Subject to Inquiry

Subject to Inquiry

THE LATEST ON GOVERNMENT INQUIRIES AND ENFORCEMENT ACTIONS

Government Investigations and White Collar Litigation Group

Timothy Fry

Photo of Timothy Fry Tim helps clients navigate the thorny compliance and regulatory issues prevalent in the healthcare industry. He advises on the federal Anti-Kickback Statute and Stark Law, Medicare policy, state fraud and abuse laws, and state licensure and certificate of need rules, among other regulatory schemes. His significant healthcare industry knowledge also allows him to counsel efficiently on regulatory aspects of strategic transactions, including structuring guidance, healthcare due diligence and compliance matters.

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Lessons for Providers and Practice Entities: Ophthalmology Groups Pay Millions to Settle Co-Management, Optometrist Relationship Allegations

Fraud, Deception and False Claims
Two ophthalmology practice groups recently reached settlements with the U.S. government totaling nearly $20 million to resolve allegations that their third-party cataract arrangements violated several healthcare laws. Read on to discover how the settlements offer guidance to vision providers with respect to the government’s focus on ophthalmology-optometry relationships, and whether the settlements’ lessons have broader… Continue Reading

Eleventh Circuit Affirms Order for $1.195 Million in Restitution and 48 Month Sentence in Commercial Insurance Healthcare Fraud Case

Fraud, Deception and False Claims
Last month, the Eleventh Circuit upheld a $1.195 million restitution order and 48-month sentence against Carlos Verdeza for three counts of healthcare fraud. See United States v. Verdeza, No. 21-10461, 2023 WL 3728960 (11th Cir. 2023). Verdeza was a case brought by the United States against a physician assistant who produced fraudulent patient files and sought reimbursement from Blue Cross Blue… Continue Reading

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