Archive

Top Ten State Healthcare and Financial Fraud Recoveries of 2020

Posted 01/8/21

State and local governments are on the front lines of enforcing anti-fraud laws and play a critical role in ensuring that businesses and individuals are held accountable. Whistleblowers with information about corporate misconduct involving healthcare, government procurement, financial regulation, and tax may find that state proceedings offer them the best option. More than 30 states have False Claims Acts that...

Tagged in: Auto Safety, Drug and DME Pricing, FCA State, Financial and Investment Fraud, Government Procurement Fraud, Government Programs Fraud, Healthcare Fraud, Medical Billing Fraud, Pharma Fraud, Provider Fraud, Tax Fraud, Top 10,

COVID Fraud: New York Pharmacy Owners Indicted on Charges Arising from their Abuse of Emergency Override Billing Codes

Posted 01/7/21

As we have previously written, regulatory changes designed to alleviate logistical and financial pressure on healthcare providers during the COVID-19 crisis, while necessary, can create opportunities for fraudsters. Last month, an indictment in New York revealed a scheme by two pharmacy owners who took advantage of relaxed rules regarding prescription prior authorization and refill timing to overcharge Medicare and...

Tagged in: Catch of the Week, COVID-19, Criminal Proceedings, Healthcare Fraud, Medical Billing Fraud, Pharma Fraud,

Top Ten Healthcare Fraud Recoveries of 2020

Posted 01/5/21

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2019 stemmed from healthcare fraud matters, and with the Biden administration eyeing a bigger role for the federal government in our healthcare system, this trend is likely to accelerate. Most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, FCPA, Government Programs Fraud, Healthcare Fraud, Home Health and Hospice, Medicaid, Medicare, Pharma Fraud, Provider Fraud, Top 10,

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,

How Whistleblowers Can Report Fraud Related to Clinical Trials

Posted 09/4/20

The COVID-19 pandemic has highlighted the importance of government-funded scientific and medical research, including clinical trials of vaccines, treatments, and more. We are all potentially at risk if there is fraud and abuse in clinical trials and other research. Individuals with knowledge of fraud and misconduct in federal grants and clinical trials may be able to bring a whistleblower action for that research...

Tagged in: COVID-19, FCA Federal, FDA Fraud, Financial and Investment Fraud, Grant and Research Fraud, Healthcare Fraud, Pharma Fraud, SEC Whistleblower Reward Program, Securities Fraud, Whistleblower Answers,

New Settlement Shows the Power of Whistleblowers to Root out Fraud against Private Insurers

Posted 08/6/20

The nation’s biggest insurers, Medicare, Medicaid, and TRICARE already incentivize whistleblowers to report fraud. Because those programs are federally-funded, a whistleblower can bring suit under the False Claims Act and share in 15-30% of the recovery. The FCA is a law that allows private individuals alleging fraud against the government to bring a lawsuit in the name of the United States. The law leads to about...

Tagged in: FCA Federal, Importance of Whistleblowers, Pharma Fraud, Private Insurance Whistleblower Reward Programs, Whistleblower Case, Whistleblower Eligibility, Whistleblower Rewards,

Catch of the Week: Indivior Agrees to Pay $600 Million to Settle Opioid Fraud Case

Posted 07/31/20

pill container spilled over with pills in the form of a dollar sign

The latest in our Catch of the Week series features Indivior Solutions’ (“Indivior”) agreement to pay $600 million to resolve criminal and civil liability associated with the marketing of the opioid-addiction-treatment drug Suboxone. This is in addition to the $1.4 billion resolution with Indivior’s former parent, Reckitt Benckiser Group PLC (“RB Group”) that was previously announced in 2019. Suboxone is a...

Tagged in: Catch of the Week, Criminal Proceedings, FCA Federal, Healthcare Fraud, Medicaid, Pharma Fraud, Whistleblower Case,

Newly Unsealed Whistleblower Lawsuit Alleges Drug Giant McKesson Gave Doctors Illegal Kickbacks in the Form of Free Software

Posted 07/24/20

Constantine Cannon LLP is pleased to announce the unsealing of a whistleblower lawsuit its client brought alleging that drug wholesaler McKesson Corp. and its affiliated companies provided illegal kickbacks in the form of free business services to encourage oncologists and other doctors to buy drugs from McKesson. The lawsuit alleges that McKesson gave doctors valuable business-management tools geared towards...

Tagged in: Anti-Kickback and Stark, CC Lawyers, FCA Federal, Pharma Fraud, Whistleblower Case,

Catch of the Week: Novartis Pays $729 Million to Settle Two Kickback Cases on Heels of $345 Million Foreign Bribery Settlement

Posted 07/2/20

This week and last, pharmaceutical manufacturer Novartis reached three settlements involving very different forms of unlawful kickbacks and bribes. First, this week the company agreed to pay a total of $678 million to resolve a New York case alleging that it paid inflated “speaking fees” and provided other incentives to doctors to induce them to prescribe Novartis drugs. Second, Novartis will pay $51.25...

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

Regeneron: The Government’s Latest Stand against Patient Kickbacks

Posted 06/25/20

pills, syringes, and money scattered around

This week, Boston-based prosecutors have filed a new False Claims Act case against Regeneron, a pharmaceutical company, alleging that it paid patients kickbacks aiming to steer them into using Regeneron’s macular degeneration drug, Eylea. Regeneron allegedly disguised the kickbacks as charitable contributions to a foundation. Prosecutors say that Regeneron only donated exactly enough money to the foundation, called...

Tagged in: Anti-Kickback and Stark, Drug and DME Pricing, FCA Federal, Medicare, Pharma Fraud,

Contact

Click here for a confidential contact or call:

Top Ten State Healthcare and Financial Fraud Recoveries of 2020

COVID Fraud: New York Pharmacy Owners Indicted on Charges Arising from their Abuse of Emergency Override Billing Codes

Top Ten Healthcare Fraud Recoveries of 2020

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

How Whistleblowers Can Report Fraud Related to Clinical Trials

New Settlement Shows the Power of Whistleblowers to Root out Fraud against Private Insurers

Catch of the Week: Indivior Agrees to Pay $600 Million to Settle Opioid Fraud Case

Newly Unsealed Whistleblower Lawsuit Alleges Drug Giant McKesson Gave Doctors Illegal Kickbacks in the Form of Free Software

Catch of the Week: Novartis Pays $729 Million to Settle Two Kickback Cases on Heels of $345 Million Foreign Bribery Settlement

Regeneron: The Government’s Latest Stand against Patient Kickbacks

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: