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Catch of the Week – EHR Developer Greenway Health to Pay $57.25 Million to Settle FCA Allegations

Posted  02/8/19
Person in scrubs holding computer tablet projecting medical data
Electronic health records (EHR) software developer Greenway Health LLC agreed to pay $57.25 million to resolve allegations that it committed fraud by misrepresenting to its users the capabilities of its EHR product “Prime Suite” and by providing unlawful remuneration to users to induce them to recommend Prime Suite. Under the American Recovery and Reinvestment Act of 2009, the government made incentive payments...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Contract Non-Compliance, Electronic Health Records, FCA Federal, Healthcare Fraud,

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Catch of the Week – Inform Diagnostics

Posted  02/1/19
Technician in laboratory safety wear using eyedropper to fill vials of blood
Texas-based pathology laboratory company Inform Diagnostics, formerly known as Miraca Life Sciences Inc., agreed on January 30th to a $63.5 million settlement to resolve allegations it violated the False Claims Act (“FCA”), the Anti-Kickback Statute (“AKS”), and the Stark Law by providing subsidies to referring physicians for electronic health record (“EHR”) technology as well as free or discounted...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Electronic Health Records, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Multiple Whistleblowers and First-to-File, Whistleblower Case,

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New Yorker Article on Whistleblowers Features Constantine Cannon

Posted  01/28/19
Silver whistle hanging on cord in front of chalkboard
In an article titled “The Personal Toll of Whistle-Blowing” published in the February 4, 2019, New Yorker magazine, Sheelah Kolhatkar describes the cases of two Constantine Cannon whistleblower clients, and features whistleblower attorney Mary Inman.  Focusing on False Claims Act cases involving fraud in the Medicare Advantage program, the article details how the FCA “effectively turned average citizens into a...

Tagged in: CC Lawyers, FCA Federal, Importance of Whistleblowers, Managed Care, Risk Adjustment Fraud,

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Top Ten Federal False Claims Act Recoveries of 2018

Posted  01/28/19
The federal False Claims Act, under which whistleblowers can bring claims to report fraud and misconduct in government contracts and programs, is the foundation of the Department of Justice's fraud recovery and the U.S. whistleblower reward system.  In 2018, the U.S. recovered over $2 billion from defendants who sought to cheat the system. The top FCA settlements for calendar year 2018, based on the amount of the...

Tagged in: FCA Federal, Government Procurement Fraud, Healthcare Fraud, Top 10, Whistleblower Rewards,

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Top Ten State Fraud Recoveries of 2018

Posted  01/25/19
Political map of continental United States with states outlined
While 2018 saw many important federal settlements and whistleblower awards across a wide range of industries, state governments were equally busy rooting out fraud. In fact, in the last few years, recognizing the ever-growing need to hold businesses accountable for defrauding taxpayers, several states have passed their own false claims statutes modeled after the federal false claims act. These laws operate in a...

Tagged in: Financial and Investment Fraud, Healthcare Fraud, Top 10,

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Catch of the Week – Walgreens Pays Record $273 Million To Settle Three FCA Suits

Posted  01/25/19
Storefront of brick-faced Walgreens location
Three separate qui tam actions brought by whistleblowers against Walgreens Boots Alliance, Inc. (Walgreens) have resolved in what amounts to the largest settlement payouts for a retail pharmacy. In the first action, two former Walgreens pharmacists alleged that the company sought reimbursement for insulin pens it dispensed to Medicare and Medicaid beneficiaries who did not need them. Walgreens did so in two ways....

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

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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,

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Top Ten Financial and Healthcare Fraud Prison Sentences of 2018

Posted  01/11/19
Hands gripping prison bars
Financial and healthcare fraud schemes can result not just in civil investigations and liability, but also in prison time for the individuals involved.  In 2018, the Department of Justice obtained substantial prison sentences in numerous cases involving healthcare and financial frauds, helping to bring justice to the patients, investors, or individuals harmed by criminal fraudsters.  Many of the fraudulent schemes...

Tagged in: Criminal Proceedings, Financial and Investment Fraud, Healthcare Fraud, Securities Fraud, Top 10,

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Healthcare Whistleblowers Continue as Backbone of DOJ Recoveries: A Look at DOJ’s 2018 Fraud and FCA Statistics

Posted  01/2/19
Department of Justice
The Department of Justice released its annual report of DOJ recoveries for fraud and false claims against the U.S., showing recoveries of $2.8 billion in settlements and judgments for the fiscal year ending September 2018. Once again, recoveries for healthcare fraud accounted for the majority of funds recovered: of the $2.8 billion recovered, $2.5 billion was attributed to healthcare fraud. And, once again,

Tagged in: FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Statistics,

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Catch of the Week — Hospice Provider to Pay $6 Million to Settle False Claims Act Suit

Posted  12/21/18
Younger person resting hand on hand of seated elderly woman with cane
SouthernCare, Inc., a hospice provider owned by Curo Health Services, has agreed to pay the federal government nearly $6 million dollars to settle a lawsuit alleging that the company defrauded Medicare by billing medically unnecessary hospice care. The fraud was unearthed by two whistleblowers formerly employed by the company, who filed suit under the qui tam provisions of the False Claims Act, where they will share...

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

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