If you seek to receive reimbursement by insurance payors in Florida, either through federal programs (Medicare, Medicaid, and Tricare), or commercial insurance (including Personal Injury Protection and Bodily Injury), you will either need a Health Care Clinic License or qualify as exempt under one of the exemptions. The process of getting a Health Care Clinic License is tedious but not...
A Missouri laboratory and its three owners have been ordered to pay more than $13.6 million to settle charges they violated the False Claims Act – the federal government’s primary tool for civil enforcement. Jerry, Jerrod and Joel W. Murphy, owners of Gamma Healthcare Inc., were accused of submitting false claims to Medicare for lab tests that were not ordered by healthcare providers and were...
The U.S. Department of Health and Human Services Office of Inspector General (OIG), has produced literature regarding their intention to prosecute private equity firms who do not conduct proper due diligence in healthcare deals. At this time, a few private equity firms have been charged in civil litigation cases for healthcare fraud related civil allegations. However, the OIG has stated that...
A Long Island man who impersonated an NBA player and others to further his complex healthcare insurance fraud scheme has been sentenced to 12 years in prison and ordered to pay restitution of $337 million and forfeit $63 million. Mathew James engaged in a years-long healthcare and insurance fraud scheme in which he and his co-conspirators, including physicians throughout the country, defrauded...
The outbreak of the COVID-19 pandemic prompted a reevaluation of healthcare regulations, particularly with regard to telemedicine and the prescription of controlled medications. One significant development in this area is the temporary exceptions granted by the Drug Enforcement Administration (DEA) to the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which governs the prescription...
A New Jersey-based clinical laboratory and its owner and CEO, Eric Leykin of New York, have agreed to pay $13 million to settle False Claims Act allegations involving the payment of illegal kickbacks and medically unnecessary lab testing. According to the settlement agreement, Leykin, owner and CEO of RDx Bioscience, perpetuated a healthcare kickback scheme that took place between 2017 and 2023...
