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Category Archives: Fraud, Deception and False Claims

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Enforcement and Prosecution Policy and Trends, Fraud, Deception and False Claims

Order Limiting Strict Liability Has Implications on FDCA Enforcement for Companies, Individuals

On May 9, 2025, President Trump signed an Executive Order titled “Fighting Overcriminalization in Federal Regulations.” The Order seeks to reduce the regulatory burden on Americans and prevent individuals from being criminally penalized for unknowingly violating complex regulations.  In pursuit of these goals, the Order sets forth a policy “generally disfavor[ing]” strict liability crimes.  Agencies… Continue Reading
Fraud, Deception and False Claims

The Risks of Rushing In: A Closer Look at DOJ Criminal Division’s Updated Corporate Enforcement Policy in the Broader Enforcement Landscape

I. Introduction: More Clarity, But Not a Complete Roadmap On June 10, Matthew Galeotti, the Head of the U.S. Department of Justice’s (DOJ) Criminal Division, delivered remarks at an event hosted by the American Conference Institute,[1] in which he discussed recent updates to the division’s Corporate Enforcement and Voluntary Self-Disclosure Policy (CEP).[2] The revisions mark… Continue Reading
Fraud, Deception and False Claims

Healthcare Fraud Enforcement in a Second Trump Administration: Trends, Priorities, and Implications

On May 12, 2025, the United States Department of Justice’s (“DOJ”) Criminal Division released a major policy memorandum outlining its enforcement priorities for the upcoming year. Unsurprisingly, the number one priority for the Division was investigating and prosecuting white-collar crimes related to waste, fraud, and abuse—and particularly healthcare fraud. This emphasis on prosecuting healthcare fraud… Continue Reading
Enforcement and Prosecution Policy and Trends, Fraud, Deception and False Claims, Government Contracts

DOJ Announces Initiative to Use False Claims Act to Investigate DEI Practices

On May 19, 2025, the U.S. Department of Justice’s (DOJ) Deputy Attorney General announced its new Civil Rights Fraud Initiative, which aims to use the False Claims Act (FCA) to investigate and pursue claims against entities that tolerate antisemitism, allow men to enter women’s spaces or compete in female athletic competitions, or engage in unlawful… Continue Reading
Compliance, Enforcement and Prosecution Policy and Trends, Fraud, Deception and False Claims, Government Contracts

Department of Justice Suggests “Aggressive” Enforcement of False Claims Act

In a speech to the Federal Bar Association’s annual qui tam conference on Feb. 20, 2025, Michael Granston, Deputy Assistant Attorney General for the Commercial Litigation Branch at the U.S. Department of Justice, discussed how the Trump administration plans to “aggressively” enforce the False Claims Act (FCA). His statements come on top of other comments from Trump… Continue Reading
Compliance, Fraud, Deception and False Claims

State Attorneys General Poised to Crack Down On Price Gouging Amid Market Pressure

This past Thursday, New York Attorney General Letitia James issued a warning to businesses against price gouging for eggs and poultry. The current bird flu outbreak began in March 2024 but has become a topic of increasing concern for consumers and businesses in the new year after more than 13 million hens—necessary to the success… Continue Reading
Compliance, Fraud, Deception and False Claims

Key Takeaways From McGuireWoods’ Webinar on Enforcement Against PE Funds in Healthcare

McGuireWoods partners Brett Barnett, Mindy Sauter, Mike Elliott, and Michael Podberesky recently conducted a solution-oriented discussion of key enforcement and compliance developments that impact private equity (PE) funds in healthcare. They also highlighted relevant cases regarding the government’s increased interest in compliance diligence in the PE space. Read on to learn about the eight key… Continue Reading
Fraud, Deception and False Claims

Federal District Court Finds Private-Insurer Relator Can Proceed with False Claims Action

Last month, the U.S. District Court for the District of New Jersey held that a private company could proceed with its whistleblower action against a clinical laboratory that allegedly submitted false claims to the federal government for medically unnecessary urine drug tests (UDTs). The lawsuit is part of a growing trend of nontraditional whistleblower-like insurance… Continue Reading
Fraud, Deception and False Claims

1st Circuit Rejects Convicted Former Medical Device Executives’ Off-Label “Free Speech” Theory

A federal appeals court recently upheld misdemeanor convictions of two former Acclarent Inc. executives for commercially distributing an adulterated and misbranded medical device by misleading the U.S. Food and Drug Administration regarding the device’s intended use. Read on for details about the decision, which rejected claims that their off-label promotion amounted to constitutionally protected commercial… Continue Reading
Fraud, Deception and False Claims

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

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
Fraud, Deception and False Claims

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

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
Fraud, Deception and False Claims

U.S. Supreme Court Clarifies DOJ’s Authority to Dismiss Whistleblowers’ False Claims Act Suits, Questions Constitutionality of Qui Tam Provisions

The U.S. Supreme Court recently resolved a circuit split by holding that, in a False Claims Act action, (1) the government may seek dismissal of a qui tam case in which the government initially declined to intervene over the relator’s objection so long as it later intervened in the litigation, and (2) district courts should… Continue Reading
Fraud, Deception and False Claims

DHS Issues Final Rule Regulating Federal Contractors’ Handling of Controlled Unclassified Information

On June 21, the U.S. Department of Homeland Security issued a long-anticipated cybersecurity final rule that revises an existing clause and adds two new clauses to the Homeland Security Acquisition Regulation related to contractors’ handling of controlled unclassified information. Read on for highlights from this rule, which goes into effect July 21 and is likely… Continue Reading
Energy Enforcement, Enforcement and Prosecution Policy and Trends, Fraud, Deception and False Claims

CFTC: Calling All Whistleblowers in Carbon Markets

With an “alert” issued June 20, the Commodity Futures Trading Commission is targeting carbon markets by asking whistleblowers to come forward with information about fraudulent or manipulative trading of carbon credits and other environmental commodities as well as related derivatives. Read on for details about the CFTC’s alert and implications for entities that trade in… Continue Reading
Fraud, Deception and False Claims, Government Contracts

Supreme Court Clarifies the False Claims Act’s Knowledge Requirement, Eliminating a Potential Defense for Government Contractors and Healthcare Providers Accused of Fraud

On June 1, 2023, the Supreme Court unanimously ruled in favor of whistleblower plaintiffs (referred to as “relators”) in consolidated False Claims Act (“FCA”) cases in a decision that clarified the application of the FCA’s knowledge requirement.  In United States ex rel. Schutte v. SuperValu Inc., the Court held that the FCA reaches defendants who… Continue Reading
Fraud, Deception and False Claims

7th Circuit Sides With Insured Party Seeking Coverage for False Claims Act Settlement

On May 3, the 7th U.S. Circuit Court of Appeals sided with the policyholder, resolving an insurance coverage dispute over a $100 million settlement related to claims under the federal Anti-Kickback Statute and the federal False Claims Act. Read on for analysis of this decision, which tries to clarify the difference between compensatory damages, which… Continue Reading
Fraud, Deception and False Claims

Ophthalmic Distributor May Face $848M in Penalties for Kickbacks, False Claims Act Violations

On Feb. 28, a federal jury in the District of Minnesota found the Cameron-Ehlen Group, d/b/a Precision Lens, and its founder and owner guilty of paying kickbacks to ophthalmic surgeons in violation of the False Claims Act and Federal Anti-Kickback Statute between 2006 and 2015. Read on for details about this case, which illustrates the… Continue Reading
Fraud, Deception and False Claims

Supreme Court to Determine Whether False Claims Act Liability Is Precluded Where Defendants Proffer an Objectively Reasonable Interpretation of an Ambiguous Legal Requirement

On January 13, 2023, the Supreme Court granted a writ of certiorari to petitioners in two False Claims Act cases to determine whether the False Claims Act’s knowledge requirement reaches defendants who can offer an “objectively reasonable” interpretation of an ambiguous legal or contractual requirement material to government payment. The Court’s decision will likely be… Continue Reading
Fraud, Deception and False Claims

Schemes that Deprive a Person of “Potentially Valuable Economic Information” – Punishable Under the Federal Wire Fraud Statute?

On Monday November 28, 2022, the U.S. Supreme Court heard oral arguments on Ciminelli v. United States. The Court will decide whether the “right-to-control” theory of fraud used by the Second Circuit is a valid basis for property fraud liability under the federal wire fraud statute. Courts and prosecutors have used the right-to-control theory to… Continue Reading
Fraud, Deception and False Claims

Pharmaceutical Manufacturer Agrees to $900 Million Dollar False Claims Act Settlement to Resolve Kickback Claims

On July 20th, on the eve of trial, Biogen Inc. agreed to pay $900 million dollars to settle claims that the company violated the False Claims Act (FCA) by allegedly paying improper consulting and speaker fees and providing lavish meals and entertainment (in violation of the Federal Anti-Kickback Statute (AKS)) to medical providers to induce… Continue Reading

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