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Top-10 False Claims Act Kickback Recoveries for 2017

Posted  January 19, 2018

Here is our look-back at the Top-10 Department of Justice False Claims Act recoveries in 2017 for violations of the Anti-Kickback Statute and/or the Stark Law.  Click here for a full chronological listing of all the DOJ False Claims Act recoveries in 2017.

  1. Shire Pharmaceuticals LLC  The Ireland-based drug maker and certain subsidiaries agreed to pay $350 million to settle charges that Shire and the company it acquired in 2011, Advanced BioHealing, violated the False Claims Act and Anti-Kickback Statute by using kickbacks and other unlawful methods to induce clinics and physicians to use or overuse their “Dermagraft” skin product. Whistleblower Insider
  1. Celgene Corp. – The New Jersey-based pharmaceutical manufacturer agreed to pay $280 million to settle charges of violating the False Claims Act by promoting two cancer treatment drugs, Thalomid and Revlimid, for uses not approved by the FDA.  The allegations included the use of false and misleading statements about the drugs, and paying kickbacks to physicians to induce them to prescribe the drugs. DOJ (CDCA)
  1. United Therapeutics Corporation – The Maryland-based pharmaceutical company agreed to pay $210 million to resolve claims it violated the False Claims Act and Anti-Kickback Statute by using a foundation as a conduit to cover the copays of Medicare patients taking the company’s pulmonary arterial hypertension drugs. DOJ
  1. eClinicalWorks  The Massachusetts company which is one of the country’s largest vendors of electronic health records software, along with certain of its employees, agreed to pay $155 million to resolve charges the company violated the False Claims Act by misrepresenting the capabilities of its software and paying kickbacks to certain customers in exchange for promoting its product. DOJ
  1. DaVita Rx LLC – The Texas-based nationwide pharmacy that specializes in serving patients with severe kidney disease, agreed to pay $63.7 million to resolve charges of violating the False Claims Act by billing Medicare for prescription medications never shipped, shipped but subsequently returned, and that did not comply with requirements for documentation of proof of delivery, refill requests, or patient consent. The settlement also resolves allegations that DaVita paid financial inducements to Medicare beneficiaries in violation of the Anti-Kickback Statute. DOJ
  1. Narco Freedom, Inc.  The former operator of outpatient chemical dependency clinics, Joining Hands Management Inc., an operator of short-term residences known as “three-quarter houses,” and Joining Hands co-owner Devorah Haigler, settled claims of violating the False Claims Act.  The government will receive a $50.5 million allowed claim in the Narco Freedom bankruptcy proceeding.  The government alleged the defendants engaged in a kickback scheme whereby Narco made monthly cash payments to Joining Hands in exchange for Haigler and others referring residents of Joining Hands three-quarter houses to NARCO outpatient programs. DOJ (SDNY)
  1. Walgreen Co. – The nationwide retail pharmacy operator agreed to pay $50 million to settle charges it violated the False Claims Act and the Anti-Kickback Statute by enrolling hundreds of thousands of beneficiaries of government healthcare programs in its Prescription Savings Club program by inducing them with discounts and other monetary incentives. DOJ (SDNY)
  1. PAMC Ltd. – PAMC and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, agreed to pay $42 million to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  These relationships took the form of (1) arrangements under which the defendants allegedly paid above-market rates to rent office space in physicians’ offices, and (2) marketing arrangements that allegedly provided undue benefit to physicians’ practices. DOJ
  1. Mercy Hospital Springfield – The Missouri hospital and its affiliate Mercy Clinic Springfield Communities agreed to pay $34 million to settle charges they violated the False Claims Act by engaging in improper financial relationships with referring physicians. DOJ
  1. EmCare Inc.  The Dallas-based physician group agreed to pay $29.6 million to settle charges of violating the False Claims Act and Anti-Kickback Statute for allegedly receiving kickbacks in exchange for patient referrals to hospitals owned by the now-defunct Health Management Associates.  According to the government, EmCare received remuneration from HMA to recommend patients be admitted to HMA hospitals on an inpatient basis when the patients should have been treated on an outpatient basis. DOJ

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Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Top 10,

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