Archive

April 23, 2015

Grady Health System agreed to pay $2,950,000 to settle claims it inaccurately coded claims for neo-natal intensive care unit patients, resulting in alleged damages to the Georgia Medicaid program. GA

Tagged in: FCA State, Healthcare Fraud, Medicaid, Medical Billing Fraud,

April 13, 2015

Hallmark Health Systems agreed to pay $1.75 million to settle allegations it improperly billed the Massachusetts Medicaid Program (MassHealth) for certain inpatient admissions at its hospitals, resulting in overpayments by MassHealth. The settlement alleges that from March 2008 to December 2013, Hallmark used a specific default code that classified MassHealth patients as having received short-stay inpatient services, when an observation or outpatient level of care would have been more appropriate. MA

Tagged in: FCA State, Medicaid, Medical Billing Fraud,

April 7, 2015

Texas Attorney General Ken Paxton announced New Jersey-based pharmaceutical product manufacturer Glenmark Generics Inc. USA agreed to pay $25 million to resolve the State’s investigation under the Texas Medicaid Fraud Prevention Act against Glenmark for fraudulently reporting inflated drug prices to the Medicaid program. TX

Tagged in: FCA State, Medicaid, Medical Billing Fraud,

March 9, 2015

Two former employees of the Mental Health Association of Rockland County, Inc. will receive an undisclosed whistleblower award from the $304,000 settlement resolving allegations MHAR violated the New York False Claims Act through its managers and employees altering records in advance of a Medicaid audit so the records would appear to support claims MHAR submitted to New York State's Medicaid program. NY

Tagged in: FCA State, Healthcare Fraud, Medicaid, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

January 30, 2015

Massachusetts Attorney General Maura Healey announced Neighborhood Diabetes, Inc. will pay more than $1.5M to settle allegations it improperly billed and received payments from the state’s Medicaid program when it automatically refilled prescription medications that were not specifically requested by MassHealth patients or caregivers. The settlement is the second case in the Commonwealth to address a pharmacy’s operation of an improper automatic refill program with MassHealth members. In September 2013, AllCare Pharmacy agreed to pay $1.6M to settle similar allegations. MA

Tagged in: FCA State, Medicaid, Pharma Fraud,

January 16, 2015

Washington Attorney General Bob Ferguson announced Sea Mar Community Health Centers agreed to pay $3.35M to settle charges of improperly billing Medicaid for thousands of dental appointments. According to the government, Sea Mar billed fluoride treatments as stand-alone appointments with a dentist or hygienist when they could have been performed much more cheaply by dental assistants as part of a patient’s regular six-month checkups. WA

Tagged in: FCA State, Medicaid, Medical Billing Fraud, Provider Fraud,

January 14, 2015

Office Depot agreed to pay $68.5M to settle charges in violated the California False Claims Act by allegedly overcharging more than 1,000 cities, counties, school districts and other government entities in California for office supplies. According to the government, Office Depot was required to but did not provide these government entities the lowest prices it was offering other government purchasers. The allegations originated with a whistleblower lawsuit filed by former Office Depot employee David Sherwin. Corporate Crime Reporter

Tagged in: FCA State, Government Procurement Fraud, Pricing Fraud, Whistleblower Case,

January 7, 2015

Florida Attorney General Pam Bondi announced that Florida, along with California, Colorado, Kentucky, and Ohio and the federal government, entered a $22 million national settlement with DaVita Healthcare Partners, Inc., one of the leading providers of dialysis services in the US. The settlement resolves allegations originating in a whistleblower lawsuit that DaVita paid illegal kickbacks to induce the referral of patients to its dialysis clinics, causing false claims to be submitted to the Medicaid program. DaVita will pay Florida $5.6 million in restitution and other recoveries. FL

Tagged in: Anti-Kickback and Stark, FCA State, Healthcare Fraud, Medicaid, Provider Fraud,

November 13, 2014

California joined a whistle-blower lawsuit against BP alleging the company overcharged the state by as much as $300M for natural gas for almost a decade. The case was unsealed today in San Francisco state court. The state and two of its university systems are pursuing the case along with a whistleblower, former BP employee Christopher Schroen. Bloomberg

Tagged in: FCA State, Government Decision, Government Procurement Fraud, Whistleblower Case,

October 31, 2014

Oklahoma-based dental company, Ocean Dental PC, which operates 28 clinics in seven states, agreed to pay more than $5M to settle charges it violated the False Claims Act by submitting false claims to the Oklahoma Medicaid program for dental work never performed or billed at a higher rate than allowed. The charges apparently stem from dental restorations by former employee Robin Lockwood who was sentenced to 18 months in federal prison in a separate case. NewsOK

Tagged in: FCA State, Medicaid, Medical Billing Fraud, Provider Fraud,

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