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Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme

Posted 08/20/21

Doctor on computer with patient discussing medicine

Underscoring the fraud risks associated with the government’s continued expansion and loosening of restrictions on telehealth, the U.S. Department of Justice recently announced that a grand jury in New Jersey has returned a superseding indictment against the Florida owner of multiple telemedicine companies, referred to by DOJ prosecutors as the Video Doctor Network, for allegedly participating in a massive Medicare...

Tagged in: Catch of the Week, COVID-19, FCA Federal, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medical Devices and DME, Medicare, Money Laundering, Whistleblower Rewards,

Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act

Posted 08/19/21

Red and yellow pills scattered on hundred dollar bills

Last week, the Seventh Circuit Court of Appeals, the federal appellate court for Illinois, Indiana, and Wisconsin decided U.S. ex rel. Yarberry v. Supervalu, an important decision that may lead more unscrupulous government contractors to help themselves to public funds to which they are not entitled. Unless the Supreme Court or Congress steps in to correct the Seventh Circuit’s errors, the government may have...

Tagged in: Contract Non-Compliance, Court Decision, Drug and DME Pricing, FCA Federal, Government Procurement Fraud, Healthcare Fraud, Medicaid, Medicare, Pharma Fraud, Pricing Fraud, Whistleblower Case,

United States Reaches a “Tipping Point” in Managed Care Enforcement: DOJ Intervenes in Constantine Cannon’s Lawsuit Against Kaiser Permanente

Posted 07/30/21

In a sign that the government’s enforcement efforts against fraud in the Medicare managed care system have reached a tipping point, the U.S. Department of Justice announced today that it is joining a portion of a whistleblower lawsuit brought by a Constantine Cannon client under the False Claims Act against Kaiser Permanente and affiliated entities, one of the nation’s largest managed-care organizations. ...

Tagged in: CC Lawyers, FCA Federal, Government Decision, Healthcare Fraud, Managed Care, Medicare, Risk Adjustment Fraud, Upcoding, Whistleblower Case,

Partner Mary Inman Speaks about Research Fraud with Science Whistleblower Dr. Elisabeth Bik at the HCCA’s Research Compliance Conference

Posted 07/23/21

On June 16, 2021, Constantine Cannon partner Mary Inman spoke at the Health Care Compliance Association’s (HCCA) Research Compliance Conference on the topic of ‘The Vital Role of Whistleblower Scientists in Exposing Fraudulent Research During the Pandemic.’ Mary was joined by co-panelist Dr. Elisabeth Bik, the Founder and Editor of the Science Integrity Digest, a blog about scientific integrity aimed at...

Tagged in: COVID-19, Grant and Research Fraud, Importance of Whistleblowers, Other Government Health Programs, Whistleblower Evidence,

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Posted 07/9/21

The Food and Drug Administration (FDA) is supposed to protect American consumers from unscrupulous private actors—charlatans, snake-oil salesmen, and the like—seeking to profit by selling unproven medical “cures,” treatments, and devices to the public. Emerging during the era of the robber barons as part of Theodore Roosevelt’s efforts to “civilize capitalism,” the FDA has prevented untold harm to...

Tagged in: FCA Federal, FDA Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicare, Pharma Fraud,

Catch of the Week: Medical Device Companies to Pay $38.75M Over Defective Coagulation Monitor Allegations Linked to Patient Deaths, Injuries

Posted 07/9/21

Medical device manufacturers Alere Inc. and Alere San Diego Inc. will pay nearly $40 million to resolve allegations that they knowingly sold defective blood coagulation monitors used by Medicare beneficiaries and falsely billed Medicare for the devices. The monitors are supposed to ensure that patients taking anticoagulant drugs receive a safe dosage to avoid life-threatening consequences from too much or too little...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Medicare,

Catch of the Week: Dental Clinics to Pay $2.7M for Using Unsterilized Tools on Medicaid Patients

Posted 05/28/21

For over five years, Upper Allegheny Health Systems, a health care system operating several dental clinics in New York and Pennsylvania, allegedly performed dental services without sterilizing equipment between patients and falsely billed Medicaid for those services. After a former employee blew the whistle, the United States and the State of New York stepped in to investigate, and the defendant agreed to a $2.7...

Tagged in: Catch of the Week, FCA Federal, Government Programs Fraud, Healthcare Fraud, Importance of Whistleblowers, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Whistleblower Case,

Catch of the Week: Virginia OB/GYN Sentenced to 59 Years in Prison for Performing Medically Unnecessary Procedures for More Than Ten Years

Posted 05/21/21

Healthcare fraudsters are typically motivated by greed. But in satisfying that greed, some fraudsters perform reprehensible acts that permanently affect the victims of the fraud, making even the penalty they receive pale in comparison. This week we focus on the conviction of Javaid Perwaiz, an OB/GYN in Hampton Roads, Virginia, who was sentenced to 59 years in prison for performing medically unnecessary surgeries...

Tagged in: Catch of the Week, Criminal Proceedings, Falsifying Invoices, Healthcare Fraud, Improper Medical Facility, Lack of Medical Necessity, Medicaid, Medical Billing Fraud,

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted 05/7/21

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Posted 04/16/21

Ivan Andre Scott, a 36-year-old Florida man, just landed a 10-year prison sentence for organizing a $3.3 million Medicare fraud scheme involving two of the hottest healthcare trends – telemedicine and genetic testing to assess the likelihood of future cancer. The conspiracy targeted vulnerable Medicare beneficiaries for pricey cancer screening genetic tests, prosecutors said. Claims for these tests were falsely...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

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Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme

Court says that fraudsters who violate rules they later claim are unclear may not violate the False Claims Act

United States Reaches a “Tipping Point” in Managed Care Enforcement: DOJ Intervenes in Constantine Cannon’s Lawsuit Against Kaiser Permanente

Partner Mary Inman Speaks about Research Fraud with Science Whistleblower Dr. Elisabeth Bik at the HCCA’s Research Compliance Conference

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Catch of the Week: Medical Device Companies to Pay $38.75M Over Defective Coagulation Monitor Allegations Linked to Patient Deaths, Injuries

Catch of the Week: Dental Clinics to Pay $2.7M for Using Unsterilized Tools on Medicaid Patients

Catch of the Week: Virginia OB/GYN Sentenced to 59 Years in Prison for Performing Medically Unnecessary Procedures for More Than Ten Years

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

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