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September 13, 2017

MediSys Health Network Inc., which owns and operates the two Queens hospitals Jamaica Hospital Medical Center and Flushing Hospital and Medical Center agreed to pay $4 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians.  These relationships took the form of compensation and office lease arrangements that did not comply with the requirements of the Stark Law, which restricts the financial relationships that hospitals may have with doctors who refer patients to them.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Satish Deshpande.  Dr. Deshpande will receive a whistleblower award of $600,000 from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

September 11, 2017

Family Medicine Centers of South Carolina LLC agreed to pay $1.56 million, and the company's principal owner and former CEO Dr. Stephen F. Serbin and its former Laboratory Director Victoria Serbin, agreed to pay $443,000 to settle charges they violated the False Claims Act and Stark Law.  Specifically, the government alleged FMC’s incentive compensation plan improperly paid FMC’s physicians a percentage of the value of laboratory and other diagnostic tests that they personally ordered through FMC.  Dr. Serbin allegedly initiated this program and reminded FMC’s physicians that they needed to order tests and other services through FMC in order to increase FMC’s profits and to ensure that their take-home pay remained in the upper level nationwide for family practice doctors.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former FMC physician Dr. Catherine A. Schaefer.  She will receive a whistleblower award of $340,510 from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

September 5, 2017

Tennessee-based affiliated home health entities Home Health Care of East Tennessee, Inc.; Home Health Care of West Tennessee, Inc.; Home Health Care Services, Inc.; Home Health Care Services II, Inc.; Health Care Staffing of Tennessee, Inc.; and Home Health Care Support Services, Inc. agreed to pay $1.8 million to settle charges of violating the False Claims Act and Stark Law for billing Medicare for home health and hospice services not properly payable due to compensation or other financial arrangements with certain referring physicians. DOJ (EDTN)

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice,

August 23, 2017

US Bioservices Corp. agreed to pay $13.4 million to settle charges it violated the False Claims Act and Anti-Kickback Statute by participating in a kickback scheme with Novartis Pharmaceuticals Corp. relating to the Novartis drug Exjade.  Specifically, the government alleges US Bio was promised additional patient referrals and related benefits in return for refilling a higher percentage of Exjade than the two other pharmacies that also dispensed Exjade.  DOJ (SDNY)

Tagged in: Anti-Kickback and Stark, FCA Federal, Pharma Fraud,

July 17, 2017

Ohio-based nursing home operators Foundations Health Solutions Inc., Olympia Therapy Inc. and Tridia Hospice Care Inc., and their executives Brian Colleran and Daniel Parker, agreed to pay roughly $19.5 million to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by former Olympia employee Vladimir Trakhter and former Tridia employees Paula Bourne and La’Tasha Goodwin.  Mr. Trahkter will receive a whistleblower award of roughly $2.9 million and Ms. Bourne and Ms. Goodwin collectively will receive an award of roughly $740,000, all from the proceeds of the government’s recovery.  Whistleblower Insider

Tagged in: Anti-Kickback and Stark, Home Health and Hospice, Lack of Medical Necessity, Multiple Whistleblowers and First-to-File, SNF, Whistleblower Case, Whistleblower Rewards,

July 6, 2017

New Jersey-based Compassionate Care Hospice Group, Inc. agreed to pay $2.4 million to resolve charges that the company and its subsidiary Compassionate Care Hospice of Atlanta violated the False Claims Act and Stark Law by engaging in improper financial relationships with contracted physicians to induce them to refer patients.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former CCH Atlanta employees Cathy Morris and Josie King.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (NDGA)

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice, Whistleblower Case,

June 28, 2017

PAMC Ltd. and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, agreed to pay $42 million to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  These relationships took the form of (1) arrangements under which the defendants allegedly paid above-market rates to rent office space in physicians’ offices, and (2) marketing arrangements that allegedly provided undue benefit to physicians’ practices.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Paul Chan, who was employed as a manager by one of the defendants.  He will receive a whistleblower award of more than $9.2 million from the proceeds of the government's recovery.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

July 26, 2017

Washington recovered nearly $750,000 in Medicaid reimbursement this week from pharmaceutical company Celgene Corporation for promoting medications to treat conditions they were not approved for, including certain types of cancer. The company is also accused of paying kickbacks to doctors for prescribing the medications and helping them change billing codes to ensure Medicaid would pay for their use. Off-label marketing, fraudulent billing and providing kickbacks to doctors are all violations of the Medicaid False Claims Act. WA

Tagged in: Anti-Kickback and Stark, FCA State, Healthcare Fraud, Off-Label and Unapproved Use, Pharma Fraud,

July 24, 2017

New Jersey-based pharmaceutical manufacturer Celgene Corp. agreed to pay $280 million to settle charges of violating the False Claims Act by promoting two cancer treatment drugs -- Thalomid and Revlimid -- for uses not approved by the FDA.  The allegations included the use of false and misleading statements about the drugs, and paying kickbacks to physicians to induce them to prescribe the drugs.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Celgene sales manager Beverly Brown.  She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (CDCA)

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Off-Label and Unapproved Use, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

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