November 1, 2018

The CEO and COO of Smart Lab LLC have been sentenced to a cumulative 10 years in prison for defrauding TRICARE of millions of dollars. CEO H. Hamilton Wayne and COO Justin Morgan Wayne allegedly paid kickbacks to substance abuse treatment centers in exchange for using Smart Lab for expensive confirmatory urinalysis testing. In some cases, treatment center patients were required to submit three medically unnecessary samples a week, but...

October 26, 2018

Abbott Laboratories and AbbVie, Inc. have agreed to pay $25 million to settle a case initiated by a whistleblower alleging that the pharma companies paid unlawful kickbacks and engaged in unlawful off-label marketing for the drug TriCor.  The kickbacks took the form of gifts and payments for consulting and speaking engagements that were meant to induce or reward physicians for prescribing TriCor.  The off-label marketing consisted of Abbott's advertising the...

October 18, 2018

Dr. Felmor Agatep, a Florida-based doctor, has plead guilty to receiving kickbacks and defrauding TRICARE over prescriptions to outrageously expensive and medically unnecessary pain and scar creams. According to the DOJ press release, a one month supply of the creams in question cost more than $16,000 when made by a compounding pharmacy. At some point in late 2014, Agatep agreed to receive kickbacks from a marketing group of $100 per...

October 9, 2018

A Florida-based pharmacy owner has plead guilty to defrauding Medicare of $8.4 million. In order to generate income for his pharmacy, Valles Pharmacy Discount, Antonio Perez Jr. allegedly paid kickbacks to Medicare beneficiaries and submitted claims on their behalf for medically unnecessary prescriptions that were not purchased by the pharmacy or provided to the beneficiaries. DOJ

October 9, 2018

The former CFO and COO of Houston-area Atrium Medical Center and Pristine Healthcare, Starsky Bomer, has been convicted for his role in a $16 million Medicare kickback scheme.  Bomer and others paid illegal kickbacks to group home owners and patient recruiters in exchange for the referral of Medicare patients for outpatient mental health treatment through the hospitals' partial hospitalization program (PHP).  While the hospitals billed Medicare $16 million for these...

October 9, 2018

A defense contractor has agreed to pay $7.8 million to settle allegations that it violated the False Claims Act by fraudulently obtaining Department of Defense contracts meant for small businesses. Arena Event Services, Inc., dba Arena Americas, allegedly paid kickbacks to the smaller Military Training Solutions, LLC (MTS) in order to obtain millions of dollars worth of contracts. The work was then performed by the larger Arena Americas in a...

October 1, 2018

Pharmaceutical distributor AmerisourceBergen Corporation will pay $625 million to the federal government and 43 states to settle claims that between 2001 and 2014 a pre-filled syringe program at one of its subsidiaries, Medical Initiatives, Inc., violated federal law.  Despite lacking the proper licensing and registration, MII opened FDA-approved sterile vials of oncology drugs, and in a non-sterile environment, pooled the medicine and transfered it into non-FDA approved pre-filled syringes which...

Catch of the Week — Health Management Associates

Health Management Associates, LLC (“HMA”), a former hospital chain now part of Community Health Systems, agreed on September 25th to a $260 million settlement to resolve allegations of false billing and kickbacks alleged in eight qui tam cases under the False Claims Act (“FCA”). HMA was a hospital chain headquartered in Tampa, Florida that was acquired by Community Health Systems Inc., a major U.S. hospital chain, in 2014. One whistleblower...

September 27, 2018

Petroleo Brasileiro S.A. has agreed to pay a $853 million penalty and $933 million in disgorgement to settle DOJ and SEC charges that it violated the Foreign Corrupt Practices Act and filed false documents with the SEC that misled U.S. investors. According to the non-prosecution agreement struck with the DOJ, and the related SEC order, the Brazilian oil and gas company allegedly paid billions of dollars in bribes to Brazilian...

September 26, 2018

Health Management Associates, LLC (HMA)—now part of Community Health Systems Inc. (CHS)—has agreed to pay a combined $260 million to settle civil and criminal charges of defrauding Medicare, Medicaid, and TRICARE and violating the Anti-Kickback Statute, the Stark Law, and False Claims Act. The alleged fraud was revealed by eight whistleblowers and involved paying kickbacks to doctors for patient referrals, pressuring doctors to meet emergency patient admission quotas, billing outpatient...