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Page 45 of 51

Have We Reached the Final Round In the Government's Tuomey Kickback Case?

Posted  07/10/15
The United States won another round in its now almost eight year battle to hold South Carolina-based Tuomey Healthcare System liable for paying doctors illegal kickbacks.  The litigation has been long and procedurally complex, but at bottom, the Government has alleged, and the jury has found, that Tuomey gave a group of doctors unreasonably lucrative employment arrangements to get them to send their patients to...

Doctors Be Warned: DOJ Steps Up Enforcement of Anti-Kickback Law Against Individual Medical Professionals

Posted  06/29/15
The Department of Justice has recovered millions of dollars from hospitals, nursing homes, pharmaceutical companies and other medical providers through civil and criminal enforcement of the Anti-Kickback Law.  But the agency has begun paying increased attention to the doctors, nurses and administrative professionals on the receiving end of these bribes. The Anti-Kickback Law (42 U.S.C. § 1320a-7b) makes it...

Medicare Part C: Fighting Back Against Risk Adjustment Fraud

Posted  06/26/15
Health insurance companies that participate in the Medicare Managed Care program (also known as Medicare Advantage or Medicare “Part C”) routinely complain about cuts to their reimbursement rates – even in years, like this one, where the reimbursement rates are actually increased.  At the same time, reports indicate that insurers are “leaning heavily on their Medicare business” and “signal[ing their]...

DOJ Gives Major Shoutout To Whistleblowers In $450M DaVita False Claims Act Settlement

Posted  06/26/15
By Gordon Schnell On Wednesday, Denver-based provider of dialysis services DaVita Healthcare Partners, Inc. agreed to pay $450 million to resolve charges it violated the False Claims Act by purposely creating and then billing the government for unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients.  DaVita is the largest provider of dialysis services in the US with dialysis clinics...

DOJ Catch Of The Week -- Hebrew Homes Health Network

Posted  06/19/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to Hebrew Homes Health Network Inc., a Florida-based operator of rehabilitation and skilled nursing facilities.  On Tuesday, the company -- along with its former president and executive director William Zubkoff -- agreed to pay $17 million to resolve allegations it violated the False Claims Act by improperly paying...

DOJ Catch Of The Week -- Orbit Medical/Rehab Medical

Posted  05/29/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to Orbit Medical Inc. and its partial successor, Rehab Medical Inc.  On Wednesday, these durable medical equipment suppliers agreed to pay $7.5 million to settle False Claims Act charges that Orbit submitted false claims to federal health care programs for power wheelchairs and accessories.  See DOJ Press...

DOJ Catch Of The Week -- PharMerica Corporation

Posted  05/15/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to PharMerica Corporation, an organization of long-term care pharmacies that dispense medications to residents of nursing homes and skilled nursing facilities across the country.  Yesterday, PharMerica agreed to pay $31.5 million to settle charges it violated the Controlled Substances Act by dispensing Schedule II...

DOJ Catch of the Week -- Health Management Associates

Posted  05/8/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to Health Management Associates Inc.  Yesterday, the hospital chain and 14 hospitals it previously owned and operated, along with 2 other hospitals, agreed to collectively pay $15.69 million to settle whistleblower charges they violated the False Claims Act by seeking and receiving Medicare reimbursement for Intensive...

Whistleblower Spotlight -- Deceased VA Whistleblower Christopher Kirkpatrick

Posted  04/23/15
By the C|C Whistleblower Lawyer Team This week's "Whistleblower Spotlight" features Christopher Kirkpatrick, the 38-year old clinical psychologist who took his own life after being fired from the Tomah Veterans Affairs Medical Center for complaining about the treatment of his patients there.  Kirkpatrick would appear to be just one of the scores of whistleblowers who have been retaliated against for stepping up to...

In Their Own Words -- Sparrow

Posted  04/23/15

-- "It shows the incentives provided for whistleblowers are working well, and all the other controls and detection systems are failing miserably."

Malcolm Sparrow, a health care fraud expert at Harvard's John F. Kennedy School of Government, on the increasing number of whistleblower actions challenging fraud in the Medicare Advantage healthcare program.  Click here for more.
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