Category: Healthcare

CMS Final Rule Aims to Save $1.6 Billion in Fraud

On April 24, 2012, the Centers for Medicare & Medicaid Services (CMS) issued a final rule requiring stronger protections against fraudsters.  The final rule allows only qualified, identifiable providers and suppliers to order or certify medical services, equipment, and supplies for Medicare beneficiaries.

CMS will be diligently verifying provider credentials. 

Walgreens Pharmacy Chain Pays $7.9 Million to Resolve False Prescription Billing Case

On April 20, 2012, the Department of Justice announced that Walgreens, a national retail pharmacy chain has paid the United States and affiliated states a $7.9 million settlement to resolve allegations that the pharmacy violated the False Claims Act.  Walgreens, allegedly offered illegal incentives to beneficiaries of government health care programs which include Medicare,

McKesson Corp. Pays U.S. More Than $190 Million to Resolve False Claims Act Allegations

On Thursday, April 26, 2012, Stuart F. Delery, Acting Assistant Attorney General for the Justice Department’s Civil Division; New Jersey U.S. Attorney Paul J. Fishman; and Daniel R. Levinson, Inspector General of the U.S. Department of Health and Human Services announced that the McKesson Corporation has agreed to pay the United States a $190 million settlement to resolve allegations that the company violated the False Claims Act.

Johnson & Johnson commits more than 238,000 violations of Arkansas’s Medicaid fraud laws

After an Arkansas jury found that Johnson & Johnson (JNJ) company officials misled doctors and patients about the risks of one of their drugs, a judge ruled that JNJ must pay more than $1.1 billion in fines. The drug was an antipsychotic medication called Risperdal. The jury had concluded that J&J’s marketing of this particular drug violated both Medicare fraud laws and Arkansas’s deceptive trade practices statutes.

RCOG to pay $3.8 Million to Settle False Claims Act Case

The Justice Department announced on April 3, 2012 that Radiotherapy Clinics of Georgia LLC, a radiation oncology practice, and its affiliates RCOG Cancer Centers LLC, Physician Oncology Services Management Company LLC, Frank A. Critz, M.D. and Physician Oncology Services L.P. (jointly, RCOG) agreed to pay $3.8 million to settle claims that they violated the False Claims Act. 

WellCare Health Plans Inc. Will Pay $137.5 Million for Alleged FCA Violations

WellCare Health Plans Inc., based in Tampa, will pay $137.5 million to settle allegations of False Claims Act violations. WellCare provides managed health care services for Medicare and Medicaid beneficiaries throughout the country. The suit alleged various schemes which included submitting false claims to government health care programs, and included allegations that WellCare wrongly overstated the amount it claimed to be spending on medical care so that they did not have to return money to these government health care programs like Medicare and Medicaid.

Urine Drug Test Scam Results in $6 Million Payout to U.S. Government

Accela Medical LLC, Coventry Diagnostics LLC and Western Slope Laboratory LLC, three Troy laboratory companies, were fined $6 million to resolve False Claims Act violations against the government.  Accela was improperly billing for urine drug testing and Coventry and Western Slope were performing the tests.  The scheme was set up by Thomas McCormick of Troy and Charles Reinhardt of Accela. 

Orthofix International Progresses in Resolution of Legal Matters with U.S. Government

Orthofix International, a global medical device company, has issued a statement regarding its substantial progress in the resolution of several U.S. Government legal matters.  The statement discussed the company’s improvements to its compliance practices, personnel, financial standings, and a stronger focus on the Company’s operations, including investments in R&D.  Three legal matters Orthofix reportedly has made progress on are: reaching an agreement to resolve matters related to the investigation of the Company’s subsidiary,

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