Category: Pharmaceuticals
Medicare Advantage Organizations have come under increased fire as their parent companies continue to acquire more healthcare practices across the country. Experts suggest that this vertical integration has led to inflated Medicare spending, with providers facing new pressure to diagnosis chronic conditions that fetch more money for Medicare Advantage plans.
It’s not always sunny for everyone on the Florida beaches. On January 30, 2023, the United States Attorney’s Office for the Middle District of Florida announced that Al Clint LaRoche of West Palm Beach pleaded guilty to two counts of bank fraud involving more than $1 million from the Paycheck Protection Program (PPP) loan program.
- 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.
- January 06, 2020
- Construction, Defense Industry, Federal False Claims Act, Financial Industry, Government Contracts, Medicaid, Medicare, Medicare Part D, Pharmaceuticals, State False Claims Acts
This is the second part of a two-part article.
In the first of this two-part series, we discussed the success of the United States’ federal False Claims Act (FCA),[1] the rise of international whistleblowers through a study of the Michael Epp case,
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,
United States ex rel. Gohil v. Aventis, Inc. is a long-running False Claims Act suit filed in the Eastern District of Pennsylvania by an ex-sales specialist against his former employer, behemoth pharmaceutical company, Sanofi Aventis. Relator Yoash Gohil filed this qui tam suit in 2002 alleging that his former employer engaged in a fraudulent marketing scheme to promote off-label the chemo-therapy drug,
On Tuesday, in United States ex rel. Nevyas v. Allergan, Inc., an Eastern District of Pennsylvania district court denied pharmaceutical giant Allergan’s motion to dismiss False Claims Act (“FCA”) allegations brought against it by Relator eye doctors in the Philadelphia area. In so doing, the Court rejected Allergan’s novel argument that,
On May 14, 2015, PharMerica Corp. agreed to pay $31.5 million to resolve a False Claims Act and Controlled Substances Act lawsuit alleging that the company had dispensed Schedule II controlled drugs without valid prescriptions and then billed Medicare for the improperly dispensed drugs.
PharMerica, a long-term care pharmacy that dispenses medications to residents of long-term care facilities,
The United States Department of Justice (“DOJ”) recently announced that PharMerica Corp. will pay $31.5 million, including more than $4 million to a whistleblower, to settle alleged violations of the Controlled Substances Act (“CSA”) and False Claims Act (“FCA”) related to the company’s improper dispensing of narcotics and submission of false claims to Medicare Part D.
Even as the abuse of prescription drugs has escalated and the national crackdown on it has occurred, new data suggests that doctors are prescribing even larger numbers of prescriptions for the most potent controlled substances to Medicare patients.
And, along with the increase in the number of prescriptions written,
