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Page 149 of 158

September 25, 2013

Kan-Di-Ki LLC, d/b/a Diagnostic Laboratories and Radiology agreed to pay $17.5M to settle allegations that the California-based company violated the federal and California False Claims Acts by paying kickbacks for referral of mobile lab and radiology services subsequently billed to Medicare and Medi-Cal (the state of California’s Medicaid program). The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

September 13, 2013

Gulf Region Radiation Oncology Centers, Sacred Heart Health System, West Florida Medical Center Clinic and others agreed to pay $3.5M to resolve allegations that they billed Medicare, Medicaid and TRICARE – the health care program for uniformed service members, retirees and their families worldwide – for radiation oncology services that were not eligible for payment. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

August 27, 2013

Imagimed LLC and the company’s former owners and chief radiologist agreed to pay $3.57M to resolve allegations that they submitted to federal healthcare programs false claims for magnetic resonance imaging (MRI) services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

January 21, 2016

New York will receive $47 million in a settlement with CenterLight Healthcare and CenterLight Health System, resolving allegations that CenterLight Healthcare’s Select Medicaid Managed Long Term Care Plan fraudulently billed Medicaid for services they did not provide to more than 1,200 Medicaid recipients. Under the settlement, CenterLight Healthcare admitted that it enrolled Medicaid beneficiaries who were referred by social adult day care centers even though the beneficiaries were not eligible to receive managed long-term care under the plan, and that the centers were providing services that did not qualify for reimbursement under New York State Department of Health standards, or CenterLight’s contract with DOH.  Whistleblower David Heisler will receive a yet-to-be-determined whistleblower award. NY

January 20, 2016

Pennsylvania announced a $450,000 consumer protection settlement with CVS Pharmacy, L.L.C. The settlement follows allegations the company violated a 2010 agreement in which it agreed to address concerns related to the sale of expired over the counter drugs, infant formula and dairy products. Agents allegedly reported finding expired products, including infant formula and drugs made for children, at five of the six CVS stores they visited. CVS employees in two cases also allegedly bypassed a register prompt that was designed to prohibit the sale of expired products. PA

January 19, 2016

New Jersey will receive a total of $2.7 million as a result of its participation in a global settlement with Qualitest Pharmaceuticals Inc. that resolves civil allegations the company mislabeled its multivitamin-with-fluoride tablets to indicate they were richer in fluoride than they actually were. Qualitest was the subject of a whistleblower lawsuit filed in 2013 by a Florida dentist who alleged that it unlawfully represented its multivitamin tablets as containing levels of fluoride recommended by the American Dental Association (ADA) when they did not. NJ

December 18, 2015

Pharmaceutical company Warner Chilcott entered in to a $23.3 million settlement with the California Department of Insurance to resolved allegations contained in a whistleblower lawsuit brought by three former employees alleging drug marketing fraud in violation of state law. The suit alleged that Warner Chilcott executives violated the California Insurance Code False Claims Act, which prohibits anyone from defrauding private insurance companies by using kickbacks or other inducements to procure or steer clients or patients. CA

December 18, 2015

Thirty-two hospitals in 15 states agreed to pay more than $28 million to settle charges they violated the False Claims Act by submitting false claims to Medicare for minimally-invasive kyphoplasty procedures used to treat certain spinal fractures often arising from osteoporosis.  According to the government, the settling hospitals billed Medicare for these procedures on a more costly inpatient basis when they should have been billed on a less costly outpatient basis.  The government has now reached settlements with more than 130 hospitals totaling approximately $105 million to resolve allegations of overcharging Medicare for kyphoplasty procedures.  The 15 current settling hospitals include: The Cleveland Clinic (Ohio); Citrus Memorial Health System (Florida); Cullman Regional Medical Center (Alabama); Martin Memorial Medical Center (Florida); MultiCare Tacoma General Hospital (Washington); Norwalk Hospital (Connecticut); Princeton Community Hospital Association (West Virginia); Sacred Heart Medical Center (Washington); Sarasota Memorial Hospital (Florida); Spartanburg Regional Health Services District Inc. (South Carolina); St. Cloud Hospital (Minnesota); Tampa General Hospital (Florida); 5 hospitals affiliated with Community Health Systems Inc. (Tennessee); 5 hospitals affiliated with Tenet Health Care Corporation (Texas); 5 hospitals formerly owned and operated by Health Management Associates (Florida); 3 hospitals affiliated with BayCare Health System (Florida); and 2 hospitals affiliated with Banner Health (Arizona).  In addition, the government previously settled with Medtronic Spine LLC, the corporate successor to Kyphon Inc., for $75 million to settle allegations the company caused false claims to be submitted to Medicare by counseling hospital providers to perform kyphoplasty procedures as inpatient rather than outpatient procedures.  All but 3 of the current settlements originated in a whistleblower lawsuit filed by Craig Patrick, a former Kyphon reimbursement manager, and Charles Bates, a former Kyphon sales manager for Kyphon.  They will receive a whistleblower award of roughly $4.75 million from the proceeds of the government’s recovery.  DOJ

December 17, 2015

Connecticut and other states have joined a global settlement with Novartis Pharmaceuticals to resolve allegations that Novartis provided kickbacks to certain specialty pharmacies in exchange for recommending the drug Exjade to Medicaid and Medicare patients. Novartis has paid the states and the federal government $390 million to resolve these allegations. CT, IL, NY, MI, WA

December 4, 2015

The New York Attorney General announced the arrest of two individuals for allegedly defrauding the state of more than $3 million. The indictment alleges that the individuals and related companies paid patients not to fill their HIV prescriptions and to forego receiving life-saving medications in return for side payments, as well as with dispensing to patients “diverted” medications obtained from unlicensed vendors. The parties then submitted false claims to Medicaid and the state AIDS Drugs Assistance Program (ADAP), claiming to have dispensed the medications to patients in accordance with state and federal law. NY
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