A federal court in the Middle District of North Carolina has sentenced Kathy Briggs, 65, to 24 months in prison, followed by 13 months of home detention and two years of supervised release, for her role in a multimillion-dollar Medicaid fraud scheme. Briggs pled guilty to one count of health care fraud related to fraudulent […]
Yadkinville Woman Sentenced for Multi-Million-Dollar Medicaid Fraud Scheme Read More »
A North Carolina physician, Dr. Steven L. Mendelsohn, has agreed to pay $549,554.26 to resolve allegations under the False Claims Act that he submitted reimbursement claims to Medicare for arthritis drugs that were not approved by the Food and Drug Administration (FDA). According to the U.S. Attorney’s Office for the Western District of North Carolina,
North Carolina Rheumatologist Settles False Claims Act Allegations Over Unapproved Drugs Read More »
A federal court in the Central District of California recently ruled against JMG Investments Inc. and its owner, Jeffrey Schwartz, finding that they violated the False Claims Act by improperly obtaining and retaining duplicate Paycheck Protection Program (PPP) loans during the COVID-19 pandemic. The court ordered the rehab center and its owner to pay $1,565,294.38
San Fernando Valley Rehab Center and Owner Ordered to Pay in Healthcare Fraud Case Read More »
The U.S. Department of Justice has announced that False Claims Act (FCA) settlements and judgments exceeded $6.8 billion in fiscal year 2025, the highest annual total in the statute’s history. More than $5.7 billion of this record level of recovery stemmed from healthcare fraud-related matters, demonstrating the government’s continued emphasis on policing improper billing, unlawful
Record False Claims Act Healthcare Fraud Recoveries Exceed $6.8B in FY 2025 Read More »
Affiliates of Kaiser Permanente have agreed to pay $556 million to resolve allegations that they violated the False Claims Act by submitting inaccurate diagnosis codes in connection with Medicare Advantage risk adjustment payments. The settlement announced in January 2026 resolves consolidated government and whistleblower-led complaints, which allege that Kaiser systematically pressured physicians to add diagnoses
Federal prosecutors in the Southern District of Texas have secured substantial prison sentences for two healthcare employees convicted in a multimillion-dollar fraud scheme that targeted elderly and vulnerable patients at adult day care facilities. A federal jury found Dr. Osama Nahas and clinic employee Isabel Pruneda guilty of conspiracy to commit healthcare fraud, healthcare fraud,
The Pennsylvania Attorney General’s Office recently secured a prison sentence against a former office manager involved in a substantial Medicaid fraud scheme tied to a Montgomery County home care provider. Barbara Thomas, 46, was sentenced in Montgomery County Court to 9 to 23 months in prison followed by four years of probation after pleading guilty
Pennsylvania Medicaid Fraud: Office Manager Sentenced in $1.76M Scheme Read More »
The healthcare industry has long been the primary target for False Claims Act (FCA) enforcement, with no other sector in close second place.Over the past year, the federal government has unveiled several new or revamped whistleblower programs, most notably the Department of Justice’s antitrust program, which we have previously written about. However, despite the expanded
The Healthcare Industry Remains the Largest Target for False Claims Act Enforcement Read More »
From the earliest days of the False Claims Act (FCA), the federal government has understood that providing financial incentives to whistleblowers is one of the best ways to encourage private citizens to come forward and file qui tam actions. That is why the FCA expressly provides that in the event of a successful case, the
Factors Determining the Relator’s Share of an FCA Recovery Read More »
Preparing a successful qui tam case comes down to evidence. It is all well and good to tell the government where and how to find supporting documents and records, but there is no substitute for providing that evidence to the government on the front end. Recorded conversations can be some of the most effective and
