Archive

A Legally-Compliant Practice: Necessary but Insufficient for Good Medicine?

By Tim McCormack and Molly Knobler (published on SCCE’s Compliance and Ethics blog) Front page headlines denouncing “bad medicine” typically only hit when a physician is indicted for fraud or a major provider settles a multi-million dollar case for unnecessary services or defective goods.  But two recent reports indicate that being in compliance with the law may be insufficient for truly “good...

There's No Such Thing as a Free BBQ: Kickbacks Cost Physicians Too

By Tim McCormack and Molly Knobler (published on the Huffington Post blog) On October 29th, pharma giant Warner Chilcott pled guilty to a felony healthcare fraud charge, agreeing to pay $125 million to settle allegations that it had paid illegal kickbacks to doctors and engaged in other illegal marketing behavior to sell its drugs Actonel®, Asacol®, Atelvia®, Doryx®, Enablex®, Estrace,® and Loestrin®. ...

State Fraud Enforcement Spotlight -- Astrazeneca and Cephalon

By the C|C Whistleblower Lawyer Team On Wednesday, New York State Attorney General Eric T. Schneiderman announced that AstraZeneca LP and Cephalon, Inc. agreed to pay $54 million to settle government charges they overcharged state Medicaid programs for their pharmaceutical products.  AstraZeneca will pay $46.5 million and Cephalon, the wholly-owned subsidiary of Teva Pharmaceutical Industries. Ltd., will pay $7.5...

DOJ Catch Of The Week -- Warner Chilcott

By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Warner Chilcott US Sales LLC, a subsidiary of pharmaceutical manufacturer Warner Chilcott PLC.  Yesterday, the company agreed to plead guilty to a felony charge of health care fraud as part of a global settlement in which Warner Chilcott agreed to pay $125 million to resolve its criminal and civil liability arising...

DOJ Scores Big With Two Whistleblower False Claims Act Wins

By the C|C Whistleblower Lawyer Team It was a good week for the Department of Justice in reigning in corporate fraud.  Not only did it secure more than $700 million in fines and penalties from Crédit Agricole for violations of the International Emergency Economic Powers and Trading With the Enemy Acts.  See DOJ Catch of the Week.  It also pulled in two additional eight and nine-figure settlements from two...

DOJ Catch of the Week — PharMerica Corp.

By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Kentucky-based PharMerica Corp.  On Wednesday, the nation’s second-largest nursing home pharmacy agreed to pay $9.25 million to resolve allegations it violated the False Claims Act by soliciting and receiving kickbacks from pharmaceutical manufacturer Abbott Laboratories in exchange for promoting the anti-epileptic...

In Their Own Words — Jackson

-- “Hospice care is only medically appropriate – and reimbursed by Medicare – for terminally ill patients who are in the last months of their lives.  We will continue to vigorously investigate health care companies that put their own profits above their duty to give appropriate medical care to their patients and bill Medicare only for legitimate health care services.”  

Special Agent in Charge Derrick L....

Should Britain’s National Health Service (NHS) Be Doing More to Counter Fraud?

By Richard Pike and Yulia Tosheva As mentioned in one of our Whistleblower Insider daily updates, the accountants PKF Littlejohn got a lot of press coverage in the UK this week for a report suggesting that the NHS may be losing as much as £5.74 billion per year to fraud. Such a big number obviously provokes a reaction but what can we really conclude about fraud in the NHS and the measures taken to address...

DOJ’s Adventist Settlement Puts the Power of Whistleblowers in “Stark” Relief

By Tim McCormack and Molly Knobler (published on SCCE’s Compliance and Ethics Blog) There is no denying that certain aspects of the Physician Self-Referral Law, more commonly known as the “Stark Law,” are complicated. The Stark Law and its corresponding regulatory scheme include a web of technical terms, safe harbors, and interpretive guidance.   Is this complexity a necessary byproduct of the...

Sleep-Disorder Fraud

Can one commit fraud while sleeping?  Sort of. Increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders that affect more than fifty million Americans.  The significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous to engage in fraudulent services and billing The most common method of diagnosing sleep disorders is a...