Archive

Houston-Area Hospitals Settle FCA Allegations for over $8M

Posted 10/5/17

By the C|C Whistleblower Lawyer Team Four hospitals in the Houston area have agreed to pay $8.6M to settle allegations that they received kickbacks from ambulance companies in exchange for the hospitals’ Medicare and Medicaid transport referrals. The hospitals are Bayshore Medical Center, Clear Lake Regional Medical Center, West Houston Medical Center, and East Houston Regional Medical Center. All four hospitals...

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

Mylan Agrees to Pay $465 Million in a False Claims Act Settlement

Posted 08/21/17

By the C|C Whistleblower Lawyer Team Last Friday, the Department of Justice (“DOJ”) announced a $465 million settlement with Mylan, Inc. to resolve claims that it violated the False Claim Act. The suit was brought by a whistleblower under the False Claims Act qui tam provisions and involved the alleged improper misclassification of the EpiPen as a generic drug to avoid paying rebates owed mainly to Medicaid....

Tagged in: Drug and DME Pricing, Medicaid, Pharma Fraud, Whistleblower Case, Whistleblower Eligibility, Whistleblower Rewards,

DOJ Catch of the Week -- Mylan

Posted 08/18/17

By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Mylan Inc. and Mylan Specialty L.P. Yesterday, the pharmaceutical companies agreed to pay $465 million to settle charges they violated the False Claims Act by purposely misclassifying EpiPen as a generic drug to avoid paying higher Medicaid rebates. In announcing the settlement, the government stressed its "unwavering...

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

Celgene to Pay $280M to Resolve Fraud Allegations

Posted 07/26/17

By the C|C Whistleblower Lawyer Team Pharmaceutical manufacturer Celgene Corp. agreed to pay $280 million to settle claims that it illegally promoted two cancer drugs, Thalomid and Revlimid, for unapproved uses. The case was filed by a former Celgene sales representative under the False Claims Act, which allows individuals to sue to recover government dollars and share in any recovery. The New York Times reports...

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medicare, Off-Label and Unapproved Use, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

Ninth Circuit Finds Materiality in the Face of Continued Government Payment

Posted 07/14/17

By Rosie Dawn Griffin Earlier this month, the U.S. Court of Appeals for the Ninth Circuit revived United States ex rel. Campie v. Gilead Scis., a False Claims Act (FCA) suit against pharmaceutical giant Gilead Sciences and, in doing so, provided the qui tam bar with additional guidance on how the lower courts will interpret the Supreme Court’s emphasis on materiality in Universal Health Services, Inc. v....

Tagged in: FCA Federal, FCA Materiality, FDA Fraud, Other Government Health Programs, Pharma Fraud, Whistleblower Case,

Mother and Daughter Owners of Home Health Agencies Each Sentenced to Over 10 Years in Prison for Roles in $20 Million Fraud Scheme

Posted 06/16/17

By the C|C Whistleblower Lawyer Team A mother and daughter who secretly co-owned and operated seven home health care agencies in the Miami, Florida area were each sentenced to over 10 years in prison for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals. Mildrey Gonzalez, 61, and her daughter, Milka Alfaro,...

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice, Medicare,

Freedom Health, Optimum Healthcare and Its Former COO to Pay $32.5 Million to Settle False Claims Act Allegations of Medicare Fraud

Posted 05/31/17

By the C|C Whistleblower Lawyer Team Yesterday, the Department of Justice and Constantine Cannon, LLP announced that they had reached a settlement with Freedom Health and Optimum Healthcare, two large health insurers and operators of Medicare managed healthcare insurance plans controlled by Dr. Kiranbhai “Kiran” C. Patel and based in Tampa, Florida, to resolve allegations of systemic Medicare and Medicaid...

Tagged in: CC Lawyers, FCA Federal, Managed Care, Medicare, Risk Adjustment Fraud, Whistleblower Case, Whistleblower Rewards,

Trump to Propose Slashing Medicaid, Giving States Power to Limit Other Benefits

Posted 05/22/17

By the C|C Whistleblower Lawyer Team The Trump Administration plans to reveal its first major budget proposal on Tuesday and it will include large cuts to Medicaid and call for more state powers in limiting benefits. The Trump budget plan calls for a reduction of $800 billion to Medicaid over the next decade. The proposals also call for allowing states more flexibility to impose work requirements for people in...

Tagged in: Medicaid,

United States Files Complaint-in-Intervention in Constantine Cannon Whistleblower’s Case Against UnitedHealth Group

Posted 05/17/17

The Department of Justice announced yesterday that it has filed a complaint-in-intervention against UnitedHealth Group (UHG) in a case brought by Constantine Cannon client Ben Poehling. The government’s complaint alleges that UHG knowingly obtained inflated risk adjustment payments from Medicare Advantage based upon false information regarding the health of beneficiaries in its plans. UHG is the nation’s...

Tagged in: FCA Federal, Healthcare Fraud, Managed Care, Medicare, Risk Adjustment Fraud,

Walgreens Settles Whistleblower Suit over Alleged Medi-Cal Fraud

Posted 04/21/17

By the C|C Whistleblower Lawyer Team Illinois-based drugstore giant Walgreens, with roughly 630 stores in California, agreed to pay $9.86 million to resolve allegations it violated the False Claims Act by knowingly submitting claims to California’s Medi-Cal program not supported by applicable diagnosis and documentation requirements. The Medi-Cal program, administered by the California Department of Health Care...

Tagged in: FCA Federal, Lack of Medical Necessity, Medicaid, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

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Houston-Area Hospitals Settle FCA Allegations for over $8M

Mylan Agrees to Pay $465 Million in a False Claims Act Settlement

DOJ Catch of the Week -- Mylan

Celgene to Pay $280M to Resolve Fraud Allegations

Ninth Circuit Finds Materiality in the Face of Continued Government Payment

Mother and Daughter Owners of Home Health Agencies Each Sentenced to Over 10 Years in Prison for Roles in $20 Million Fraud Scheme

Freedom Health, Optimum Healthcare and Its Former COO to Pay $32.5 Million to Settle False Claims Act Allegations of Medicare Fraud

Trump to Propose Slashing Medicaid, Giving States Power to Limit Other Benefits

United States Files Complaint-in-Intervention in Constantine Cannon Whistleblower’s Case Against UnitedHealth Group

Walgreens Settles Whistleblower Suit over Alleged Medi-Cal Fraud

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