healthcare-fraud

10 cases — ← All topics

Case Title Lower Court Docketed Status Flags Tags Question Presented
24A778 Frank H. Bynes, Jr. v. United States Eleventh Circuit 2025-02-11 Presumed Complete controlled-substances criminal-intent drug-distribution healthcare-fraud medical-practice prescription-fraud Question not identified.
23-7132 Thomas G. O'Lear v. United States Sixth Circuit 2024-04-04 Denied Response WaivedIFP healthcare-fraud insurance-company medicaid medicare offense-level-enhancement sentencing-guidelines victim-definition vulnerable-victim United States Sentencing Guideline § 3A1.1 provides for a base offense level increase where the victim of the offense was vulnerable. In a case involv…
23-716 Shawn Mark Henry v. United States Fifth Circuit 2024-01-03 Denied Response Waived anti-kickback-statute criminal-intent federal-benefits federal-healthcare-benefits healthcare-fraud interstate-commerce mens-rea statutory-interpretation travel-act I. Does the Anti-Kickback Statute, 42 U.S.C. § 1320a-7(b)(1), require the government to prove that the defendant received remuneration for referring p…
23-139 United States, ex rel. Shannon Martin, M.D., et al. v. Darren Hathaway, M.D., et al. Sixth Circuit 2023-08-15 Denied Response Waived anti-kickback-statute false-claims-act federal-health-care-program government-claims healthcare-fraud liability remuneration statutory-interpretation 1. Does the term "remuneration" under the Anti-Kickback Statute encompass solicitation or receipt of any kind of reward or compensation, or is it limi…
22-6653 Jayson Montgomery v. United States Sixth Circuit 2023-01-27 Denied IFP anti-kickback-statute circuit-split controlled-substances-act criminal-law due-process healthcare-fraud intent ruan-v-united-states subjective-intent To convict a defendant of violating the anti-kickback statute, is the government required to establish that the accused intended to engage in unlawful…
22-685 Jerry Wayne Wilkerson, et al. v. United States Sixth Circuit 2023-01-24 Denied anti-kickback-statute commission-payment controlled-substances-act healthcare-fraud objective-intent-standard pharmacy-benefit prescription-marketing sixth-circuit subjective-intent Must the government establish subjective intent to engage in unlawful conduct in order to convict a defendant of healthcare fraud and violation of the…
22-339 Pfizer Inc. v. Department of Health and Human Services, et al. Second Circuit 2022-10-12 Denied Amici (5) advisory-opinion-process anti-kickback-statute criminal-intent healthcare-fraud medical-decision-making medicare mens-rea remuneration rule-of-lenity statutory-interpretation Whether the AKS is violated only if the person offering the "remuneration * * * to induce" the purchase of federally reimbursed healthcare intends to …
21-445 Floyd Calhoun Dent, III v. United States, et al. Fourth Circuit 2021-09-22 Denied Response Waived anti-kickback-statute federal-healthcare-programs healthcare-fraud independent-contractor independent-contractors marketing medical-referral referral remuneration sales-commission statutory-interpretation Whether the AKS prohibits the payment of sales commissions to independent contractors who make marketing presentations to physicians but who are not m…
20-1692 Henry Evans v. United States Fifth Circuit 2021-06-07 Denied Response Waived administrative-law criminal-procedure criminal-prosecution expert-testimony health-care-fraud healthcare-fraud medicaid medicare medicare-regulations statutory-interpretation 1.) Are the Medicare rules, regulations, and policies "controlling" in a criminal prosecution under 18 U.S.C. § 1347; i.e. is evidence of compliance o…
19-866 Emmanuel E. Ubinas-Brache v. Surgery Center of Texas, LP Texas 2020-01-10 Denied Response Waived anti-kickback-statute healthcare-fraud limited-partnership medicaid medicare partnership-agreement preemption state-contract-law surgical-center Animated by concerns over fraud and rising costs in federal healthcare reimbursement programs like Medicare and Medicaid, Congress enacted an anti-kic…