In Their Own Words -- McQuade
Posted 12/29/16
Archive
DOJ Catch of The Week -- Forest Labs
Posted 12/16/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to New York City-based Forest Laboratories LLC. Yesterday, the drug company and its subsidiary Forest Pharmaceuticals Inc. agreed to pay $38 million to resolve allegations they violated the False Claims Act and Anti-Kickback Statute by paying kickbacks to induce physicians to prescribe the drugs Bystolic, Savella and...
Medical Loss Ratio Minimum Requirements Save Taxpayer Dollars
Posted 12/14/16
By the C|C Whistleblower Lawyer Team
Last month the Department of Health and Human Services’ Office of the Inspector General (OIG) published a report about the Medicaid Managed Care program and the potential savings related to a minimum medical loss ratio (MLR). An MLR is, generally, the percentage of premium revenues an insurer spends on clinical services and quality improvements as opposed to on things like...
First Circuit Weighs in on Supreme Court’s Materiality Standard in Escobar Remand
Posted 12/9/16
By Rosie Dawn Griffin
The Supreme Court’s opinion in Universal Health Services, Inc. v. United States ex rel. Escobar—in which the high court upheld the implied false certification theory of liability but placed a new focus on materiality under the False Claims Act (FCA)—has predictably spawned a number of lower court decisions grappling with materiality in the varied factual landscape of FCA litigation,...
DOJ Catch of the Week -- Allied Home Mortgage
Posted 12/2/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Allied Home Mortgage. On Wednesday, a Houston jury found the entities formerly known as Allied Home Mortgage Capital Corp., Allied Home Mortgage Corp., and their president and chief executive officer Jim C. Hodge liable for violating the False Claims Act and the Financial Institutions Reform, Recovery, and...
Post-Escobar, Seventh Circuit Again Dismisses Suit Against For-Profit Educational Institution
Posted 11/18/16
By Hallie Noecker
Another federal circuit recently weighed in to apply the U.S. Supreme Court’s holding in Universal Health Services, Inc. v. United States ex rel. Escobar. Escobar was largely a victory for the United States and whistleblowers combatting fraud under the False Claims Act (FCA), resolving a split in the federal circuits by unanimously upholding implied false certification as a viable theory of FCA...
DOJ Catch of the Week -- Life Care Centers of America Inc.
Posted 10/28/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Life Care Centers of America Inc. On Monday, the Tennessee-based operator of more than 220 skilled nursing facilities, and its owner Forrest L. Preston, agreed to pay $145 million to resolve charges that Life Care violated the False Claims Act by submitting claims to Medicare and TRICARE for rehabilitation therapy...
DOJ Catch of the Week -- Omnicare, Inc.
Posted 10/21/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Omnicare, Inc. On Monday, the Ohio-based nursing home pharmacy, the largest in the country, agreed to pay roughly $28 million to resolve charges of violating the False Claims Act by soliciting and receiving kickbacks from pharmaceutical manufacturer Abbott Laboratories in exchange for promoting the prescription...
Accountability Through Individual Prosecution: Former Tuomey CEO Pays $1 Million in False Claims Act Settlement
Posted 10/5/16
By Ronny Valdes
On September 27, the Department of Justice (DOJ) announced former Tuomey Healthcare Systems CEO Ralph “Jay” Cox would pay $1 million to settle allegations related to his personal involvement in a fraudulent physician compensation scheme that violated the Stark Law and the False Claims Act (FCA). Tuomey, for its part, settled claims arising from the same scheme last year. In the original case...
DOJ Catch of The Week -- Vibra Healthcare
Posted 09/30/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Pennsylvania-based hospital chain Vibra Healthcare LLC. On Wednesday, the company agreed to pay $32.7 million to settle charges it violated the False Claims Act by billing Medicare for medically unnecessary services. Vibra operates roughly three-dozen long term care hospitals and inpatient rehabilitation...