September 25, 2018

Six individuals in the New Orleans area - four physicians, a medical biller, and a medical office manager - were sentenced after having been found guilty of conspiracy to commit health care fraud and to pay and receive unlawful kickbacks.   The defendants fraudulently billed Medicare for medically unnecessary home health services for patients who were not homebound and had no legitimate medical need for the services, creating false and...

September 17, 2018

In the largest healthcare fraud case ever to come out of Mississippi, the co-owner of two Mississippi-based compounding pharmacies, Marco Bisa Hawkins Moran, has pleaded guilty to defrauding TRICARE of more than $22 million. As part of the fraud, Moran and others allegedly paid kickbacks to doctors and marketers to prescribe drugs for beneficiaries covered by TRICARE and other lucrative health benefit programs. Additionally, they allegedly selected formulas meant to...

September 11, 2018

Through a tip by Connecticut State Comptroller, Kevin Lembo, a Florida-based compounding pharmacy, Assured, Rx, along with multiple individuals—many of them former and current Connecticut state government employees—have been sued by the State of Connecticut for alleged violations of the Connecticut False Claims Act. The pharmacy is accused of paying kickbacks to co-defendants Nicholas and Lisette Maulucci, who then paid other individuals to file reimbursement claims from a state employee...

August 27, 2018

Following a lawsuit by whistleblower Dr. Stephen Dean, seven defendants in the ambulance industry have agreed to pay over $21 million altogether in order to settle claims that they violated the Anti-Kickback Statute and False Claims Act. The defendants with the largest fines—East Texas Medical Center and Paramedics Plus—had been accused of giving kickbacks to the others in exchange for their business. For his role in the case, Dr. Dean...

August 23, 2018

Reliant Rehabilitation Holdings Inc has agreed to pay $6.1 million to settle claims brought on by whistleblower Dr. Thomas Prose that it paid kickbacks to doctors and nursing homes to promote its business and filed reimbursement claims arising from improper contracts — both violations of the False Claims Act. Under the settlement agreement, Dr. Prose will receive a relator’s share of $915,000. DOJ

August 15, 2018

Post Acute Medical, LLC has agreed to pay $13,031,502 to the United States, $114,016 to Texas, and $22,482 to Louisiana to settle allegations brought on by whistleblower Douglas Johnson that it violated the Anti-Kickback Statute, Physician Self-Referral Law, and state and federal False Claims Acts. The operator of long-term care and rehabilitation hospitals nationwide was accused of cultivating "reciprocal referral relationships" with outside healthcare providers and then billing Medicare and...

August 13, 2018

Nurse practitioner Sandra Haar, founder and chief executive officer of Horisons Unlimited, a non-profit provider of health and dental services in Merced, California, pleaded guilty to health care fraud and conspiracy to receive kickbacks.  Haar's scheme billed for services that were not rendered or were medically unnecessary, even submitting bills for office visits with doctors when, in fact, patients were met in local parking lots and given Suboxone, an opioid...

August 10, 2018

Trinity Medical Pharmacy, LLP and several members of its leadership have agreed to pay $2,244,270.14 to settle allegations that it violated the False Claims Act by giving illegal kickbacks to patients and providers, billing TRICARE and other government programs for medical reimbursement claims arising from those kickbacks, and failing to disclose information that would have barred it from becoming a provider for Express Scripts, which provides pharmaceutical services for TRICARE....

AstraZeneca Settles Seroquel False Claims Action -- Again

On August 8, 2018, AstraZeneca agreed to pay $110 million to the state of Texas to settle allegations that it promoted two of its drugs without FDA approval resulting in health risks to children, adolescents, and other state hospital patients. This case was brought by two whistleblowers under the qui tam provisions of Texas’s Medicaid Fraud Prevention Act. The whistleblowers, two former AstraZeneca employees, among them a sales representative, first...

July 16, 2018

Two additional Southern California surgeons have been indicted in a kickback scheme that is alleged to have generated over a billion dollars in fraudulent claims to federal and California healthcare programs. The two physicians were charged for their roles in receiving kickbacks to refer patients to Pacific Hospital. USAO Central District of California