Independence Blue Cross (“IBC”) announced on April 10, 2013, that it agreed to sell 20% of IBC’s New Jersey health insurance subsidiary, AmeriHealth New Jersey, to Cooper University Health Care (“Cooper”) of Camden, NJ.
The University of Pennsylvania Health System announced yesterday that it had reported a cardiologist to federal authorities, state regulators, and patients for performing unnecessary stent procedures at a system hospital. The physician, Vidya Banka, 71, was an independent cardiologist with medical privileges at Pennsylvania Hospital (he has since given up those privileges).
On March 26, 2013, OIG issued a Special Fraud Alert regarding physician-owned distributorships (“PODs”) involved in the sale of implantable medical devices. OIG noted that a joint venture is “inherently suspect” from an Anti-Kickback perspective when it involves physician-owners who are also in the position to purchase these medical devices for use in surgical procedures.
Par Pharmaceutical Company has agreed to pay $45 million to settle civil and criminal allegations that the company launched a long term care sales force to promote Megace ES for off-label uses including weight loss in elderly patients.
Under currently existing rules, a whistleblower tipster can collect a reward of 15%-30% of proceeds brought in as a direct result of a tip. The case must involve tax evasion of at least $2 million or tax fraud by an individual making at least $200,000 a year.
Manhattan tailor Mohanbhai “Mohan” Ramchandani and his business corporation, Mohan’s Custom Tailors, Inc., pleaded guilty to felony charges related to a ten-year scheme to evade payment of New York sales and income taxes, and agreed to pay $5.
In another win for the Health Care Fraud Prevention and Enforcement Action Team (“HEAT”) initiative between the Department of Justice and the Department of Health and Human Services, Fairfax Nursing Center (“FNC”) and its owners will pay $700,000 to resolve allegations raised in a qui tam Complaint.
A quick summary:
Venice dermatologist Steven J. Wasserman will pay $26 million to the federal government for claims of Medicare fraud under the False Claims Act. It was alleged that he accepted illegal kickbacks from pathologist Jose SuarezHoyos, owner of Tampa Pathology Laboratory. Allegedly, Wasserman would send Medicare patients’ biopsy specimens for analysis and diagnosis to TPL.
The Internal Revenue Service has recommended new whistleblower rules which could weaken the Foreign Account Tax Compliance Act. The FATCA seeks to thwart international tax evasion by mandating that foreign financial institutions must report information regarding U.S. taxpayer accounts to the IRS. Under the Bank Secrecy Act, taxpayers who have financial interest or signature authority over a foreign financial account must report account information each year to the IRS by filing a Report of Foreign Bank and Financial Accounts.
If you are aware of any person, corporation or entity that you think may be violating the False Claims Act, securities, commodities, tax, anti-money laundering, or sanctions laws, contact us today.