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Top Ten Healthcare False Claims Act Recoveries for 2023

Posted 01/30/24

Doctor Holding Stethoscope with Crossed Arms

This past year was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. And as we noted in our recent Top Ten listing of False Claims Act recoveries for 2023, all but 3 of the Top Ten recoveries were in the healthcare space involving various schemes to defraud Medicare and Medicaid. So here is our look at the Top Ten healthcare recoveries for...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Top 10, Whistleblower Case,

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Posted 01/12/24

Laboratory Analysis. Scientist Measuring Sample

RDx Bioscience Inc. (“RDx”), a clinical laboratory that operated in New Jersey, and its owner and CEO agreed to pay $13.25 million to settle a False Claims Act case alleging kickbacks and unnecessary testing schemes, according to a recent DOJ press release. The press release also notes that RDx and its owner/CEO agreed to cooperate with the DOJ’s “investigations of, and litigation against, other participants...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity,

Top Ten False Claims Act Recoveries in 2023

Posted 01/11/24

It was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. As usual, most of the recoveries were in the healthcare space with seven of the Top-10 involving various schemes to defraud Medicare and Medicaid. Several of these Top-10 recoveries involved enforcement actions targeting violations of the Anti-Kickback Statute and Stark Law, which prohibit medical...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, Government Programs Fraud, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Top 10, Whistleblower Case,

Community Health Network Pays $345 Million to Settle Stark Law Case

Posted 12/21/23

Handshake in room with dark window blinds

Community Health Network Inc., based in Indianapolis, recently settled with the U.S. government for $345 million, addressing allegations under the False Claims Act related to the Stark Law. This landmark case emphasizes the importance of whistleblowers to combat Medicare fraud. The Stark Law prevents hospitals from billing Medicare for services referred by physicians who have a financial relationship with the...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Whistleblower Case,

$45.6 Million Settlement in False Claims Act Case Against Nursing Facility Defendants

Posted 11/17/23

Nurse Holding Clipboard in Front of Nursing Patient

The DOJ recently announced another settlement of a False Claims Act case against skilled nursing facilities (SNFs). This time, it was a $45.6 million settlement of a False Claims Act case that the government brought against six SNFs; a management company called Paksn Inc.; and Prema Thekkek, the owner. The six SNFs do business as (i) Bay Point Healthcare Center (Kayal Inc.); (ii) Gateway Care & Rehabilitation...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, SNF, Whistleblower Case,

Catch of the Week: Gramercy Cardiac Diagnostic Services

Posted 09/26/23

businessmen shaking hands and other placing money in others pocket

This week's Department of Justice (DOJ) Catch of the Week goes to Gramercy Cardiac Diagnostic Services and its owner Klaus Peter Rentrop. Gramercy provides cardiac diagnostic imaging services, previously operating out of four offices in New York City. On Monday (September 18), the DOJ announced Rentrop and Gramercy will pay $6.5 million for violating the False Claims Act and Anti-Kickback Statute through their...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Provider Fraud, Whistleblower Case,

Scoundrel Spotlight - Medicare Fraudster Minal Patel

Posted 08/23/23

This week's Scoundrel in the Spotlight is Minal Patel who last week (August 18) was sentenced to 27 years in prison for defrauding Medicare of almost half a billion dollars for genetic testing patients did not need and were procured through bribes and kickbacks. In announcing the sentencing, the government trumpeted the matter as one of the largest genetic testing fraud cases ever tried to verdict. Here is how...

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

District Court Rules that Broad Measure of Damages Applies in False Claims Act Case, Greatly Increasing Defendants’ Exposure

Posted 07/21/23

Several aspects of the federal False Claims Act incentivize the government and relators to bring fraud claims to recover damages to the government. In addition to awarding relators typically between 15% and 30% of the proceeds of the action or settlement; awarding reasonable attorneys’ fees, expenses, and costs; and applying statutory penalties for each false claim submitted; the act also provides for treble...

Tagged in: Anti-Kickback and Stark, Court Decision, FCA Federal, Healthcare Fraud,

Catch of the Week: NextGen Healthcare

Posted 07/14/23

This week's Department of Justice (DOJ) Catch of the Week goes to electronic health record (EHR) technology vendor NextGen Healthcare Inc. Today, DOJ announced the company has agreed to pay $31 million to settle charges it violated the False Claims Act by misrepresenting to the government the capabilities of its EHR software and providing kickbacks to its users to induce them to recommend NextGen’s software. The...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Electronic Health Records, FCA Federal, Healthcare Fraud, Whistleblower Case,

Catch of the Week: Smart Pharmacy, Inc.

Posted 06/16/23

This week's Department of Justice (DOJ) Catch of the Week goes to Florida-based compounding pharmacies Smart Pharmacy, Inc. and SP₂, and their owner Gregory Balotin. Yesterday, they agreed to pay at least $7.4 million to settle charges they violated the False Claims Act by adding an antipsychotic drug to topical pain creams solely to boost Medicare reimbursement. Not because of any medical purpose the drug...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicare, Whistleblower Case,

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Top Ten Healthcare False Claims Act Recoveries for 2023

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Top Ten False Claims Act Recoveries in 2023

Community Health Network Pays $345 Million to Settle Stark Law Case

$45.6 Million Settlement in False Claims Act Case Against Nursing Facility Defendants

Catch of the Week: Gramercy Cardiac Diagnostic Services

Scoundrel Spotlight - Medicare Fraudster Minal Patel

District Court Rules that Broad Measure of Damages Applies in False Claims Act Case, Greatly Increasing Defendants’ Exposure

Catch of the Week: NextGen Healthcare

Catch of the Week: Smart Pharmacy, Inc.

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