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August 18, 2017

Illinois and other states announced a $465 million settlement between the federal government and states with Mylan Inc. and its wholly-owned subsidiary, Mylan Specialty L.P. (Mylan), to resolve allegations that Mylan knowingly underpaid rebates owed to the Medicaid program for EpiPen® and EpiPen Jr.® (EpiPen) dispensed to Medicaid beneficiaries. The settlement resolves allegations that from July 29, 2010 to March 31, 2017, Mylan submitted false statements to the Centers for Medicare and Medicaid Services (CMS) that incorrectly classified EpiPens under terms defined in the Rebate Statute and Rebate Agreement. Mylan also failed to report a "Best Price" to CMS for EpiPens, as directed by the same statute. As a result, Mylan submitted false statements related to EpiPens to CMS and the states for Medicaid rebate purposes and underpaid EpiPen rebates to the state Medicaid programs. IL, IA

August 18, 2017

Illinois announced a $4.45 million settlement with the pharmaceutical company Insys Therapeutics Inc. (Insys) for deceptively marketing and selling a highly addictive opioid drug for an array of treatments that were not approved by the Food And Drug Administration (FDA). The settlement resolves Madigan’s 2016 lawsuit against Insys for its sale of Subsys, which is significantly more powerful than morphine and intended exclusively for the treatment of breakthrough cancer pain. Madigan alleged Insys deceptively promoted and sold Subsys to treat a wide variety of pain, such as back and neck pain, even though the drug was not approved for those uses. IL

August 2, 2017

Posted  08/8/17
Atlanta-based pain management clinic Atlanta Medical Clinic and its owner Dr. Timothy Dembowski agreed to pay $250,000 to resolve charges they violated the False Claims Act by billing for services performed by a physician suspended from the Medicare program and administering foreign, non-FDA approved drugs, which are not eligible for reimbursement under the Medicare program.  DOJ (NDGA)

July 24, 2017

Posted  08/8/17
Dr. James Norman, the owner and operator of Norman Parathyroid Center, agreed to pay $4 million to resolve allegations he violated the False Claims Act by billing Medicare for pre-operative examination services for which he had already received payment from the government.  These extra fees ranged from $150 to $750 for Florida residents, to $1,750 or more for patients who lived out-of-state, adding up to hundreds of...

July 24, 2017

Posted  08/8/17
Tennessee-based Pain Management Group P.C. agreed to pay $312,000 to settle charges it violated the False Claims Act by billing for medically unnecessary urine drug tests and non-FDA approved pharmaceuticals Botox, Supartz, and Eufflexa, which the company purchased from foreign-based suppliers.  DOJ (MDTN)

July 21, 2017

Posted  08/8/17
Baton Rouge-based home healthcare company Charter Home Health agreed to pay $1.7 million to settle charges of violating the False Claims Act and Anti-Kickback Statute by paying for patient referrals.  DOJ (MDLA)

July 17, 2017

Posted  08/8/17
Ohio-based nursing home operators Foundations Health Solutions Inc., Olympia Therapy Inc. and Tridia Hospice Care Inc., and their executives Brian Colleran and Daniel Parker, agreed to pay roughly $19.5 million to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the...

July 14, 2017

Posted  08/8/17
Rodney Hesson and Gertrude Parker, owners of Nursing Home Psychological Services and Psychological Care Services, were respectively sentenced to 180 months and 84 months in prison and to respectively pay $13.8 million and $7.3 million in restitution for their involvement in a $25.2 million Medicare fraud scheme involving billing Medicare for psychological testing services that nursing home residents did not need or in...

July 14, 2017

Posted  08/8/17
Narco Freedom, Inc., a 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, and Joining Hands and Haigler will...

July 13, 2017

Posted  08/8/17
The DOJ and HHS announced the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings.  DOJ
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