The New York Times published an article noting that, despite huge investments in preventing Medicare fraud—up to $600 million a year—fraud against the program persists to the tune of $60 billion, which is equivalent to 10% of Medicare’s cost. For example, last year, the federal government was only able to recover $4.3 billion.
The United States District Court for the Eastern District of Pennsylvania has denied Merck’s attempt to obtain dismissal of a lawsuit accusing the drug company of violating the False Claims Act by providing the government with false information regarding the effectiveness of its mumps vaccine.
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A fraud suit alleging that five hospitals in the south bribed local clinics to refer undocumented immigrants to the hospitals to give birth has survived a motion to dismiss.
In the suit, captioned U.S. ex rel. Williams v. Health Management Associates (M.D. Ga.), a whistleblower alleges that the Georgia- and South Carolina-based hospitals paid local clinics fees,
The Eleventh Circuit has turned back an appeal from a nursing-home operator convicted of healthcare fraud after he billed government programs while his residents went without food, diapers and medication.
The case, United States v. Houser, is notable for its treatment of the so-called “worthless services” theory,
In a qui tam suit brought against Allergan, the U.S. Attorney’s Office in Philadelphia argued that the Anti-Kickback Statute should be interpreted more broadly to bar payment in exchange for health care services paid for by the Government. The government made this argument in a Statement of Interest filed in the non-intervened case of U.S.
Medtronic, Inc., a Fridley, Minnesota company, is alleged to have used various types of payments as incentives to physicians for implantation of pacemakers and defibrillators. Under the False Claims Act, the company agreed to pay 9.9 million dollars to resolve these allegations.
Medtronic induced the physicians to implant these devices by: paying the physicians for speaking engagements to increase the flow of referrals;
The Justice Department announced that Ashland Hospital Corp. d/b/a King’s Daughters Medical Center (KDMC) has agreed to pay nearly $41 million for needless medical procedures, between 2006 and 2011, including coronary stents and diagnostic catherizations that were submitted falsely to the Kentucky Medicaid and federal Medicare programs. It is also alleged that the hospital had a prohibited financial relationship with physician to refer patients to the hospital.
The Hope Cancer Institute, based in Kansas City, Kansas, and its Director, Dr. Raj Sadasivan, will pay $2.9 million to resolve a lawsuit filed by three former employees of the under the qui tam provisions of the False Claims Act. The suit alleges that from 2007 to 2011, Sadasivan instructed the cancer treatment center to submit bills for dosages of the cancer drugs Rituxan,
Endo Health and its subsidiary Endo Pharmaceuticals will pay $192 million to settle false claims act after whistleblower uncovered off-label marketing of Lidoderm. The FDA only approved Lidoderm for treatment of a complication of shingles. The company required its sales staff to market the drug for unapproved ailments including low-back pain and carpal tunnel syndrome.
Memorial Hospital of Ohio recently settled government claims related to improper referrals under the Anti-kickback and Stark statutes. These statutes restrict the financial incentives that health care providers can provide to other health care providers. The allegations concerned Memorial Hospital’s financial arrangement with a joint venture it had with a pain management physician and a relationship with an ophthalmologist who sold intraocular lenses at inflated prices through the hospital.
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.