Archive

December 17, 2015

Connecticut and other states have joined a global settlement with Novartis Pharmaceuticals to resolve allegations that Novartis provided kickbacks to certain specialty pharmacies in exchange for recommending the drug Exjade to Medicaid and Medicare patients. Novartis has paid the states and the federal government $390 million to resolve these allegations. CT, IL, NY, MI, WA

November 24, 2015

In a series of related cases, a former hospital CFO, two orthopedic surgeons and two others have been charged in long-running health care fraud schemes that illegally referred thousands of patients for spinal surgeries and generated nearly $600 million in fraudulent billings over an eight-year period. The schemes involved tens of millions of dollars in illegal kickbacks to dozens of doctors, chiropractors and others. As a result of the illegal payments, thousands of patients were referred for spinal surgeries at California hospitals. Many of the fraudulent claims were paid by the California worker’s compensation system and the federal government. CA

October 14, 2015

The Maryland Attorney General announced a $13.5 million settlement with NuVasive, Inc, resolving allegations brought in a whistleblower suit that the California medical device company improperly marketed its spine surgery products and provided kickbacks to doctors through speaking fees and other payments. MD

October 8, 2015

43 states joined the federal government in a $9.25 million dollar settlement with PharMerica over allegations in two separate whistleblower actions that PharMerica conspired with Abbott Laboratories, a drug manufacturer, through a number of disguised kickback arrangements to increase overall utilization of the drug Depakote and to promote misbranded Depakote. FL; MA; NH

September 29, 2015

The New Jersey Medicaid Fraud Control Unit and Office of the Insurance Fraud Prosecutor obtained an indictment against a doctor, Syed Jaffery, for accepting kickbacks in exchange for patient referrals. The indictment alleges that from 2010 to 2013, Jaffrey participated in a scheme by which he agreed to refer patients needing MRI and CT scans to Diagnostic Imaging Services of South Jersey in exchange for monetary kickbacks. Over the course of the scheme, Jaffrey allegedly accepted approximately $195,000. In an attempt to disguise the arrangement, the kickback checks were made payable to Jaffrey’s alleged shell company Mask Realities and purported to be for a rental space for billing services. NJ

May 11, 2015

Acting New Jersey Attorney General John J. Hoffman announced guilty plea of Rehan Zuberi and his wife Humara Paracha to charges they bribed dozens of doctors in exchange for referrals, worth several million dollars, to the medical imaging centers they owned and operated under the umbrella group Diagnostic Imaging Affiliates which managed numerous diagnostic imaging facilities throughout northern and central New Jersey. NJ

May 8, 2015

New York Attorney General Eric T. Schneiderman announced an agreement in principle to settle kickback claims against Medco Health Solutions subsidiary Accredo Health Group, Inc. to resolve allegations that Accredo recommended the drug Exjade to Medicaid patients in exchange for kickbacks from Novartis Pharmaceuticals Corporation which markets the drug. Under the settlement, Accredo will pay $60 million to the federal government, New York, and several other states. About $3.4 million of the settlement will resolve claims relating to New York’s Medicaid program. In January 2014, another pharmacy, BioScrip, Inc., agreed to pay $15 million to resolve similar claims. The case against Novartis is ongoing. NY

March 16, 2015

New York Attorney General Eric T. Schneiderman announced that New York along with 49 other states and the District of Columbia have reached a settlement with global pharmaceutical company Daiichi Sankyo, Inc. to resolves allegations that Daiichi violated the False Claims Act by using lavish meals and speaker programs to improperly induce physicians to prescribe the drugs Azor, Benicar, Tribenzor and Welchol. Under the agreement, Daiichi agreed to pay the US and state Medicaid programs $39 million. The allegations originated in a whistleblower lawsuit filed by former Daiichi sales representative Kathy Fragoules under the qui tam provisions of the federal and New York State False Claims Acts. She will receive $6.1 million of the federal recovery and an undisclosed portion of the state recoveries. NY

January 20, 2015

Massachusetts Attorney General Martha Coakley announced South Shore Physician Hospital Organization will pay $1.77M to settle allegations of operating a recruitment grant program through which it paid kickbacks to its physician members in exchange for patient referrals. MA

January 7, 2015

Florida Attorney General Pam Bondi announced that Florida, along with California, Colorado, Kentucky, and Ohio and the federal government, entered a $22 million national settlement with DaVita Healthcare Partners, Inc., one of the leading providers of dialysis services in the US. The settlement resolves allegations originating in a whistleblower lawsuit that DaVita paid illegal kickbacks to induce the referral of patients to its dialysis clinics, causing false claims to be submitted to the Medicaid program. DaVita will pay Florida $5.6 million in restitution and other recoveries. FL