Under the Affordable Care Act, all providers had to go through a reapplication process in order to participate in Medicare. Those who didn’t meet certain requirements, had felony convictions, incorrect addresses or didn’t have the proper licenses were removed from participation in the Medicare program.
In the 1970’s, the Florida Medical Association and individual physicians filed suit objecting to the release of a list by the U.S. Department of Health and Human Services identifying physicians or practices which received annual payments of $100,000 or more in Medicare reimbursements. On October 22, 1979, a federal district court judge found that the doctors’ privacy interests outweighed the public’s interest in disclosure and prohibited the Department from revealing “any ….
American Commercial College, which is based in Lubock, Texas, will pay $1 million over the next five years to settle allegations that it falsified financial records in order to qualify for federal student aid money. The college may also have to pay an additional $1.5 million. However, it is unclear under what circumstances more money would have to be paid.
Connecticut has settled claims against Gary Anusavice of North Kingstown, Rhode Island and six of Anusavice’s management and consulting companies in a civil suit revolving around an allegedly fraudulent Medicaid billing scheme. The suit, which was brought last May, alleged that Anusavice, his companies and other defendants took part in an elaborate plot covering a two year period which led to the payment of more than $24 million in fraudulent Medicaid claims.
Tony West, the acting Associate Attorney General, claimed that the Justice Department is a “friend” of whistleblowers in his testimony before Capitol Hill regarding his nomination. West noted that it was his leadership as Chief of the Civil Division that led to the filing of a greater number of whistleblower suits and greater recovery of taxpayer dollars than at any other time in history.
Dallas-based hospital, Parkland Memorial, agreed to pay $1.4 million to the federal government to settle allegations that Parkland and University of Texas Southwestern Medical Center submitted false claims for rehabilitation consultations that did not occur. Additionally, the settlement resolves allegations that Parkland billed for certain medical procedures without required physician supervision.
To date, the District of Columbia and two other states have adopted some form of a false claims act. Although two municipalities – Philadelphia and Allegheny County – have adopted legislation which prohibits city or county contractors from submitting false claims for reimbursement – the Commonwealth of Pennsylvania has yet to adopt a law which applies to individuals and/or companies who submit fraudulent requests for payment to the state.
In the largest drug safety settlement ever by a generic drug manufacturer, Ranbaxy USA, Inc. (“Ranbaxy”), a subsidiary of the Indian generic drug manufacturer Ranbaxy Laboratories Limited, agreed to pay $500 million to resolve a whistleblower lawsuit and criminal charges that it manufactured and distributed adulterated drugs which it sold in the U.S.
C.R. Bard, Inc., a New Jersey-based drug manufacturer, agreed to pay $48.26 million to the United States to resolve allegations that it violated the FCA by providing illegal remuneration to physicians and potential customers to induce them to purchase its brachytherapy seeds used to treat prostate cancer.
Judge Maurice B. Foley, a U.S. Tax Court judge, slammed the IRS for its handling of the cases of two whistleblowers who were denied awards after submitting whistleblower claims against their employers.
The two whistleblowers, who remain anonymous, appealed the dismissal of their awards claims in November 2012.
If you are aware of any person, corporation or entity that you think may be violating the Federal False Claims Act or a State False Claims Act, contact us today.