Archive

Catch of the Week – Walgreens Pays Record $273 Million To Settle Three FCA Suits

Posted 01/25/19

Storefront of brick-faced Walgreens location

Three separate qui tam actions brought by whistleblowers against Walgreens Boots Alliance, Inc. (Walgreens) have resolved in what amounts to the largest settlement payouts for a retail pharmacy. In the first action, two former Walgreens pharmacists alleged that the company sought reimbursement for insulin pens it dispensed to Medicare and Medicaid beneficiaries who did not need them. Walgreens did so in two ways....

Tagged in: Catch of the Week, Drug and DME Pricing, FCA Federal, Pharma Fraud, Whistleblower Rewards,

Top Ten Healthcare Recoveries of 2018

Posted 01/15/19

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2018 stemmed from healthcare fraud matters. And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. Here are the top ten healthcare recoveries of 2018 by the numbers:

1. Amerisource Bergen Corporation - In...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Managed Care, Medical Billing Fraud, Medical Devices and DME, Medicare, Pharma Fraud, Risk Adjustment Fraud, Top 10,

Top Ten Financial and Healthcare Fraud Prison Sentences of 2018

Posted 01/11/19

Financial and healthcare fraud schemes can result not just in civil investigations and liability, but also in prison time for the individuals involved. In 2018, the Department of Justice obtained substantial prison sentences in numerous cases involving healthcare and financial frauds, helping to bring justice to the patients, investors, or individuals harmed by criminal fraudsters. Many of the fraudulent schemes...

Tagged in: Criminal Proceedings, Financial and Investment Fraud, Healthcare Fraud, Securities Fraud, Top 10,

Healthcare Whistleblowers Continue as Backbone of DOJ Recoveries: A Look at DOJ’s 2018 Fraud and FCA Statistics

Posted 01/2/19

The Department of Justice released its annual report of DOJ recoveries for fraud and false claims against the U.S., showing recoveries of $2.8 billion in settlements and judgments for the fiscal year ending September 2018. Once again, recoveries for healthcare fraud accounted for the majority of funds recovered: of the $2.8 billion recovered, $2.5 billion was attributed to healthcare fraud. And, once again,

Tagged in: FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Statistics,

Catch of the Week — Hospice Provider to Pay $6 Million to Settle False Claims Act Suit

Posted 12/21/18

Younger person resting hand on hand of seated elderly woman with cane

SouthernCare, Inc., a hospice provider owned by Curo Health Services, has agreed to pay the federal government nearly $6 million dollars to settle a lawsuit alleging that the company defrauded Medicare by billing medically unnecessary hospice care. The fraud was unearthed by two whistleblowers formerly employed by the company, who filed suit under the qui tam provisions of the False Claims Act, where they will share...

Tagged in: Catch of the Week, FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case,

Catch of the Week — PA Hospital and Health System Pays $12.5 Million to Settle FCA Allegations

Posted 12/14/18

Doctor discussing knee injury with patient seated on exam table

Coordinated Health Holding Company, LLC, a for-profit hospital and health system, and its founder, owner, and CEO, Emil DiIorio, M.D., have agreed to pay a combined $12.5 million to settle allegations of violating the False Claims Act for submitting false claims to Medicare and other federal health care programs for orthopedic surgeries. Coordinated Health is a for-profit hospital and health system based in the Lehigh...

Tagged in: Bundling and Unbundling, Catch of the Week, FCA Federal, Healthcare Fraud, Hospital Fraud, Medical Billing Fraud, Medicare, Other Government Health Programs, Provider Fraud,

When a Gift is Not a Gift: Pharma Companies Use Charities to Increase Drug Profits

Posted 12/13/18

Pile of blister packs with medications of different colors and sizes

Imagine if at the end of Charles Dickens’ “A Christmas Carol,” Ebenezer Scrooge announced that he was giving the prize turkey to the Cratchit family for Christmas dinner, but that this “gift” was conditional upon Bob Cratchit agreeing to work even longer hours in the new year, the turkey being cooked in a certain way, and only certain family members eating it. Would we consider Scrooge to have been truly...

Tagged in: Anti-Kickback and Stark, FCA Federal, Pharma Fraud,

Listen: Expected Dismissal of Providence Health Upcoding Suit

Posted 12/7/18

Constantine Cannon partner Mary Inman joins the RAC Monitor “Monitor Monday” podcast to comment on the government’s decision to decline to intervene in a $188.1 million whistleblower lawsuit Med Analytics, LLC filed against Providence Health (now known as Providence St. Joseph) alleging Providence upcoded diagnoses it submitted to government health programs for reimbursement. Several reports have indicated the...

Tagged in: CC Lawyers, Managed Care, Upcoding, Whistleblower Case,

Catch of the Week — Actelion Pharmaceticals

Posted 12/7/18

Red and yellow capsules on top of U.S. currency

This week's Department of Justice "Catch of the Week" goes to Actelion Pharmaceuticals US, Inc., a California pharmaceutical company that sells various pulmonary arterial hypertension drugs, including Tracleer, Ventavis, Veletri, and Opsumit. Yesterday, Actelion agreed to pay $360 million to resolve allegations that it violated the Anti-Kickback Statute by indirectly paying drug copays for thousands of Medicare...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Healthcare Fraud, Pharma Fraud,

Watch: “Taking Advantage” Highlights Medicare Risk Adjustment Fraud

Posted 11/2/18

Constantine Cannon partner Mary Inman and two Constantine Cannon whistleblower clients are featured in Episode 3 of the PBS series “Playing by the Rules: Ethics at Work.” The episode investigates ”risk adjustment” in the Medicare Advantage program and practices by some of America’s largest insurance companies to make patients look sicker than they really are-which boosts payments to the insurance companies...

Tagged in: CC Lawyers, Healthcare Fraud, Managed Care, Risk Adjustment Fraud,

Contact

Click here for a confidential contact or call:

Catch of the Week – Walgreens Pays Record $273 Million To Settle Three FCA Suits

Top Ten Healthcare Recoveries of 2018

Top Ten Financial and Healthcare Fraud Prison Sentences of 2018

Healthcare Whistleblowers Continue as Backbone of DOJ Recoveries: A Look at DOJ’s 2018 Fraud and FCA Statistics

Catch of the Week — Hospice Provider to Pay $6 Million to Settle False Claims Act Suit

Catch of the Week — PA Hospital and Health System Pays $12.5 Million to Settle FCA Allegations

When a Gift is Not a Gift: Pharma Companies Use Charities to Increase Drug Profits

Listen: Expected Dismissal of Providence Health Upcoding Suit

Catch of the Week — Actelion Pharmaceticals

Watch: “Taking Advantage” Highlights Medicare Risk Adjustment Fraud

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: