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Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Posted 11/15/21

Person Handing Hundred Dollar Bill to Another Person

The Department of Justice regularly highlights the areas of fraudulent conduct it intends to target as enforcement priorities. These identified enforcement priorities tend to cover burgeoning areas of fraud or particular misbehavior especially ripe or prevalent because of the particular times we live in. As might be expected, DOJ's current listing of priorities includes fraud related to the pandemic, opioids, the

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medical Devices and DME, Pharma Fraud, Provider Fraud,

Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act

Posted 08/19/21

Red and yellow pills scattered on hundred dollar bills

Last week, the Seventh Circuit Court of Appeals, the federal appellate court for Illinois, Indiana, and Wisconsin decided U.S. ex rel. Yarberry v. Supervalu, an important decision that may lead more unscrupulous government contractors to help themselves to public funds to which they are not entitled. Unless the Supreme Court or Congress steps in to correct the Seventh Circuit’s errors, the government may have...

Tagged in: Contract Non-Compliance, Court Decision, Drug and DME Pricing, FCA Federal, Government Procurement Fraud, Healthcare Fraud, Medicaid, Medicare, Pharma Fraud, Pricing Fraud, Whistleblower Case,

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Posted 07/9/21

The Food and Drug Administration (FDA) is supposed to protect American consumers from unscrupulous private actors—charlatans, snake-oil salesmen, and the like—seeking to profit by selling unproven medical “cures,” treatments, and devices to the public. Emerging during the era of the robber barons as part of Theodore Roosevelt’s efforts to “civilize capitalism,” the FDA has prevented untold harm to...

Tagged in: FCA Federal, FDA Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicare, Pharma Fraud,

Book Review: “Empire of Pain: The Secret History of the Sackler Dynasty,” by Patrick Radden Keefe

Posted 06/3/21

Last October, Purdue Pharma, the inventor, manufacturer, and marketer of Oxycontin, the drug at the center of the opioid crisis, reached a massive healthcare fraud settlement with the Department of Justice. The Department advertised the settlement as an $8.3 billion dollar recovery, which would make it one of the largest healthcare fraud settlements in history. In his book Empire of Pain, Patrick Radden Keefe explores...

Tagged in: Importance of Whistleblowers, Pharma Fraud, Whistleblower Bookshelf,

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Posted 05/28/21

Hey, fraudsters, did you hear? There was a global pandemic, so the government pumped trillions of dollars into the economy. Probably a good time to get a piece of the cut, you ask? They’ll never find out, right? So many ways to grift! Well, not so much. From the start, the cops on the beat, led by the United States Department of Justice, have screamed from the rooftops: “Don’t do it. We WILL...

Tagged in: COVID-19, Criminal Proceedings, FCA Federal, Financial and Investment Fraud, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Laboratory and IDTF, Lack of Medical Necessity, Market Manipulation and Trading Violations, Medical Billing Fraud, Misrepresentations, Pharma Fraud, Securities Fraud,

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted 05/7/21

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

Posted 04/30/21

On Thursday, an Alabama District Court Judge sentenced dozens of defendants to prison for participating in a massive conspiracy to swindle insurers for medically unnecessary compound drugs. The defendants included company executives and managers, a prescriber, billers, and sales representatives associated with Northside Pharmacy, which was doing business as Global Compounding Pharmacy (Global). According to the DOJ...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Compounding Pharmacy Fraud, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Pharma Fraud, Whistleblower Case,

Bristol-Myers Squibb Settlement Highlights a Common-Sense Law: The Medicaid Drug Rebate Program

Posted 04/2/21

Drug prices are out of control. They now account for roughly 10% of our healthcare spending and America’s per capita outlay has nearly doubled over the past two decades. For the least fortunate among us, many of these medications have become out of reach altogether. While new proposals are regularly made, one approach that often gets overlooked is simply enforcing the laws already on the books. That is just...

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

March Madness: AstraZeneca Fudges the Clinical Trial Results for Its COVID-19 Vaccine

Posted 03/26/21

In case you haven’t been following the NCAA Men’s Basketball Tournament (or even if you have), you might be surprised to learn that the University of Hartford is poised to win it all this year—except for the fact that it lost in the first round of the tournament to Baylor University, 79-55, and has been eliminated from the competition. Likewise, in case you haven’t been following the results of COVID-19...

Tagged in: COVID-19, FDA Fraud, Financial and Investment Fraud, Government Programs Fraud, Grant and Research Fraud, Healthcare Fraud, Pharma Fraud,

The False Claims Act: It Benefits More than Just the Government

Posted 03/5/21

The False Claims Act, a Civil War-era law, encourages private individuals, such as whistleblowers, to come forward and file suit against unscrupulous government contractors, and share in the government's recovery. The passage of the law was inspired by contractors selling the Union Army bags of sand as flour, lame mules as cavalry horses, and glued-together rags as uniforms. The main purpose of the law is, of...

Tagged in: Dosage Fraud, Environmental Fraud, FCA Federal, Government Procurement Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medicare, Prevailing Wage,

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Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Book Review: “Empire of Pain: The Secret History of the Sackler Dynasty,” by Patrick Radden Keefe

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

Bristol-Myers Squibb Settlement Highlights a Common-Sense Law: The Medicaid Drug Rebate Program

March Madness: AstraZeneca Fudges the Clinical Trial Results for Its COVID-19 Vaccine

The False Claims Act: It Benefits More than Just the Government

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