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August 6, 2014

New York Attorney General Eric T. Schneiderman announced he, along with 40 other state Attorneys General and the District of Columbia, reached a $35M settlement with Pfizer arising from alleged improper marketing and promotion of the immunosuppressive drug Rapamune. New York’s share of the settlement is over $1.7M. Pfizer, as parent of Wyeth Pharmaceuticals Inc., agreed to be bound by the judgment and to resolve allegations that Wyeth unlawfully promoted Rapamune. Attorney General Schneiderman’s office served on the Executive Committee of this multi-state investigation. NYAG

Tagged in: FCA State, Medicaid, Off-Label and Unapproved Use, Pharma Fraud,

July 28, 2014

Vascular Solutions Inc (VSI), a Minneapolis-based medical device maker, agreed to pay $520,000 to resolve allegations that it violated the False Claims Act by marketing a product for sealing veins without FDA approval.  Specifically, the government charged that VSI marketed and sold its "Vari-Lase Short Kit" for treating perforator veins (which run deep in the leg muscle) even though the FDA approved the device only for treating surface (or superficial) veins.  DeSalle Bui, a former sales representative of VSI, will receive a whistleblower award in an undisclosed amount.  DOJ

Tagged in: Drug and DME Pricing, FCA Federal, FDA Fraud, Medical Devices and DME, Off-Label and Unapproved Use, Whistleblower Case, Whistleblower Rewards,

June 25, 2014

Ohio-based Omnicare Inc., the country’s largest provider of pharmaceuticals and pharmacy services to nursing homes, agreed to pay $124 million to settle government charges of offering improper financial incentives to skilled nursing facilities in return for their continued selection of Omnicare to supply drugs to their elderly Medicare and Medicaid patients. Donald Gale, former employee of Omnicare Inc., will receive a whistleblower award of roughly $17M from the settlement.  DOJ

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

June 4, 2014

New York Attorney General Eric T. Schneiderman announced he, along with 43 other State Attorneys General and the District of Columbia, reached a $105M settlement with GlaxoSmithKline, LLC (GSK) arising from alleged improper marketing and promotion of the asthma drug Advair and the anti-depressant drugs Paxil and Wellbutrin. New York’s share of the settlement is over $4.1M. NYAG

Tagged in: Off-Label and Unapproved Use, Pharma Fraud,

May 28, 2014

Medical device manufacturer Medtronic Inc. agreed to pay $9.9M to resolve allegations under the False Claims Act that the company used various types of illegal kickbacks to induce physicians to use pacemakers and defibrillators made and sold by Medtronic. Among the the illegal inducements the government charged Medtronic with using were: 1) paying implanting physicians to speak at events intended to increase the flow of referral business; 2) developing marketing/business development plans for physicians at no cost; and 3) providing tickets to sporting events. The settlement stems from a whistleblower complaint filed by former Medtronic employee Adolfo Schroeder under the qui tam provisions of the False Claims Act. He will receive a whistleblower reward of approximately $1.73M. DOJ  

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

April 23, 2014

Amedisys home health companies agreed to pay $150M resolve allegations they violated the False Claims Act by allegedly billing Medicare for nursing and therapy services not medically necessary or provided to patients who were not homebound, and by otherwise misrepresenting patients’ conditions to increase its Medicare payments. The allegations were first raised in several qui tam lawsuit filed by former Amedisys employees under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

April 16, 2014

CRC Health Corp., a nationwide provider of substance abuse and mental health treatment services, agreed to pay $9.25 million to settle allegations that CRC violated the False Claims Act by providing substandard treatment in its Tennessee facility to adult and adolescent Medicaid patients suffering from alcohol and drug addiction.  The allegations were first raised in a qui tam lawsuit filed by Angie Cederoth, a former billing clerk in the CRC facility, under the whistleblower provisions of the False Claims Act.  She will receive a whistleblower award of$1.5 million.  DOJ

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

April 16, 2014

Drug manufacturer Astellas Pharma US agreed to pay $7.3 million to resolve allegations it violated the False Claims Act in connection with its marketing and promotion of the drug Mycamine for pediatric use when the drug did not have FDA approval for such use.  The allegations were first raised in a qui tam lawsuit filed by Frank Smith, a former Astellas sales representative, under the whistleblower provisions of the False Claims Act.  He will receive a whistleblower award of $708,852.  DOJ

Tagged in: FCA Federal, Off-Label and Unapproved Use, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

April 14, 2014

Hope Cancer Institute, a cancer treatment facility in Kansas, and its owner Dr. Raj Sadasivan, agreed to pay $2.9M to resolve allegations they violated the False Claims Act by submitting claims to Medicare, Medicaid and the Federal Employee Health Benefits Program for chemotherapy drugs and services not actually provided.  The allegations were first raised in a qui tam lawsuit filed by former employees of the facility Krisha Turner, Crystal Dercher and Amanda Reynolds under the whistleblower provisions of the False Claims Act.  DOJ

Tagged in: FCA Federal, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 18, 2014

American Family Care Inc., a network of walk-in medical clinics with offices in Alabama, Tennessee and Georgia, agreed to pay $1.2M to resolve allegations under the False Claims Act that it knowingly submitted claims to Medicare for outpatient office visits that were billed at a higher rate than was appropriate.  The settlement resolves a qui tam lawsuit filed by Anita C. Salters, a former employee of American Family Care under the whistleblower provision of the False Claims Act.  DOJ

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

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