Archive

Buying Blind – New Study Shows Continued Lack of Transparency in Healthcare Pricing

Posted 02/28/13

By Gordon Schnell It has been talked about for years as a way to rein in the runaway costs of healthcare in this country -- making price matter to the consumer. That is how it is with every other kind of purchase. Whether it is a car, a house, a college education, a new pair of sneakers, or even a quart of milk, virtually everyone weighs heavily into their purchase decision what it is ultimately going to...

Tagged in: Bundling and Unbundling, Healthcare Fraud,

A Hot Year for Health Care Fraud Recoveries

Posted 02/25/13

By Marlene Koury The coordinated efforts of the Departments of Justice (DOJ) and Health and Human Services (HHS) have resulted in a record breaking $4.2 billion in health care fraud recoveries in fiscal year 2012. The agencies are required to collaborate under the Health Care Fraud and Abuse Program, which is a joint DOJ/HHS effort to coordinate federal, state and local law enforcement activities to crack down on...

Tagged in: Healthcare Fraud,

Blaming the Whistleblower – Court Rejects Novel Defense to False Claims Act Charges

Posted 02/21/13

By Gordon Schnell It would seem on its face to be a rather brazen approach to defending a False Claims Act lawsuit. A healthcare company is charged with defrauding Medicare by billing it for medications the company never provided its patients. The company not only denies the wrongdoing. It goes one step further by arguing that, if there were any such misconduct, it was the whistleblower's fault by not...

Tagged in: Court Decision, Healthcare Fraud,

Electronic Medical Records – Still Waiting for the Big Returns

Posted 02/13/13

By Gordon Schnell The Obama administration is spending billions of dollars to push hospitals and doctors to go digital with their medical and billing records. It is supposed to revolutionize the industry, improving efficiency and patient safety and drastically reducing the cost of healthcare in this country. Unfortunately, the move to electronic health records (EHRs) has fallen far short of these hoped-for...

Tagged in: Electronic Health Records,

Scooter Store Caught Cheating the Government Out of Millions

Posted 01/24/13

By Marlene Koury It seems like such a wholesome company. They have those nice commercials where elderly folks are scooting to and fro on their power-mobility devices. It would seem that only an honest and trustworthy company would dedicate itself to caring for the needs of the elderly in this way. But, according to an independent auditor, The Scooter Store – the purveyor of these fine commercials and the...

Tagged in: Lack of Medical Necessity, Provider Fraud,

Stiff Amgen Fine Shows No Slowing Down in Government Prosecution of Off-Label Marketing

Posted 12/20/12

By Gordon Schnell It was only two weeks ago that the Second Circuit Court of Appeals came down with its groundbreaking decision in U.S. v. Caronia. In a 2-to-1 ruling by a three-judge panel, the appeals court overturned the conviction of a drug company sales representative for promoting a prescription drug for uses not approved by the FDA. The majority reasoned that banning such off-label marketing violated the...

Tagged in: Off-Label and Unapproved Use, Pharma Fraud,

More Trouble for Orthofix

Posted 12/20/12

By Marlene Koury Medical device maker Orthofix, Inc. this week obtained court approval for its June 2012 settlement proposal to resolve civil and criminal allegations that it defrauded Medicare through kickback schemes and overbilling for its bone-growth stimulators. Click here for the original government press release. The company will pay approximately $43 million for its misdeeds. This payment follows on...

Tagged in: Anti-Kickback and Stark, FCA Federal, Medicare,

Big Pharma Does Good -- Providing Access to the Poor

Posted 12/6/12

By Gordon Schnell There has been a lot of negative press on the fraudulent misadventures of Big Pharma. Particularly lately. Whether it be for falsifying studies, selling bad or ineffective drugs, concealing risky side effects, or ignoring FDA restrictions, it seems like every major drugmaker has been sued recently for putting profits before public health and safety. You name the industry player, chances are...

Tagged in: Healthcare Fraud,

Another Bad Report Card for the Beleaguered FDA

Posted 11/29/12

By Gordon Schnell The Food and Drug Administration (FDA) admittedly has a lot on its plate. Tasked with regulating the country’s food and medicine supply, not to mention the ever-evolving array of medical devices and procedures, the FDA is the federal agency perhaps most responsible for ensuring our health and well-being. If the agency does not perform up to task, a lot of people are affected. So it is no...

Tagged in: FDA Fraud,

Blackstone Medical Caught “Entertaining” Physicians in Exchange for Business

Posted 11/13/12

By Marlene Koury Orthofix International NV has agreed to pay $30 million to settle allegations that its subsidiary, Blackstone Medical Inc., ran a seven year long kickback scheme ranging from sham consulting agreements to providing physicians with adult “entertainment” to induce them into ordering their products. Click here to see Department of Justice press release and here for the complaint. Blackstone...

Tagged in: Healthcare Fraud, Other Government Health Programs,

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Buying Blind – New Study Shows Continued Lack of Transparency in Healthcare Pricing

A Hot Year for Health Care Fraud Recoveries

Blaming the Whistleblower – Court Rejects Novel Defense to False Claims Act Charges

Electronic Medical Records – Still Waiting for the Big Returns

Scooter Store Caught Cheating the Government Out of Millions

Stiff Amgen Fine Shows No Slowing Down in Government Prosecution of Off-Label Marketing

More Trouble for Orthofix

Big Pharma Does Good -- Providing Access to the Poor

Another Bad Report Card for the Beleaguered FDA

Blackstone Medical Caught “Entertaining” Physicians in Exchange for Business

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