Whistleblower News From The Inside — October 16, 2015

By the C|C Whistleblower Lawyer Team Hospice company AseraCare loses first round of False Claims trial -- A jury in Alabama delivered a blow to AseraCare on Thursday when it found 104 of 121 hospice claims were false or unsupported in a case seeking to determine whether the hospice provider admitted Medicare beneficiaries who were not eligible for end-of-life care, sending “a very strong signal to the for-profit hospice industry...

Whistleblower News From The Inside -- October 15, 2015

By the C|C Whistleblower Lawyer Team Mental Health Providers Plead Guilty in $70 Million Fraud Scheme – An owner, a clinical director, and a therapist pleaded guilty Wednesday for their roles in a health care fraud scheme involving three Miami-based mental health centers that purported to provide intensive mental health services to Medicare beneficiaries.  From 2008 through 2010, the clinics billed Medicare for costly partial hospitalization program (PHP) services that...

October 14, 2015

The Maryland Attorney General announced a $13.5 million settlement with NuVasive, Inc, resolving allegations brought in a whistleblower suit that the California medical device company improperly marketed its spine surgery products and provided kickbacks to doctors through speaking fees and other payments. MD

Whistleblower News From The Inside — October 14, 2015

By the C|C Whistleblower Lawyer Team Education Management Corp. “within a hair of settling” $11 billion lawsuits – The for-profit company is close to settling the False Claims Act lawsuits brought by whistleblowers, the federal government, and several states.  Pittsburgh Tribune-Review Whistleblower alleges Benghazi investigation was politicized - Bradley Podliska, a former staffer working on the investigation, says that he was fired after he complained that the investigation was politically...

DOJ Catch of the Week — PharMerica Corp.

By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Kentucky-based PharMerica Corp.  On Wednesday, the nation’s second-largest nursing home pharmacy agreed to pay $9.25 million to resolve allegations it violated the False Claims Act by soliciting and receiving kickbacks from pharmaceutical manufacturer Abbott Laboratories in exchange for promoting the anti-epileptic prescription drug Depakote for nursing home patients.  See DOJ Press Release. Nursing...

Whistleblower News From The Inside — October 7, 2015

By the C|C Whistleblower Lawyer Team Fifth Third to pay $85M to settle whistleblower charges of mortgage fraud -- According to US Attorney Preet Bharara, the bank admitted failing to report to HUD roughly 1,400 defective mortgage loans it originated from 2003 through 2013.  DOJ PharMerica to pay $9.25M to settle whistleblower charges of illegal kickbacks --  According to the whistleblowers and government, the nation’s second-largest nursing home pharmacy solicited...

Whistleblower News From The Inside — October 5, 2015

By the C|C Whistleblower Lawyer Team United States Settles False Claims Act Suit against Guardian Hospice -- Guardian and related entities agreed to pay $3 million to resolve allegations that Guardian knowingly submitted false claims to the Medicare program for hospice patients who were not terminally ill. The case was initiated by whistleblowers Rose Betts and Jennifer Williams, former employees of Guardian, who will receive approximately $510,000 of the $3 million settlement....

Whistleblower News From The Inside — October 2, 2015

By the C|C Whistleblower Lawyer Team JPMorgan to pay a third of $1.86B swaps settlement -- JPMorgan Chase & Co is set to pay almost a third of a $1.86 billion settlement to resolve claims that a dozen big banks conspired to limit competition in the credit-default swaps market, with Morgan Stanley, Barclays Plc and Goldman Sachs Group paying about $230 million, $175 million and $164 million, respectively.  Reuters Strata...

September 29, 2015

The New Jersey Medicaid Fraud Control Unit and Office of the Insurance Fraud Prosecutor obtained an indictment against a doctor, Syed Jaffery, for accepting kickbacks in exchange for patient referrals. The indictment alleges that from 2010 to 2013, Jaffrey participated in a scheme by which he agreed to refer patients needing MRI and CT scans to Diagnostic Imaging Services of South Jersey in exchange for monetary kickbacks. Over the course...

DOJ’s Adventist Settlement Puts the Power of Whistleblowers in “Stark” Relief

By Tim McCormack and Molly Knobler (published on SCCE’s Compliance and Ethics Blog) There is no denying that certain aspects of the Physician Self-Referral Law, more commonly known as the “Stark Law,” are complicated. The Stark Law and its corresponding regulatory scheme include a web of technical terms, safe harbors, and interpretive guidance.   Is this complexity a necessary byproduct of the multi-faceted and increasingly sophisticated relationships between and among healthcare providers,...