How Copayment Waivers can Give Rise to a Whistleblower Claim
Posted 06/8/18
What’s not to like about a doctor waiving a patient’s copayment, or a pharmaceutical company offering a prescription drug assistance program? Turns out there are plenty of reasons to be concerned about such activities. And, as a recently announced $24 million settlement with Pfizer illustrates, unlawful patient cost waivers can result in big liability for defendants.
Patient cost-sharing is a core principle...
On May 23, the US District Court in South Carolina 
The Department of Justice today 
The owner of a Michigan home health agency pleaded guilty to fraud charges for his role in a scheme involving approximately $8 million in fraudulent Medicare claims for home health services that were procured through the payment of illegal kickbacks. Zahir Shah, 48, of West Bloomfield, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to pay and...
By the C|C Whistleblower Lawyer Team
The DOJ charged two Tennessee health care executives, John Davis and Brenda Montgomery, for their alleged participation in a $4.6 million Medicare kickback scheme involving durable medical equipment. Davis is the former CEO of pain management company Comprehensive Pain Specialists (CPS). Montgomery is the owner of medical equipment company CCC Medical Inc. See 
By the C|C Whistleblower Lawyer Team
Georgia Bone & Joint, Summit Surgery Center, Southern Crescent Anesthesiology, Sentry Anesthesia Management, and David LaGuardia agreed to pay $3.2 million to settle allegations that LaGuardia, Sentry, and SCA provided a free medical director to Summit Surgery Center in order to induce it to choose to perform more procedures at the surgery center rather than in the GBJ office. GBJ...
By the C|C Whistleblower Lawyer Team
The 
By the C|C Whistleblower Lawyer Team
The Justice Department announced that Abiomed, Inc. agreed to pay $3.1 million to resolve allegations it violated the False Claims Act by purchasing extravagant meals for physicians to induce them to use Abiomed’s Impella line of heart pumps.
“We expect today’s settlement with Abiomed to serve as a warning to medical device manufacturers who try to improperly influence the...
By the C|C Whistleblower Lawyer Team
UPMC Hamot and Medicor Associates, a hospital and a cardiology group located in Erie, Pennsylvania, have 
By the C|C Whistleblower Lawyer Team
On Wednesday, former pharmaceutical sales representative Steven Butcher admitted to running a $45 million scheme to swindle both federally-funded and private health care benefit programs. Butcher was charged with one count of conspiracy to commit health care fraud and one count of conspiracy to violate the Anti-Kickback Statute, a law designed to remove financial incentives...