Archive

Question of the Week — Will Healthcare Settlements Continue to Dominate False Claims Act Recoveries?

Posted 07/24/19

Recent blockbuster settlements continue past trends: healthcare fraud has so far this year dominated FCA recoveries. During the first half of 2019, the Department of Justice (“DOJ”) secured over $750 million in settlements from False Claims Act (“FCA”) cases. And just past the mid-year point, total recoveries have nearly doubled due to a $700 million civil settlement ($1.4 billion total) entered on July 11th...

Tagged in: FCA Federal, Government Programs Fraud, Healthcare Fraud, Housing and Mortgage Fraud, Pharma Fraud,

Government Documents Dangerous Failures in Hospice-Care Facilities

Posted 07/19/19

The Department of Health and Human Services (HHS) recently released two deeply concerning reports about failures in hospice care. Hospices put patients in harm’s way by failing to meet Medicare’s standards of care, failing to protect patients from abuse, and failing to report dangerous conditions. All told, the reports paint a grim picture of substandard health services for a particularly vulnerable patient...

Tagged in: Healthcare Fraud, Home Health and Hospice, Medicare,

Question of the Week — Is DOJ’s Blockbuster $1.4 Billion Opioid Settlement Just the Tip of the Iceberg?

Posted 07/12/19

Pill container spilled over with pills fallen out.

On July 11, DOJ announced a record-breaking $1.4 billion settlement with Reckitt Benckiser Group plc (RB Group) over allegations that its former subsidiary Indivior Inc. inflated prescriptions of its opioid-withdrawal drug Suboxone through numerous unestablished representations about the drug’s safety and addictiveness. The settlement resolves RB Group’s potential civil and criminal liability, but Indivior still...

Tagged in: Anti-Kickback and Stark, FDA Fraud, Healthcare Fraud, Medicaid, Medicare, Other Government Health Programs, Pharma Fraud, Provider Fraud,

New York Introduces Bills to Expand Whistleblower Protections

Posted 06/21/19

Under current law, whistleblowers who reported fraudulent activity in the government or other settings in the State of New York are typically barred from bringing other legal actions. Maybe not anymore. Last week, both the New York State Senate and Assembly signed off on a series of amendments aimed at providing greater protection for employees who notice and report illegal activity, and expanding the definition of a...

Tagged in: FCA State, Healthcare Fraud, Importance of Whistleblowers, Pharma Fraud, Retaliation, Whistleblower Eligibility, Whistleblower Protection Laws,

Question of the Week — Should providers who defraud Medicare be excluded from it?

Posted 06/18/19

Fortune Cookie with Message with Message Saying "Not Eligible for Medicare!"

Sometimes, though rarely, when a medical provider settles a False Claims Act case or is found to have violated the FCA at trial, they are excluded from participating in healthcare programs as a condition of resolving the case. Often, this is a limited-time ban that is meant to incentivize providers to follow Medicare’s rules in the future and to deter other providers from committing fraud. Between Medicare,...

Tagged in: FCA Federal, Medical Billing Fraud, Medicare, Question of the Week, Upcoding,

Question of the Week — Is it time for a legislative fix to limit sky high air ambulance costs?

Posted 06/14/19

Emergency Personnel Rushing to Helicopter Ambulance

As rural hospitals continue to shutter, accessible emergency medical care is out of reach for an increasing number of Americans. When health emergencies arise, patients in rural communities often must rely on helicopter ambulances to get them quickly to care. But the Government Accountability Office reported the median cost for a helicopter ambulance ride was over $36,000 in 2017. The problem will likely continue...

Tagged in: Ambulance, Question of the Week,

Catch of the Week — Wound Care Device Manufacturer ACell Inc.

Posted 06/14/19

Our Catch of the Week goes to ACell Inc., a Maryland-based medical device manufacturer that pleaded guilty to violating the Federal Food, Drug, and Cosmetic Act (FDCA) by failing to report that it had partially removed its wound-care product, MicroMatrix, from the market because it was contaminated with endotoxins, placing treated patients in danger of serious infection, even death, without informing the FDA that it...

Tagged in: Catch of the Week, FCA Federal, FDA Fraud, Medical Devices and DME, Whistleblower Case,

Question of the Week — Should the Medicare Fraud Hotline or HHS OIG Reward Informants?

Posted 06/7/19

Opioid manufacturer Insys Therapeutics agreed to a $225 million settlement related to allegations that it unlawfully marketed its drug Subsys and paid kickbacks to providers through “speaker programs” that rewarded providers who prescribed Subsys. We previously asked whether our readers thought CEOs should be more liable for corporate wrongdoing after the Insys CEO was convicted for participating in a criminal...

Tagged in: FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medicare, Question of the Week, Reporting to Government, Whistleblower Rewards,

Default by Nursing Home Chain on HUD-Guaranteed Mortgage Highlights Potential for Fraud in Section 232 Program

Posted 06/3/19

Last week, the New York Times reported on the collapse of Rosewood Care Centers, a chain of nursing homes with facilities in Illinois and Missouri. According to the report, the chain had faced years of operational and financial difficulties, including fines by state regulators, personal injury claims by residents, and lawsuits by investors and vendors. When it went under, Rosewood defaulted on $146 million in...

Tagged in: FCA Federal, Government Loan Programs, Housing and Mortgage Fraud, SNF,

DOJ Catch of the Week — Dr. Joseph Galichia

Posted 05/31/19

Paper Ripped Uncovering Medical Necessity Wording

This week's DOJ Catch of the Week goes to Kansas cardiologist Joseph Galichia. Yesterday, he agreed to pay $5.8 million to resolve allegations that he and his company, Galichia Medical Group, violated the False Claims Act by billing federal health care programs for medically unnecessary cardiac stent procedures. This is the government's third False Claims Act settlement with Dr. Galichia. Which may explain why he also...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

Contact

Click here for a confidential contact or call:

Question of the Week — Will Healthcare Settlements Continue to Dominate False Claims Act Recoveries?

Government Documents Dangerous Failures in Hospice-Care Facilities

Question of the Week — Is DOJ’s Blockbuster $1.4 Billion Opioid Settlement Just the Tip of the Iceberg?

New York Introduces Bills to Expand Whistleblower Protections

Question of the Week — Should providers who defraud Medicare be excluded from it?

Question of the Week — Is it time for a legislative fix to limit sky high air ambulance costs?

Catch of the Week — Wound Care Device Manufacturer ACell Inc.

Question of the Week — Should the Medicare Fraud Hotline or HHS OIG Reward Informants?

Default by Nursing Home Chain on HUD-Guaranteed Mortgage Highlights Potential for Fraud in Section 232 Program

DOJ Catch of the Week — Dr. Joseph Galichia

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: