Category: Healthcare
- January 18, 2021
- Construction, Defense Industry, Federal False Claims Act, Financial Industry, Government Contracts, Healthcare, Investigations, Medicaid, Medicare, Medicare Part D, Pharmaceuticals, Research, State False Claims Acts
Takeaways:
- Over $300 million awarded to whistleblowers.
- Dip in recoveries reflects pandemic and economic challenges.
- Number of FCA filings hits a record.
- Healthcare continues to dominate FCA recoveries with kickbacks a major focus.
- Rebound in recoveries is likely as defendants regain financial footing.
On April 16, 2020, the Honorable William M. McSwain, United
States Attorney for the Eastern District of Pennsylvania, issued a sweeping
request for help in identifying companies and individuals who seek to “exploit
the devastating effects of the coronavirus pandemic for their own benefit.” The
Philadelphia United States Attorney’s Office has a long history fighting fraud.
On Sept. 27, the U.S. Department of Justice announced criminal charges against 35 individuals across various jurisdictions, allegedly involved in genetic testing fraud schemes that cost taxpayers over $2.1 billion.
The government asserted that the individuals had engaged in audacious schemes to target seniors and the disabled through the ordering of cancer genetic screening,
Member States of the European Union, over the last several years, have passed a series of so-called “Whistleblower Laws.” These laws are being implemented allegedly to bolster anti-corruption efforts throughout Europe. While corruption is no stranger to either side of the Atlantic,
The beat goes on…
According to a May 31, 2018 filing in New Jersey federal court, Dr. Thomas Savino of Staten Island was sentenced to four years imprisonment and three years’ supervised release, and was ordered to pay a $100,000 fine and forfeit $27,500 for his part in the Biodiagnostic Laboratory Services fraud.
What Happened?
On May 23, 2018, the U.S. District Court for the District of South Carolina, Judge Richard M. Gergel, imposed a $111 million judgment against former Health Diagnostics Laboratory (“HDL”) CEO, Latonya Mallory, and former BlueWave Healthcare Consultants (“BlueWave”) owners, Floyd Dent III and Robert Bradford Johnson.
What Happened?
In affirming the district court’s entry of summary judgment in favor of Accredo Health Group, Inc., and its co-defendants, the U.S. Court of Appeals for the Third Circuit held that a plaintiff alleging a False Claims Act (“FCA”) violation based on an anti-kickback theory must show that (1) a particular patient was exposed to a kickback-tainted referral,
The United States Court of Appeals for the Fourth Circuit has affirmed a District Court’s judgment on a husband and wife’s health care fraud convictions. The Appellate Court found that medical necessity was a “critical prerequisite to payment” and insurers would not have knowingly paid for medically unnecessary urine drug tests.
On Monday, the DOJ announced the resolution of criminal allegations and a False Claims Act (“FCA”) lawsuit a relating to a scheme to defraud the United States and obtain kickbacks in exchange for patient referrals. A major U.S. hospital chain, Tenet Healthcare Corporation and two subsidiaries, Atlanta Medical Center, Inc.
Respironics is to pay $34.8 million for alleged False Claims Act violations related to the sale of sleep masks designed to treat sleep apnea. Allegedly Respironics, a Murrysville, PA based company, paid kickbacks in the form of free call center services to durable medical equipment (DME) companies that purchased the masks.