Archive

July 13, 2022

Solera Specialty Pharmacy and its CEO, Nicholas Saraniti, has agreed to pay $1.31 million and enter into a three-year integrity agreement to resolve allegations of defrauding Medicare. Solera allegedly submitted fraudulent claims for Evzio—a high-priced version of naloxone, which reverses opioid overdoses—based on prior authorization requests that contained false clinical information, that were not actually approved by physicians, and that improperly listed Solera’s contact information as if it were the physician’s. In connection with a criminal information, Solera has also entered into a deferred prosecution agreement. The whistleblower in this case, a former employee of Evzio manufacturer kaléo Inc. named Rebecca Socol, will receive a $262,000 share of the settlement. DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

July 7, 2022

A hospital in West Virginia, Weirton Medical Center, has agreed to pay $1.5 million to settle allegations of submitting or causing to be submitted claims to Medicare that resulted from an improper financial relationship. In violation of the Stark Law, Weirton allegedly paid referring physicians compensation based on volume and that exceeded fair market value. USAO NDWV

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

July 1, 2022

MCS Advantage, Inc. has agreed to pay $4.2 million in order to resolve allegations of submitted or causing to be submitted false claims to Medicare. In violation of the Anti-Kickback Statute and False Claims Act, MCS allegedly distributed 1,703 gift cards totaling $42,575 to administrative assistants working under healthcare providers in order to induce referrals of Medicare beneficiaries to its plan. USAO PR

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

June 29, 2022

Citadel Care Centers LLC and Plaza Rehab and Nursing Center will pay $7.85 million for switching their elderly residents’ Medicare coverage to maximize the Medicare payments the centers would receive--a blatant False Claims Act violation. Citadel directed Plaza employees to disenroll residents from Medicare Advantage Plans and enroll them in Original Medicare instead—without the residents’ knowledge or consent—to maximize their reimbursements. USAO SDNY

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Provider Fraud, SNF,

June 16, 2022

A Florida man who was convicted of defrauding Medicare of over $20 million and evading taxes has been sentenced to 14 years in prison and ordered to pay $4 million in restitution to the IRS. As the owner and operator of multiple telemarking and telemedicine companies, Marc Sporn marketed and sold signed prescription orders for medically unnecessary genetic tests, in exchange for illegal kickbacks from pharmacies and laboratories. USAO SDFL

Tagged in: Criminal Proceedings, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare, Tax Fraud,

June 13, 2022

Centene Corporation has agreed to pay $13.7 million to the State of New Mexico, after an investigation by the Attorney General’s Office found the company layered fees and failed to pass discounts onto the state’s Medicaid program, in violation of Medicaid rules and the New Mexico Medicaid False Claims Act. NM AG

Tagged in: Drug and DME Pricing, FCA State, Healthcare Fraud, Medicaid, Pharma Fraud,

June 10, 2022

A doctor who allegedly submitted claims to Medicare and Medi-Cal for unperformed procedures, services, and tests, in violation of the California and federal False Claims Acts, has agreed to pay $9.5 million to resolve a civil suit. The qui tam case by Minas Kochumian’s former medical assistant Elize Oganesyan, and former IT consultant Damon Davies, alleged that claims for treatment of osteopathic issues that were submitted over a six year period were false. The settlement includes $5.5 million that Kochumian already paid as criminal restitution in a separate case in the Central District. As part of the civil settlement, Oganesyan and Davies will share a $1.75 million award. CA AG; USAO EDCA

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

June 8, 2022

Pharmaceutical manufacturer Dr. Reddy’s Laboratories (DRL) has agreed to pay $12.9 million to the State of Texas to resolve allegations of violating the Texas Medicaid Fraud Prevention Act. DRL had allegedly reported inflated drug prices to the Texas Medicaid program in order to receive higher reimbursements. TX AG

Tagged in: Drug and DME Pricing, FCA State, Healthcare Fraud, Medicaid, Pharma Fraud,

June 6, 2022

SNAP Diagnostics LLC, along with its founder, Gil Raviv, and vice president, Stephen Burton, will pay a combined $3.925 million to settle allegations of False Claims Act and Anti-Kickback Statute violations. SNAP routinely submitted claims for Medicare and TRICARE patients’ second and third nights of home sleep testing, when patients with private health insurance were routinely billed only for the first night. Additionally, SNAP multiplied copays from senior citizen Medicare beneficiaries, and incentivized physicians to refer their patients for sleep testing services. USAO NDIL

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medical Billing Fraud, Medicare, Other Government Health Programs, Provider Fraud,

June 3, 2022

Rodney L. Yentzer will pay $900,000 for violating the False Claims Act. Through Pain Medicine of York, a group of clinics he controlled, Yentzer caused the submission of false claims for payment to Medicare for urine drug tests that were not medically reasonable or necessary and were not used to aid in the diagnosis and treatment of patients. He is excluded from participation in all federal health care programs for 22 years. In March of 2022, Yentzer pleaded guilty to Health Care Fraud, Money Laundering, and Theft of Public Money for defrauding Medicare, Medicaid, and the U.S. Department of Health and Human Services between 2016 and 2020. USAO MDPA

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medicare, Other Government Health Programs, Provider Fraud,

Contact

Click here for a confidential contact or call: