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Catch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown

Posted 10/2/20

Paper Ripped Uncovering Medical Necessity Wording

In the largest health care fraud and opioid enforcement action in the Justice Department’s history, 345 defendants—including more than 100 doctors, nurses, and other medical professionals—face charges for submitting over $6 billion in false or fraudulent claims to federal and private insurers. Defendants stand accused of submitting $4.5 billion in fraudulent claims linked to telemedicine, $845 million...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Pharma Fraud, Provider Fraud,

Catch of the Week: Colorado Neurosurgeon and His Three Companies Settle Spinal Implant Kickback Claims for $2.35M

Posted 02/14/20

This edition of our Catch of the Week series features the successful resolution of a whistleblower suit against neurosurgeon Dr. William Choi and three companies he owned. The defendants agreed to pay the United States $2.35 million to resolve allegations that, for over five years, Dr. Choi received illegal kickbacks from spinal implant device distributors for devices he used in surgeries. The kickbacks rendered...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Medicaid, Medical Devices and DME, Medicare, Other Government Health Programs,

Catch of the Week: ResMed Pays $37.5 Million to Settle Five Qui Tam Cases Alleging Kickbacks

Posted 01/16/20

Sleep apnea equipment manufacturer ResMed agreed to pay $37.5 million to resolve allegations that it violated the False Claims Act and Anti-Kickback Statute by providing unlawful remuneration to durable medical equipment distributors, sleep labs, doctors, and other healthcare providers. It seems that ResMed’s kickback schemes struck many people as wrong: the settlement resolves five separate cases brought by...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medical Devices and DME, Multiple Whistleblowers and First-to-File, Whistleblower Case,

Catch of the Week — Wound Care Device Manufacturer ACell Inc.

Posted 06/14/19

Our Catch of the Week goes to ACell Inc., a Maryland-based medical device manufacturer that pleaded guilty to violating the Federal Food, Drug, and Cosmetic Act (FDCA) by failing to report that it had partially removed its wound-care product, MicroMatrix, from the market because it was contaminated with endotoxins, placing treated patients in danger of serious infection, even death, without informing the FDA that it...

Tagged in: Catch of the Week, FCA Federal, FDA Fraud, Medical Devices and DME, Whistleblower Case,

DOJ Announces Criminal Indictments in International Health Care Fraud Scheme that Caused $1.2 Billion in Medicare Losses

Posted 04/12/19

The U.S. Department of Justice announced this week that it had issued criminal indictments against two dozen individuals in one of the largest health care fraud schemes in U.S. history. The indictments target an alleged scheme involving the payment of illegal kickbacks and bribes by durable medical equipment (DME) companies in exchange for the referral of Medicare beneficiaries by doctors working with fraudulent...

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Medical Devices and DME,

Top Ten Healthcare Recoveries of 2018

Posted 01/15/19

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2018 stemmed from healthcare fraud matters. And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. Here are the top ten healthcare recoveries of 2018 by the numbers:

1. Amerisource Bergen Corporation - In...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Managed Care, Medical Billing Fraud, Medical Devices and DME, Medicare, Pharma Fraud, Risk Adjustment Fraud, Top 10,

Catch of the Week -- AngioDynamics

Posted 07/20/18

This week's Department of Justice "Catch of the Week" goes to New York-based medical device maker AngioDynamics, Inc. On Wednesday, the company agreed to pay $12.5 million to resolve allegations it violated the False Claims Act by making false and misleading promotional claims about the LC Bead and Perforator Vein Ablation Kit (PVAK) medical devices. Angio served as the U.S. distributor for Biocompatibles plc, the...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Medical Devices and DME, Off-Label and Unapproved Use, Whistleblower Case, Whistleblower Rewards,

Three Sentenced To Prison For Fraudulent Sales of Laser Devices to Seniors

Posted 04/24/18

Three individuals were sentenced to prison for their fraudulent marketing and sale of light-emitting medical devices to elderly consumers. Robert “Larry” Lytle, the leader of the scheme, was sentenced to 12 years in prison; Ronald D. Weir Jr. was sentenced to 24 months in prison; and Irina Kossovskaia was sentenced to 15 months in prison. See DOJ Press Release. As part of his guilty plea, Lytle admitted...

Tagged in: Healthcare Fraud, Medical Devices and DME, Off-Label and Unapproved Use,

Rotech Agrees to Pay $9.68 Million to Settle False Claims Act Liability Related to Improper Billing for Portable Oxygen

Posted 04/16/18

By the C|C Whistleblower Lawyer Team The Justice Department announced a settlement last week for $9.68 million with Rotech Healthcare Inc. to settle charges of knowingly submitting false claims for portable oxygen contents to Medicare. The settlement included an admission by Rotech that is knowingly billed portable oxygen contents to Medicare for beneficiaries who neither used nor required them and that Rotech billed...

Tagged in: FCA Federal, Medical Billing Fraud, Medical Devices and DME, Whistleblower Rewards,

Tennessee Health Care Executives Charged in Kickback Scheme

Posted 04/10/18

By the C|C Whistleblower Lawyer Team The DOJ charged two Tennessee health care executives, John Davis and Brenda Montgomery, for their alleged participation in a $4.6 million Medicare kickback scheme involving durable medical equipment. Davis is the former CEO of pain management company Comprehensive Pain Specialists (CPS). Montgomery is the owner of medical equipment company CCC Medical Inc. See DOJ Press...

Tagged in: Anti-Kickback and Stark, Medical Devices and DME,

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Catch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown

Catch of the Week: Colorado Neurosurgeon and His Three Companies Settle Spinal Implant Kickback Claims for $2.35M

Catch of the Week: ResMed Pays $37.5 Million to Settle Five Qui Tam Cases Alleging Kickbacks

Catch of the Week — Wound Care Device Manufacturer ACell Inc.

DOJ Announces Criminal Indictments in International Health Care Fraud Scheme that Caused $1.2 Billion in Medicare Losses

Top Ten Healthcare Recoveries of 2018

Catch of the Week -- AngioDynamics

Three Sentenced To Prison For Fraudulent Sales of Laser Devices to Seniors

Rotech Agrees to Pay $9.68 Million to Settle False Claims Act Liability Related to Improper Billing for Portable Oxygen

Tennessee Health Care Executives Charged in Kickback Scheme

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