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Health care fraud and False Claims Act cases continue to generate a significant source of funds for the Federal Government. Although, when announcing its focus, the government listed treatment options are not always clear. What these settlements often have in common is that the underlying complaints allege that the services that were rendered and reimbursed lacked medical necessity.
Health care fraud and False Claims Act cases continue to generate a significant source of funds for the Federal Government. During Fiscal Year 2017, the Federal Government won or settled over $2.4 billion in health care fraud judgments and settlements, most of which went into the Medicare Trust or Treasury.
“Spoofing” as Fraud: A Novel and Untested Theory of Prosecution
By Jodi Misher Peikin and Justin Roller
The DOJ has signaled its intent to pursue prosecutions for spoofing — which the law defines as “bidding or offering with the intent to cancel the bid or offer before execution” — aggressively. This article begins with a brief discussion of the elements that the government must prove to establish commodities fraud and wire fraud. It then examines recent spoofing prosecutions that raise important questions about the applicability of the traditional fraud statutes to spoofing-related activity. How the federal courts answer these open questions will have significant implications for participants in the commodities markets.
FCA Cases: Convincing DOJ to Move to Dismiss
By Jacqueline C. Wolff
Recent actions by the DOJ suggest that although the DOJ may continue to prosecute certain relators’ FCA cases, other relators may find themselves on the other side of a government motion to dismiss.
By Kate Monks
The Ninth Circuit affirmed the majority of an $11 million jury verdict brought by a whistleblower who claimed that his company fired him for raising concerns about possible FCPA violations.
By Kate Monks
The former CEO of a pharmaceutical company was found guilty by a jury on eight counts of wire fraud affecting a financial institution for orchestrating a scheme that led to the collapse of one of Puerto Rico’s biggest banks.
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