Top Ten Healthcare False Claims Act Recoveries for 2023
Posted 01/30/24
This past year was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. And as we noted in our recent Top Ten listing of False Claims Act recoveries for 2023, all but 3 of the Top Ten recoveries were in the healthcare space involving various schemes to defraud Medicare and Medicaid. So here is our look at the Top Ten healthcare recoveries for...
Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million
Posted 01/12/24
RDx Bioscience Inc. (“RDx”), a clinical laboratory that operated in New Jersey, and its owner and CEO agreed to pay $13.25 million to settle a False Claims Act case alleging kickbacks and unnecessary testing schemes, according to a recent DOJ press release. The press release also notes that RDx and its owner/CEO agreed to cooperate with the DOJ’s “investigations of, and litigation against, other participants...
It was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. As usual, most of the recoveries were in the healthcare space with seven of the Top-10 involving various schemes to defraud Medicare and Medicaid.
Several of these Top-10 recoveries involved enforcement actions targeting violations of the Anti-Kickback Statute and Stark Law, which prohibit medical...
Community Health Network Pays $345 Million to Settle Stark Law Case
Posted 12/21/23
Community Health Network Inc., based in Indianapolis, recently settled with the U.S. government for $345 million, addressing allegations under the False Claims Act related to the Stark Law. This landmark case emphasizes the importance of whistleblowers to combat Medicare fraud.
The Stark Law prevents hospitals from billing Medicare for services referred by physicians who have a financial relationship with the...
$45.6 Million Settlement in False Claims Act Case Against Nursing Facility Defendants
Posted 11/17/23
The DOJ recently announced another settlement of a False Claims Act case against skilled nursing facilities (SNFs). This time, it was a $45.6 million settlement of a False Claims Act case that the government brought against six SNFs; a management company called Paksn Inc.; and Prema Thekkek, the owner. The six SNFs do business as (i) Bay Point Healthcare Center (Kayal Inc.); (ii) Gateway Care & Rehabilitation...
Catch of the Week: Gramercy Cardiac Diagnostic Services
Posted 09/26/23
This week's Department of Justice (DOJ) Catch of the Week goes to Gramercy Cardiac Diagnostic Services and its owner Klaus Peter Rentrop. Gramercy provides cardiac diagnostic imaging services, previously operating out of four offices in New York City. On Monday (September 18), the DOJ announced Rentrop and Gramercy will pay $6.5 million for violating the False Claims Act and Anti-Kickback Statute through their...
This week's Scoundrel in the Spotlight is Minal Patel who last week (August 18) was sentenced to 27 years in prison for defrauding Medicare of almost half a billion dollars for genetic testing patients did not need and were procured through bribes and kickbacks. In announcing the sentencing, the government trumpeted the matter as one of the largest genetic testing fraud cases ever tried to verdict.
Here is how...
District Court Rules that Broad Measure of Damages Applies in False Claims Act Case, Greatly Increasing Defendants’ Exposure
Posted 07/21/23
Several aspects of the federal False Claims Act incentivize the government and relators to bring fraud claims to recover damages to the government. In addition to awarding relators typically between 15% and 30% of the proceeds of the action or settlement; awarding reasonable attorneys’ fees, expenses, and costs; and applying statutory penalties for each false claim submitted; the act also provides for treble...
This week's Department of Justice (DOJ) Catch of the Week goes to electronic health record (EHR) technology vendor NextGen Healthcare Inc. Today, DOJ announced the company has agreed to pay $31 million to settle charges it violated the False Claims Act by misrepresenting to the government the capabilities of its EHR software and providing kickbacks to its users to induce them to recommend NextGen’s software. The...
This week's Department of Justice (DOJ) Catch of the Week goes to Florida-based compounding pharmacies Smart Pharmacy, Inc. and SP2, and their owner Gregory Balotin. Yesterday, they agreed to pay at least $7.4 million to settle charges they violated the False Claims Act by adding an antipsychotic drug to topical pain creams solely to boost Medicare reimbursement. Not because of any medical purpose the drug...