; (3) Devonna Miller-West, a pharmacist and […]Read More
In a July 2019 report, HHS’s Office of Inspector General (OIG) issued a report urging the Centers for Medicare and Medicaid Services (CMS) to increase its oversight of hospice providers. The OIG noted its own existing initiatives related to hospice fraud and abuse, ineligible patient enrollment, altered patient medical records, falsified documentation, and improper billing. […]Read More
On July 16, 2019, the Financial Crimes Enforcement Network (FinCEN), a U.S. Department of Treasury agency, issued an advisory about business email compromise (BEC) fraud. While FinCEN’s mission involves monitoring and safeguarding the U.S. financial system, FinCen also identifies criminal trends affecting all industries, such as the surge of BEC schemes. BEC scams involve malware, […]Read More
Data Breach exposes information of at least 20 million patients prompting multiple U.S. Senate inquiries, numerous class-action lawsuits, and bankruptcy.
On June 3, 2019, Quest Diagnostics Incorporated (Quest) and Opko Health notified the U.S. Securities and Exchange Commission of a data breach affecting a third-party vendor website. The vendor was Retrieval-Masters Creditors Bureau, Inc. d/b/a American Medical Collection Agency (AMCA), which provided billing collections services. AMCA notified various entities of “potential unauthorized activity on AMCA’s […]Read More
Agreement to Pay the Government $6 Million Highlights Coexisting Criminal and Civil Exposure in False Claims Act and Anti-Kickback Matters.
Last month, Mr. Roderic Bain, the owner of over a dozen durable medical equipment companies, was sentenced to 40 months in federal prison and ordered to pay over $1.9 million in fines for submitting over $10 million in claims to Medicare for medically unnecessary durable medical equipment, such as back and knee braces. According to […]Read More