DOJ just won another victory in the long-running Omnicare case. Back in April, the jury found that Omnicare had submitted 3.3 million false claims and was liable for damages of over $135 million. The Judge trebled that damages number, as required by the False Claims Act, reaching a final damages amount of over $406 million, […]
Genetic testing fraud enforcement has dramatically increased in recent years, and that trend continues this week with yet another suit. Recurring schemes in this space include billing Medicare for a test or screening that was 1. not medically necessary, 2. not ordered by the treating physician, and/or 3. tainted by a kickback. Medicare will cover […]
Today, the Department of Justice announced a new Antitrust Whistleblower program for antitrust violations that include actions affecting the Postal Service. Years in the making, this Program fills a significant gap in existing whistleblower programs by providing a means for individuals to report price-fixing, bid-rigging, and other antitrust conspiracies. Antitrust violations harm consumers and the […]
Last week, OFAC announced a whopping $215,988,868 penalty against a San Francisco venture capital firm for sanctions violations and for failing to comply with an OFAC subpoena. That number represents the maximum applicable civil monetary penalty. According to the agency’s press release, the firm, GVA Capital Ltd., knowingly continued to manage an investment for Russian […]
CVS, the largest pharmacy chain in the USA, has been accused of fraud against the Medicaid Programs of nearly 30 States. The allegations stem from a set of laws known as the “Usual and Customary” (“U&C”) requirements. U&C laws generally require pharmacies to disclose how much various customers are paying for drugs. The goal of […]
This is my first Mother’s Day after my mother’s death in December. Before she died, she suffered for years from Alzheimer’s, a disease that came on slowly then quickly, transforming my warm, quick-witted mother from the beating heart of any gathering to a withdrawn and occasionally angry presence. She eventually came to require a level […]
Since its launch in 1998, the Medicare Advantage (MA) program has grown rapidly, now enrolling more beneficiaries than traditional Medicare. Unlike traditional Medicare—which generally reimburses providers on a fee-for-service basis (meaning, for the services they perform)—Medicare Advantage operates through a managed care model, with private insurers receiving capitated payments based on the demographics and health […]
In early April 2025, the Department of Justice filed a lawsuit against one of the nation’s largest wound care providers, Vohra, and its majority owner. Vohra contracts with hundreds of nursing homes and other long-term care providers to come in and provide wound care for patients in those facilities. This case is the latest datapoint […]
With dramatic steps to reshape federal agencies underway, the Department of Health and Human Services (HHS) is now at the center of a contentious overhaul. U.S. Secretary of HHS Robert F. Kennedy Jr. just announced sweeping cuts to HHS, including slashing a quarter of its ~91,000 person workforce and consolidating its 28 divisions into just […]
Proposed legislation in California to allow whistleblowers to report state tax law violations advanced through the state senate on Tuesday, as supporters refuted claims from business groups that it would lead to abusive lawsuits and that tax fraud should be exempt from scrutiny. The bill passed the California Senate Judiciary Committee by a 10-2 vote, […]
