In late March 2023, Dr. Paul Koch, the former owner of a chain of Rhode Island ophthalmology practices, agreed to pay $1.1 million to the U.S. Attorney’s Office to settle false claims act allegations. This case arose from a qui tam complaint brought by two whistleblowers alleging that over a five-year period, Koch paid kickbacks to optometrists to induce referrals for patients for cataract surgeries. Notably, the settlement included a non-admission clause by Dr. Koch, denying liability and disputing the relators’ entitlement to attorneys’ fees, and the court entered a Stipulation of Partial Dismissal and Consent to Dismissal on Behalf of the United States shortly thereafter.Continue Reading Settling False Claims Act Cases Involves More than Just Cutting a Check to DOJ
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Podcast: FCA Dismissals under the Granston Memo
By Payal Nanavati on
In our first episode of Payers, Providers, and Patients – Oh My!, John Brennan talks with Joe Records and Payal Nanavati about FCA dismissals under the Granston Memo.
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Health Care Fraud and Abuse Control Program FY 2017: Insights from Our Enforcement Team
By Christopher Flynn on
Posted in Fraud, Waste & Abuse
The Health Care Group’s newest partners, William S.W. Chang and Laura M. Kidd Cordova, along with Counsel Stephanie D. Willis, have authored an Alert about the 21st Health Care Fraud and Abuse Control Program (HCFAC) annual report released last Friday. The HCFAC report is a joint effort of the U.S. Department of Justice (DOJ) and…
FY 2014 HCFAC Report Shows Increasing DOJ and OIG Fraud-Fighting Efficiency
By Stephanie Willis on
Posted in Fraud, Waste & Abuse
Every year, the Department of Justice (DOJ) and the Department of Health and Human Services Office of the Inspector General (OIG) report the results of their fraud prevention and recovery efforts to Congress. As recounted in the recently released Health Care Fraud and Abuse Control Program (HCFAC) report, the overall amount recovered in FY 2014 was $1 billion less than what the agencies reported in 2013 ($4.3 billion). Nevertheless, the report touted the $2 increase in the return on investment from DOJ and OIG’s fraud and abuse investigations overall (from $5.70 to $7.70). The HCFAC report shows that, despite losing $62.1 million in funding beginning in FY 2013 due to sequestration, both DOJ’s and OIG’s antifraud work remains potent and is growing more sophisticated.
Here is an overall comparison of the FY 2014 and FY 2013 reports:
| DOJ Activities | FY 2013 | FY 2014 |
| New Criminal Investigations | 1,013 | 924 |
| New Civil Investigations | 1,083 | 782 |
| Health Care Fraud Convictions | 718 | 734 |
| Total Allocation | $573,667,581 | $571,702,217 |
| OIG Activities | FY 2013 | FY 2014 |
| New Criminal Actions | 849 | 924 |
| New Civil Actions | 458 | 529 |
| Individuals Excluded from Federal Health Care Programs | 3,214 | 4,017 |
| Total Allocation | $487,381,848 | $485,824,633 |
Continue Reading FY 2014 HCFAC Report Shows Increasing DOJ and OIG Fraud-Fighting Efficiency