Category: Healthcare
On May 30, 2010, the Dallas Morning News brought to light allegations of decades of Medicare and Medicaid billing fraud at the prestigious University of Texas Southwestern Medical Center and its affiliated Parkland Memorial Hospital. The report provided examples of the systemic allegations, including medical residents performing surgeries such as appendectomies and even a leg amputation without faculty or attending physician supervision.
The State of Idaho has agreed to settle claims against two groups of the Actavis pharmaceutical company related to allegations that Actavis knowingly inflated reported wholesale prices of certain drugs in order to receive extra compensation from the State’s Medicaid program. For $1.2 million, the two Actavis companies will be released from a lawsuit that was filed in 2007 by the State’s Attorney General against them and other pharmaceutical companies,
On May 24, 2010, an Irvine physician, Xinming Fu, was sentenced for his role in a scheme which bilked Medicare out of $15 million in unnecessary respiratory treatments which were not performed in accordance with the Medicare rules or not performed at all. Dr. Fu, who was sentenced to thirty (30) months in federal prison,
Robert Wood Johnson University Hospital has agreed to pay $6.35 Million to settle allegations of violations of the False Claims Act. The suits alleged that the Hamilton, New Jersey hospital fraudulently inflated its charges to Medicare patients to obtain larger “outlier payments.” Congress enacted the supplemental outlier payments to ensure that hospitals have incentives to treat patients whose care requires unusually high costs.
Christiana Care Health System (CCHS) has agreed to pay the United States and the State of Delaware $3.3 Million to settle a whistleblower lawsuit that alleged that CCHS paid kickbacks to, and entered into improper self-referral relationships, with a physicians’ practice located in New Castle, Delaware.
The United States and the State of New York have entered into settlement agreements with three home health agencies to resolve allegations that the agencies submitted false claims to the New York Medicaid and Medicare Programs.
The New York Medicaid Program provides coverage for home health aides only if those aides have valid certificates showing that they received proper training.
St. John’s Health System, headquartered in Tulsa, Oklahoma, has agreed to pay the United States $13,229,348.88 to settle allegations that it submitted claims to Medicare and Medicaid that were tainted by the hospital’s financial relationships with referring physicians.
Federal law prohibits health care providers like St. John’s from billing the federal healthcare program for referrals from doctors with whom the providers have a financial relationship,
The Visiting Physicians Association (“VPA”), which provides home health services in Michigan, Ohio, Georgia and Wisconsin, will pay the United States and the state of Michigan $9.5 million to settle allegations that the VPA violated the False Claims Act by submitting false claims to Medicare, TRICARE and the Michigan Medicaid program.
The Department of Justice announced that Spectranetics Corporation, a medical device manufacturer, has agreed to pay the United States $4.9 million in civil damages plus a $100,000.00 forfeiture to resolve various claims against the company. Spectranetics sells certain types of medical lasers and peripheral devices for those lasers. The claims against Spectranetics arose from allegations that the company engaged in several inappropriate acts from 2003 to 2008,
Wheaton Community Hospital, the City of Wheaton (MN), and Dr. Stanley Gallagher have agreed to pay the United States $846,461.00 to settle allegations that their hospital admission practices violated the False Claims Act. In particular, the suit against Wheaton Community Hospital, the City, and Dr. Gallagher alleged that they admitted some patients and kept others admitted to acute care when doing so was not medically necessary.
