The state of Georgia publicly joined a pending federal whistleblower case against two hospital companies, Tenet Healthcare Corporation and Health Management Associates, Inc. and an entity commonly known as Clinica de la Mama. The suit alleges that Clinica operates prenatal clinics to identify and recruit pregnant, undocumented Hispanic women and refers them to Tenet and HMA hospitals that pay for the referrals because the deliveries will be paid for by Medicare and Medicaid.
Federal Officials are scaling back numerous high-profile healthcare False Claims Act investigations due to budget decline. The Department of Health and Human Services’ Office of Inspector General, which investigates Medicare and Medicaid fraud, is losing 400 staff members through 2015, about 20% of its workforce.
An unspecified number of investigations into poor quality care in hospitals are being delayed due to “significantly reduced” travel budgets and the high cost of paying experts to review medical files.
Pfizer Inc., the owner of Wyeth Pharmaceuticals Inc., will pay $491 million to resolve allegations of off-label marketing of the drug Rapamune.
Mark Campbell, the whistleblower and a former Wyeth sales representative, alleged that Wyeth illegally marketed, for over a decade, the transplant drug for uses that had not been approved by the U.S.
AccMed Healthcare Systems, LLC, also knows as the Florida Spine Care and Pain Center, have resolved allegations that it violated the False Claims Act.
The U.S. Attorney’s Office said the settlement involves Bao Pham, D.O, allegedly submitting false claims between 2004 and 2008 for non-reimbursable procedures and services by up-coding and unbundling medical services provided to beneficiaries of Medicare and Federal Office of Workers Compensation programs.
Beth Israel Deaconess Medical Center, located in Boston and one of the world’s leading teaching hospitals, will pay over $5 million to settle allegations of improper Medicare claims.
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Zachery Wolfson, the son of Mitchell Wolfson, the chief medical officer and founding partner of Park Avenue Medical Associates (“PAMA”), reportedly filed a False Claims Act complaint that led to the New York company settling Medicare fraud allegations for $1 million.
The Department of Justice alleged that PAMA billed for psychiatry services for patients whose dementia or cognitive disorders actually made them unable to benefit from psychotherapy.
In a 25-page rebuke of the allegations that Lance Armstrong defrauded the government when he took sponsorship dollars from the Postal Service with the understanding that there would be no use of performance-enhancing drugs, Armstrong says that the Postal Service should have known that he was doping.
The U.S. Federal whistleblower statute enables individuals known as whistleblowers to unveil fraud within the government. Enacted in the 1860’s and significantly modified in the mid-1980’s, this statute has thus far led to the recovery of more than $30 billion for the U.S. Government in the last three decades alone by giving incentives and protection to those with information and willingness to blow the whistle on the unlawful activity.
CyTerra Corporation, a defense contractor and maker of IED sensors for the US Military, has agreed to pay $2 million to resolve civil-fraud allegations. The whistleblowers in the case, two former finance executives with the company, alleged that CyTerra inflated the costs of labor and materials to increase the company’s profits.
The DOJ has recently announced that the Doctors Hospital of Augusta, LLC has agreed to pay $1,020,000 to settle allegations that they submitted or caused the submission of false claims to the TRICARE and Medicare programs. The Doctors Hospital of Augusta, LLC is owned and operated by HCA Inc.
