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Department of Justice

DOJ Approves Merger Between Cigna and Express Scripts, Paving the Way for Increased Vertical Integration Between Payers and PBMs

[10/04/18]

Posted on October 4, 2018 in Health Law News

Published by: Hall Render

On September 17, 2018, the U.S. Department of Justice (“DOJ”) approved the $52 billion vertical merger between health insurer Cigna Corp. (“Cigna”) and pharmacy benefit manager (“PBM”) Express Scripts. The Cigna-Express Scripts merger is just one in a string of recent health insurer/PBM acquisitions. For more on these transactions, click here. As the largest unaffiliated... READ MORE

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Massive Penalty Spike Darkens the FCA Landscape

[06/30/16]

Posted on June 30, 2016 in False Claims Act Defense

Written by: David B. Honig

In November 2015, the Bipartisan Budget Act of 2015 went into effect. One aspect of that act was the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. The new law required that the Program Fraud Civil Remedies Act and the False Claims Act (“FCA”) penalties be “corrected” to adjust for inflation since... READ MORE

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DOJ Seeks to Nearly Double Health Care Fraud Litigation Budget for 2016

[02/04/15]

Posted on February 4, 2015 in False Claims Act Defense

Written by: Drew B. Howk

Just three months ago, the Department of Justice announced a record year for False Claims Act recoveries totaling more than $5 billion, including $2.3 billion from health care defendants alone. Helping to contribute to these recoveries was another record: over 700 whistleblower cases filed in 2014. READ MORE

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Qui Tam Complaints to Be Reviewed by Criminal Division

[10/01/14]

Posted on October 1, 2014 in False Claims Act Defense

Written by: David B. Honig

Leslie R. Caldwell, Assistant Attorney General for the Criminal Division, announced recently that all new qui tam complaints would be “shared by the Civil Division with the Criminal Division as soon as the cases are filed.” Fraud prosecutors will now review all qui tam complaints to determine whether to open a parallel criminal investigation. READ MORE

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Hospice Owner Indicted for $14.3 Million in False Claims

[10/14/11]

Posted on October 14, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On October 12, 2011, the U.S. Department of Justice unsealed an indictment charging Matthew Kolodesh a/k/a Matvei Kolodech, with conspiracy to defraud Medicare of more than $14 million.  According to the indictment, Kolodesh’s business, Home Care Hospice, Inc. (HCH), located in Philadelphia, PA, submitted Medicare claims for approximately $14.3 million dollars for patients who... READ MORE

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