Archive

Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam

Posted 04/3/20

Erik Santos of Braselton, Georgia had run a fraudulent genetic cancer-screening-test scheme for months, then spotted an opportunity capitalize on fear surrounding COVID-19. According to the criminal complaint, Santos targeted elderly persons to determine if they met certain eligibility requirements for testing under government health-care programs. He passed the information along to co-conspirator testing...

Tagged in: Anti-Kickback and Stark, CC Lawyers, COVID-19, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Laboratory and IDTF, Lack of Medical Necessity, Provider Fraud,

The Missing Ventilator Stockpile Was Not Inevitable

Posted 04/3/20

The coronavirus crisis has been a crash course for the general public in how lifesaving ventilators work. But the federal government has long known how crucial they are and how important it is to be able to stockpile sufficient numbers. Five years ago, the government tried to plan ahead by commissioning the design and production of a low-cost ventilator to build up public and private stores in case an...

Tagged in: Anti-Kickback and Stark, COVID-19, Drug and DME Pricing, FCA Federal, Healthcare Fraud,

First Circuit Revives Whistleblower Suit Against PharMerica, Rejecting Public Disclosure Challenge

Posted 02/28/20

Rejecting an argument that only a fraudster could love, the First Circuit Court of Appeals revived a whistleblower’s lawsuit and rightly recognized that whistleblowers can have “direct” knowledge of fraud even if they did not themselves participate in the fraud. In United States ex rel. Banigan & Templin, et al. v. PharMerica, Inc., the First Circuit interpreted the so-called “original source” provision of...

Tagged in: Anti-Kickback and Stark, Court Decision, FCA Federal, Original Source, Pharma Fraud, Public Disclosure and Public Information, Whistleblower Case,

Catch of the Week: Colorado Neurosurgeon and His Three Companies Settle Spinal Implant Kickback Claims for $2.35M

Posted 02/14/20

This edition of our Catch of the Week series features the successful resolution of a whistleblower suit against neurosurgeon Dr. William Choi and three companies he owned. The defendants agreed to pay the United States $2.35 million to resolve allegations that, for over five years, Dr. Choi received illegal kickbacks from spinal implant device distributors for devices he used in surgeries. The kickbacks rendered...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Medicaid, Medical Devices and DME, Medicare, Other Government Health Programs,

Opioid Executive Sentenced to Over Five Years in Prison for Role in Healthcare Fraud Scheme

Posted 01/31/20

Insys Therapeutics, an opioid manufacturer whose main product is Subsys, a spray from of fentanyl that is 100 times stronger than morphine and cost tens of thousands a month, is in the news again. The company and its former CEO, John Kapoor, have been facing a mountain of legal issues in the past three years. Last week, in a decision that most of our readers agree with, Kapoor was sentenced to 66 months in prison.

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medicaid, Medicare, SEC Whistleblower Reward Program, Whistleblower Case, Whistleblower Rewards,

Catch of the Week: Practice Fusion Pays $145 Million for EHR Kickbacks and Misrepresentations about Software

Posted 01/28/20

Healthcare providers talk about the importance of behavioral “nudges” – gentle pushes to encourage healthy choices and positive behaviors. In our Catch of the Week, healthcare providers were nudged to prescribe highly addictive extended-release opioids in a manner that was not consistent with accepted medical standards. Who nudged them? Their own electronic health records system, which was paid to do so by the...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Criminal Proceedings, Electronic Health Records, FCA Federal, Healthcare Fraud, Pharma Fraud,

Top Ten Healthcare Fraud Recoveries of 2019

Posted 01/24/20

Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2019 stemmed from healthcare fraud matters. And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act. Not surprisingly, seven of the top ten spots in our list involved false claims act lawsuits against drug companies...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, Healthcare Fraud, Hospital Fraud, Medicaid, Medicare, Pharma Fraud, Provider Fraud, Top 10,

Top Ten Financial and Healthcare Fraud Prison Sentences of 2019

Posted 01/23/20

Prison tower and fence silhouetted against sky

Financial and healthcare fraud schemes can result not just in civil investigations and liability, but also in prison time for the individuals involved. In 2019, the Department of Justice obtained substantial prison sentences in numerous cases involving healthcare and financial frauds, helping to bring justice to the patients, investors, or individuals harmed by criminal fraudsters. Many of the fraudulent...

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Financial and Investment Fraud, Healthcare Fraud, Ponzi Schemes, Top 10,

Catch of the Week: ResMed Pays $37.5 Million to Settle Five Qui Tam Cases Alleging Kickbacks

Posted 01/16/20

Sleep apnea equipment manufacturer ResMed agreed to pay $37.5 million to resolve allegations that it violated the False Claims Act and Anti-Kickback Statute by providing unlawful remuneration to durable medical equipment distributors, sleep labs, doctors, and other healthcare providers. It seems that ResMed’s kickback schemes struck many people as wrong: the settlement resolves five separate cases brought by...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medical Devices and DME, Multiple Whistleblowers and First-to-File, Whistleblower Case,

Catch of the Week: Teva, A Pharmaceutical Company, Pays $54M to Settle Kickback Allegations

Posted 01/9/20

pill container spilled over with pills in the form of a dollar sign

A recent settlement between the Department of Justice and Teva, a pharmaceutical company, show how creative, and how hard to identify, kickbacks allegedly paid to physicians can be. The company has agreed to pay $54M to resolve claims when it violated the False Claims Act by paying kickbacks to doctors to boost sales of two of their drugs. Broadly speaking, the Anti-Kickback statute prohibits healthcare providers,...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Whistleblower Case, Whistleblower Protection Laws,

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Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam

The Missing Ventilator Stockpile Was Not Inevitable

First Circuit Revives Whistleblower Suit Against PharMerica, Rejecting Public Disclosure Challenge

Catch of the Week: Colorado Neurosurgeon and His Three Companies Settle Spinal Implant Kickback Claims for $2.35M

Opioid Executive Sentenced to Over Five Years in Prison for Role in Healthcare Fraud Scheme

Catch of the Week: Practice Fusion Pays $145 Million for EHR Kickbacks and Misrepresentations about Software

Top Ten Healthcare Fraud Recoveries of 2019

Top Ten Financial and Healthcare Fraud Prison Sentences of 2019

Catch of the Week: ResMed Pays $37.5 Million to Settle Five Qui Tam Cases Alleging Kickbacks

Catch of the Week: Teva, A Pharmaceutical Company, Pays $54M to Settle Kickback Allegations

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