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Sleep Disorder Fraud: With the uptick in sleep disorder services and government spending comes the discovery of schemes and scams.

Posted  01/26/16
By Jessica Moore, published in ADVANCE Healthcare Network  Increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders that affect more than fifty million Americans.  The significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous to engage in fraudulent services and billing of federal and state heath care programs that...

DOJ Catch of the Week -- CenterLight Healthcare

Posted  01/22/16
By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to New York-based CenterLight Healthcare, Inc. and CenterLight Health System, Inc.  Yesterday, the companies agreed to pay $46.7 million to resolve allegations that they violated the federal and New York State False Claims Acts by enrolling ineligible members in their Medicaid managed long-term care plan. ...

A Big Friday for Whistleblowers

Posted  12/21/15
By the C|C Whistleblower Lawyer Team In what might be a first of its kind for whistleblowers and the government, this past Friday there were four significant government fraud recoveries all initiated by whistleblowers. In the midst of what is certainly an ever-expanding parade of whistleblower-prompted fraud settlements by the government, this may be the only time four major settlements were announced in a single...

Medicare Advantage Plan Loses Members, Responds with Plans to Raise Risk Adjustment Scores

Posted  09/22/15
By Tim McCormack and Molly Knobler (published on The Compliance & Ethics Blog) Modern Healthcare recently reported that although enrollment in the Medicare Managed Care Program (also known as Medicare Advantage or Medicare Part C) has grown by 8% on average since 2010, several top Medicare Advantage Plans are losing membership.  Highmark, Blue Cross and Blue Shield of North Carolina, HealthNow New York, Wellcare...

Constantine Cannon And Department of Justice Continue Joint Pursuit Against California Sleep-Clinic Chain

Posted  09/4/15
By Jessica T. Moore Constantine Cannon LLP has filed an amended complaint on behalf of a whistleblower alleging multi-faceted fraud on the part of Bay Sleep Clinic and its owners and operators, and billing company Access Medical Consultants.  The filing in United States ex rel. Dresser v. Qualium Corp., et al, Civil Action No. 12-1745 in the Northern District of California, comes on the same day the United...

Congress Highlights Medicare Part D Plans’ Failure To Prevent Fraud

Posted  07/16/15
Fraud in the Medicare Part D prescription drug program is getting the attention of not only the Department of Health and Human Services’ Office of the Inspector General (HHS OIG) but also watchdogs on Capitol Hill.  On Tuesday, July 14, 2015, the House of Representatives’ Committee on Energy and Commerce held a hearing to examine two recent reports from HHS OIG examining improper spending in the Medicare Part...

DOJ Gives Major Shoutout To Whistleblowers In $450M DaVita False Claims Act Settlement

Posted  06/26/15
By Gordon Schnell On Wednesday, Denver-based provider of dialysis services DaVita Healthcare Partners, Inc. agreed to pay $450 million to resolve charges it violated the False Claims Act by purposely creating and then billing the government for unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients.  DaVita is the largest provider of dialysis services in the US with dialysis clinics...

Whistleblower Spotlight -- Deceased VA Whistleblower Christopher Kirkpatrick

Posted  04/23/15
By the C|C Whistleblower Lawyer Team This week's "Whistleblower Spotlight" features Christopher Kirkpatrick, the 38-year old clinical psychologist who took his own life after being fired from the Tomah Veterans Affairs Medical Center for complaining about the treatment of his patients there.  Kirkpatrick would appear to be just one of the scores of whistleblowers who have been retaliated against for stepping up to...

DOJ Catch Of The Week — Medtronic

Posted  04/3/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to medical device maker Medtronic plc and affiliated Medtronic companies, Medtronic Inc., Medtronic USA Inc., and Medtronic Sofamor Danek USA Inc.  Yesterday, the companies agreed to pay $4.4 million to resolve allegations they violated the False Claims Act by making false statements to the Department of Veterans...

DOJ Catch of the Week -- Community Health Systems

Posted  08/8/14
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to Community Health Systems, Inc.  On Monday, the Tennessee-based operator of acute care hospitals -- the largest in the country with 206 affiliated hospitals in 29 states -- agreed to pay $98 million to resolve charges of billing the government for inpatient services that should have been billed as significantly less...
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