Category: Healthcare
A federal lawsuit filed by prominent Delaware Valley cardiologist Nicholas L. DePace, M.D., sparked a multi-year investigation by the United States Department of Justice and the New Jersey Attorney General’s Office that has resulted in New-Jersey based Cooper Health System, and Cooper University Hospital paying $12,600,000 to settle Medicare and Medicaid fraud allegations.
Despite recently pleading guilty in a major Medicare fraud case, Amgen, the world’s largest bio-technology company, received a major gift from Congress in its “fiscal cliff” bill—a delay in Medicare price restraints on a class of drugs that includes Amgen’s profitable Sensipar pill.
Under the provision, Amgen will be able to continue to sell Sensipar,
U.S. District Court judge Terrence Boyle rejected a proposed settlement and deferred prosecution agreement by WakeMed Health and Hospitals, a North Carolina health system criminally charged with ripping off Medicare for at least $1.2 million. The first hospital or health system to be criminally charged with defrauding Medicare, WakeMed Health and Hospitals allegedly made false statements to Medicare in order to be reimbursed for costly inpatient stays of Medicare patients who never actually were inpatients at the hospital.
On January 4, 2013, the Attorney General for Texas, Greg Abbott, announced that Pfizer, Inc. and Endo Pharmaceuticals will pay $36 million to settle a whistleblower suit filed under Texas’ Medicaid Fraud Prevention Act. The settlement resolves allegations that the companies defrauded Medicaid by misreporting the price of generic drugs for the Medicaid program.
On January 10, 2013, a pharmaceutical company based in San Diego, Victory Pharma, Inc., agreed to pay $11.4 Million to resolve allegations that it improperly marketed its pharmaceutical products. It is alleged that Victory violated the federal Anti-Kickback Statute and False Claims Act by paying kickbacks to doctors who prescribe the company’s drugs.
On January 7, 2013, the U.S. Department of Justice announced a settlement resolving False Claims Act allegations against EMH Regional Medical Center (“EMH”) and North Ohio Art Center, Inc. (“NOHC”). It was alleged that EMH and NOHC performed unnecessary stent procedures on patients between 2001 and 2006, including those reimbursed by Medicare.
Amgen, one of the world’s largest biotechnology companies, agreed to pay $762 million to resolve criminal and civil allegations that it marketed its drug Aranesp for off-label uses. Of the $762 million, $612 million will be used to settle a number of whistleblower suits brought under the qui tam provisions of the False Claims Act,
Two subsidiaries of France-based drug manufacturer Sanofi, Sanofi-Aventis, Inc. and Sanofi-Aventis, LLC, agreed to pay $109 million to the U.S. to resolve allegations that it violated the federal False Claims Act by providing units of its knee injection, Hyalgan, to physicians for free in order to induce them to buy and prescribe Hyalgan in violation of the Anti-Kickback Statute.
Pfizer agreed to pay $55 million to the U.S. government for marketing its drug Protonix, approved to treat erosive esophagitis, for unapproved use. According to the Justice Department, Pfizer promoted Protonix for all forms of gastroesophageal reflux disease even though it is only approved for short-term treatment of erosive esophagitis.
The Office of Inspector General (OIG) of the Department of Health & Human Services has announced that it expects to recover approximately $6.9 billion in fiscal year 2012. Of this amount, $923.8 million is attributable to audit receivables and $6 billion to investigative receivables. OIG also reported that approximately $8.5 billion has been saved as a result of legislative,
