Community Health Network – Healthcare Fraud/Kickbacks ($135 million)

Constantine Cannon represented a whistleblower alleging Indiana-based Community Health Network violated the False Claims Act and Stark Law by paying physicians exorbitant salaries in exchange for referrals to Community Health facilities.  In December 2024, Community Health agreed to pay $135 million to settle the matter.  This was in addition to the $345 million the company paid in December 2023 to settle related allegations.  Read more – Indy Star, Modern Healthcare, DOJ, CC.

Fraud alert! California Hospital Pays $10.25M to Resolve Whistleblower Suit Alleging Medically Unnecessary Inpatient Admissions and Kickbacks

On December 12, the DOJ announced that California’s Oroville Hospital will pay $10,250,000 to the United States and the State of California to resolve allegations that it submitted false claims to Medicare and Medicaid for medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme, and the use of incorrect diagnosis codes to maximize reimbursements. Oroville Hospital will pay $9,518,954 to the federal government and $731,046 to the State of...

DaVita – Healthcare Fraud/Kickbacks ($34.5 million)

Constantine Cannon represented a whistleblower alleging Denver-based provider of dialysis services DaVita Inc. violated the False Claims Act and Anti-Kickback Statute by paying physicians for referring patients to DaVita’s dialysis centers and paying a competitor for referrals to DaVita Rx, a former subsidiary that provided pharmacy services for dialysis patients.  In July 2024, DaVita agreed to settle the matter for roughly $34.5 million.  The whistleblower received roughly 18.5% of the government’s recovery.  Read more...

Texas Pharmacy Owner Sentenced for Illegal Kickbacks and Money Laundering in $59M Settlement

In a recent case of healthcare fraud, a pharmacy owner from Fort Worth, Texas, has been sentenced to four years and four months in prison and has been ordered to pay over $59 million in restitution for his role in an alleged illegal kickback and money laundering scheme. Specifically, the allegations of fraud involved TRICARE, the federal program that provides health insurance benefits to active and retired military service members...

Healthcare Fraud Jury Verdict Demonstrates DOJ’s Commitment to Prosecuting Kickbacks

Very few cases ever filed reach jury trial. The vast majority are dismissed or settle long before that stage. This trend is particularly true for cases filed under the False Claims Act (FCA), where defendants face treble damages and penalties if they are found liable at trial.  In FCA trials where the Government and/or whistleblower prevails, the judge, unbeknownst to the jury, is required to triple the amount of compensatory...

Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

The Department of Justice regularly highlights the areas of fraudulent conduct it intends to target as enforcement priorities.  These identified enforcement priorities tend to cover burgeoning areas of fraud or particular misbehavior especially ripe or prevalent because of the particular times we live in.  As might be expected, DOJ's current listing of priorities includes fraud related to the pandemic, opioids, the elderly, electronic health records, telehealth services, and as most...

Catch of the Week: Bayada Home Health Care Settles Kickback Allegations for $17 Million in Case Demonstrating that Kickbacks Come in Many Forms

Last week, Bayada Home Health Care, Inc., a national home health company with more than $1.5 billion in reported revenues and offices in twenty-two states, agreed to pay the United States $17 million to settle allegations that it violated the federal Anti-Kickback Statute (AKS).  The AKS prohibits paying illegal remuneration in any form to induce business or referrals paid for with federal health care dollars, and the Bayada case demonstrates...

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe anemia and fatigue.  This is...

Catch of the Week: Roche and Humana Agree to Settle Kickbacks in the Medicare Advantage Program

A recent settlement of a whistleblower case might be a sign of things to come for litigation under the False Claims Act (FCA) in the whistleblower program. Pharmaceutical company, Roche, and Medicare Advantage insurer, Humana, have agreed to pay $12.5 million to resolve allegations that the companies violated the anti-kickback statute. This is the first FCA settlement resulting out of a pharmaceutical company allegedly paying kickbacks to a Medicare Advantage...

Constantine Cannon Settles Case Alleging Kickbacks to Multi-Practice Physicians’ Group for Referrals to Wholly Owned Ambulatory Surgery Center – Whistleblower Was Former CEO

Constantine Cannon, on behalf of whistleblower Jeffery Neuberger, has settled a False Claims Act action against Mid Dakota Clinic and a related entity.  Mr. Neuberger, the former CEO of the medical group, filed his case in 2017 alleging a scheme in violation of the Anti-Kickback Statute (AKS) between the medical group and its wholly owned ambulatory surgery center (ASC).  At issue was a financial arrangement whereby all of the multi-practice...