Archive

September 22, 2017

The Securities and Exchange Commission today filed fraud charges against Aegerion Pharmaceuticals for exaggerating how many new patients actually filled prescriptions for an expensive drug that was its sole source of revenue. Aegerion, now a subsidiary of Novelion Therapeutics, has agreed to pay a $4.1 million penalty to settle the charges that it misled investors on multiple occasions in 2013.  The SEC’s complaint alleges that Aegerion told investors that the number of unfilled prescriptions for Juxtapid was not material and the “vast majority” of patients receiving prescriptions ultimately purchased the drug.  The SEC alleges that Aegerion’s records reflect that it was actually around 50 percent of prescriptions that resulted in actual drug purchases. SEC

November 7, 2017

Detroit-area doctor Johnny Trotter was sentenced to 180 months in prison and to pay roughly $9 million in restitution for his role in a $26 million health care fraud scheme that involved billing Medicare for nerve block injections that were never provided and efforts to circumvent Medicare’s investigation of the fraudulent scheme.  DOJ

October 30, 2017

Ohio-based Chemed Corporation and various wholly-owned subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation, agreed to pay $75 million to resolve charges they violated the False Claims Act by submitting claims for hospice services to Medicare for patients not terminally ill.  Vitas is the largest for-profit hospice chain in the United States and was acquired by Chemed in 2004.  The government alleged the defendants rewarded employees with bonuses for the number of patients receiving hospice services, without regard to whether they were actually terminally ill and whether they would have benefited from continuing curative care.  The government further alleged that Vitas submitted false claims to Medicare for continuous home care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements.  The allegations originated in several whistleblower lawsuits filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive a portion of the proceeds of the government's recovery.  DOJ

October 24, 2017

A federal judge awarded the government roughly $2 million in a verdict against Maryland-based home health care company Dynamic Visions, Inc. for violating the False Claims Act because its employees repeatedly and routinely falsified records to obtain funds from Medicaid.  Specifically, a government investigation found many of the company's patient files did not contain physician authorizations, called “plans of care,” as required under applicable regulations; contained plans of care that were not signed by physicians or other qualified health care workers; or contained forged signatures in order to cover up the lack of a physician’s authorization. DOJ (DDC)

October 20, 2017

Jacksonville-based toxicology lab Total Lab Care, LLC agreed to pay $212,500 to resolve allegations it violated the False Claims Act and Anti-Kickback Statute by improperly paying a physician for referring toxicology samples.  DOJ (MDFL)

October 13, 2017

First Coast Cardiovascular Institute, P.A. agreed to pay roughly $450,000 to settle charges of violating the False Claims Act by knowingly delaying repayment of more than $175,000 in overpayments owed to Medicare, Medicaid, TRICARE, and the Department of Veterans Affairs.  Specifically, the government alleged the company accrued credit balances or overpayments owed to federal health care programs and despite repeated warning failed to pay back the money it owed.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former First Coast employee Douglas Malie.  He will receive a whistleblower award of $90,000 from the proceeds of the government's recovery.  DOJ (MDFL)

October 4, 2017

Med-Fast Pharmacy, Inc. and its owner Douglas Kaleugher agreed to pay roughly $2.7 million to settle charges of violating the False Claims Act by distributing and submitting claims to Medicare for medication that it had either recycled from long-term care facilities serviced by its institutional pharmacy, or that otherwise differed from the medications identified as part of the claims submitted to the government.  The government further alleged the company sought reimbursement for the retail-packaged version of diabetes testing strips, while actually supplying patients with cheaper mail-order-packaged version of the same strips.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive an award from the proceeds of the government's recovery. DOJ (WDPA)

October 4, 2017

Four Houston-area hospitals agreed to pay $8.6 million to settle allegations they violated the False Claims Act and Anti-Kickback Statute by receiving kickbacks from various ambulance companies in exchange for rights to the hospitals’ more lucrative Medicare and Medicaid transport referrals.  The hospitals are all affiliated with Nashville-based Hospital Corporation of America include Bayshore Medical Center, Clear Lake Regional Medical Center, West Houston Medical Center and East Houston Regional Medical Center.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive an award from the proceeds of the government's recovery. DOJ (SDTX)

October 3, 2017

Michigan physician Abdul Haq pleaded guilty to conspiracy to commit health care fraud for his role in an approximately $19 million Medicare fraud scheme involving three Detroit area providers.  Haq admitted he conspired with the owner of the Tri-County Network and others to prescribe medically unnecessary controlled substances, including Oxycodone, Hydrocodone and Opana, to Medicare beneficiaries, many of whom were addicted to narcotics. DOJ

October 3, 2017

New York Anesthesiology Medical Specialties, P.C. (d/b/a New York Spine and Wellness Center) agreed to pay roughly $2 million to resolve claims it violated the False Claims Act by improperly billing the government for moderate sedation services.  DOJ (NDNY)