May 8, 2025 | False Claims Act, Fraud Investigations, Health Care, Health Care Fraud
Earlier this year, Chilivis Grubman founding partner Scott Grubman wrote an article for the Georgia State Bar Health Law Section’s Newsletter, wherein he discussed the continued fight over the constitutionality of the False Claims Act’s (FCA) qui tam (or...
Apr 30, 2025 | False Claims Act, Health Care, Health Care Fraud
On April 29, 2025, the U.S. Department of Justice (United States Attorney’s Office, Southern District of New York) announced that pharmaceutical giant Gilead Sciences agreed to pay a whopping $202 Million to resolve a False Claims Act investigation. At issue...
Apr 14, 2025 | False Claims Act, Fraud Investigations, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
On April 4, 2025, the Department of Justice announced that it had filed a lawsuit under the federal False Claims Act against Vohra Wound Physicians Management and its founder, Dr. Ameet Vohra. According to the DOJ, Dr. Vohra and his company allegedly submitted false...
Apr 2, 2025 | Health Care, Health Care Fraud, Healthcare Transactions
A federal judge recently dismissed a lawsuit against Wells Fargo filed by a group of former employees who accused the bank of violating its fiduciary responsibilities by allowing its pharmacy benefit manager (PBM), Express Scripts, to overcharge for prescription...
Mar 30, 2025 | False Claims Act, Health Care, Health Care Fraud
The Eighth Amendment to the United States Constitution guarantees the “freedom from excessive fines.” In 2018, the late Justice Ruth Bader Ginsberg held that this safeguard is “fundamental to our scheme of ordered liberty.” Timbs v. Indiana. And yet, it is not...
Mar 24, 2025 | Administrative Law, Health Care, Medicare and Medicaid, Overpayment Appeals
Because Medicare processes over one billion fee-for-service claims annually, it is impossible for CMS and its contractors to review every claim – or even a substantial percentage of claims – on a pre-payment basis. Accordingly, Medicare has set up various...
