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Ex-Manager and CEO Convicted in $9.7 Million Valeant Kickback Scheme

Posted 05/23/18

By the C|C Whistleblower Lawyer Team Yesterday, a federal jury in Manhattan convicted Gary Tanner, a midlevel executive at Valeant Pharmaceuticals International, and Andrew Davenport, the CEO of Philidor Rx Services, of conspiring to bring about Valeant’s purchase of Philidor in exchange for a $9.7 million kickback. The scheme allegedly netted Davenport $40 million, and he kicked back a portion of it to...

Tagged in: Financial and Investment Fraud, Pharma Fraud,

Michigan Home Health Agency Owner Pleads Guilty to Health Care Fraud Charges

Posted 05/18/18

The owner of a Michigan home health agency pleaded guilty to fraud charges for his role in a scheme involving approximately $8 million in fraudulent Medicare claims for home health services that were procured through the payment of illegal kickbacks. Zahir Shah, 48, of West Bloomfield, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to pay and...

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice, Medicare,

Medicare Fraudsters Beware; DOJ May Be Reviewing Your Billing Data

Posted 05/15/18

By the C|C Whistleblower Lawyer Team Maryland physician Sureshkumar Muttath agreed to pay more than $1.5 million to settle claims he violated the False Claims Act by submitting claims to Medicare for medically unnecessary autonomic nervous function tests and neurobehavioral status exams. The settlement originated under DOJ’s new initiative of tracking irregularities in Medicare billing data. See DOJ Press...

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud,

Jazz Pharmaceuticals Sets Aside $57M to Settle DOJ Probe

Posted 05/9/18

Jazz Pharmaceuticals Plc disclosed yesterday it has reached a tentative agreement to pay $57 million to resolve a Justice Department probe over its donations to charities that reduce drug prices for Medicare patients. The company manufactures Xyrem, a costly drug used to treat narcolepsy. Jazz had previously received multiple DOJ subpoenas concerning its charitable donations and announced the agreement in principle...

Tagged in: Pharma Fraud,

New York Urgent Care Clinic Pays Over $6.6M to Settle FCA Suit

Posted 05/7/18

By the C|C Whistleblower Lawyer Team CityMD, a company that manages over 80 urgent care clinics in and around New York City, has settled allegations that it billed Medicare for more expensive services than were actually performed, and that it billed Medicare under the names of doctors who did not actually perform the services. Under the terms of the settlement, CityMD also accepted responsibility for its...

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Provider Fraud, Upcoding, Whistleblower Case,

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,

Supreme Court Considers Revisiting Key FCA Decision

Posted 04/17/18

By the C|C Whistleblower Lawyer Team Yesterday, the justices asked the Trump Administration’s Office of the Solicitor General’s views on a petition for certiorari in United States ex rel. Campie v. Gilead Scis., a False Claims Act (FCA) suit against pharmaceutical giant Gilead Sciences. The suit, which was brought by two former Gilead employees turned whistleblowers, alleges the company made false statements...

Tagged in: FCA Federal, FCA Materiality, FDA Fraud, Pharma Fraud,

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,

Banner Health Agrees to Pay $18 Million to Settle Whistleblower Case

Posted 04/13/18

By the C|C Whistleblower Lawyer Team Banner Health has agreed to pay over $18 million to settle allegations that 12 of its hospitals in Arizona and Colorado knowingly submitted false claims to Medicare by admitting patients who could have been treated on a less costly outpatient basis. Headquartered in Arizona, Banner Health owns and operates 28 acute-care hospitals in multiple states. “Taxpayers should not bear...

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, 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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Ex-Manager and CEO Convicted in $9.7 Million Valeant Kickback Scheme

Michigan Home Health Agency Owner Pleads Guilty to Health Care Fraud Charges

Medicare Fraudsters Beware; DOJ May Be Reviewing Your Billing Data

Jazz Pharmaceuticals Sets Aside $57M to Settle DOJ Probe

New York Urgent Care Clinic Pays Over $6.6M to Settle FCA Suit

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

Supreme Court Considers Revisiting Key FCA Decision

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

Banner Health Agrees to Pay $18 Million to Settle Whistleblower Case

Tennessee Health Care Executives Charged in Kickback Scheme

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