Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
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June 11, 2019
Two additional co-defendants in a recently reported home health fraud case have been sentenced to 6-10 years in prison and ordered to pay over $4.3 million each for their involvement. Angela Avetisyan and Ashot Minasyan, the co-owners and operators of Fifth Avenue Home Health, paid kickbacks to Marina Merino and other patient recruiters to bring Medicare patients to a clinic owned by Robert Glazer. In exchange, they received referrals from Glazer’s clinic for home health services that were allegedly medically unnecessary. DOJ; USAO CDCAJune 11, 2019
A Maryland-based medical device manufacturer facing criminal charges and civil charges under the False Claims Act has agreed to pay $15 million to settle all claims. According to former employee and whistleblower John Murtaugh, when the company discovered that its MicroMatrix wound dressing powder was contaminated with high levels of endotoxins, it allegedly removed certain MicroMatrix products off the market, but failed to report the removal to the FDA and disclose the reason to doctors, hospitals, and its own sales representatives. ACell also allegedly caused false claims to be submitted to federal healthcare programs by directing its sales representatives to market the product as safe and effective, providing coding recommendations designed to elicit higher payments from Medicare, and providing improper inducements to encourage use of its product. As part of the settlement, Murtaugh will receive $2.3 million, and ACell will enter into a 5-year corporate integrity agreement. DOJJune 7, 2019
Robert A. Glazer and Marina Menino have been found guilty at trial for their actions directing a Medicare fraud scheme that billed $33 million to the government. Menino received kickbacks from Glazer in exchange for recruiting patients for his Glazer Clinic. Glazer then billed Medicare for services the patients did not need or did not receive, referred them to medically unnecessary home health or hospice services, and ordered durable medical equipment that they did not need or receive. Defendants will be sentenced in September 2019. DOJ; USAO C.D.Cal.June 5, 2019
Opioid manufacturer Insys Therapeutics will pay $225 million to resolve federal criminal and civil claims against it regarding the unlawful marketing of its drug Subsys, including the payment of kickbacks to providers through sham "speaker programs" that rewarded practitioners who increased their Subsys prescribing, as well as jobs for prescribers' relatives and friends, and lavish meals and entertainment. $195 million of the settlement will be paid to resolve False Claim Act allegations in five separate whistleblower lawsuits in which the government intervened in 2018; the whistleblower reward shares have not yet been determined. To resolve the criminal claims, Insys will pay $2 million and forfeit $28 million; its operating subsidiary will plead guilty to wire fraud and related charges. In addition, Insys entered into a five-year Corporate Integrity Agreement and a five-year deferred prosecution agreement. Previously, five former Insys executives were convicted of racketeering in connection with Subsys marketing. DOJ; USAO MassJune 3, 2019
Rialto Capital Management LLC (Rialto) and its former affiliate, RL BB-IN KRE LLC (RL BB), have agreed to pay $3.6 million to resolve allegations that a RL BB hospital violated the Anti-Kickback Statute, the Stark Law, and the False Claims Act. A qui tam lawsuit filed by Dr. Abdul Buridi had revealed that Indiana-based Kentuckiana Medical Center, under Rialto’s direction, had provided personal loans to two referring doctors and then failed to collect on those loans after they became due in full. Of the $3.6 million recovered, Dr. Buridi will receive $612,000. DOJJune 3, 2019
A former physician’s assistant in New Hampshire has been sentenced to 4 years in prison for writing prescriptions of a fentanyl spray in exchange for over $49,000 in kickbacks masked as speaker honorariums. After being approached by a drug manufacturer in 2013, Christopher Clough wrote upwards of 750 prescriptions for the spray, which was intended for management of breakthrough cancer pain (BTCP). Over 215 of those prescriptions were for Medicare and TRICARE patients and led to payments of over $2.1 million by Medicare and almost $600,000 by TRICARE. On top of the kickback charges, Clough was accused of causing patient harm for prescribing the drug, in high doses, to patients who didn’t have BTCP, and then rebuffing patient and family requests to get off the drug. USAO NHMay 31, 2019
Generic drug maker Heritage Pharmaceuticals, Inc. has entered into a deferred prosecution agreement for criminal antitrust charges, admitting that it conspired to fix prices, rig bids, and allocate customers for the diabetes drug glyburide. Heritage will pay a $225,000 criminal penalty and has agreed to cooperate in ongoing antitrust investigations. In addition, Heritage will pay $7.1 million to resolve allegations under the False Claims Act that the company paid and received unlawful remuneration under the Anti-Kickback Statute through its arrangements with other generic drug makers regarding prices, supply, and allocation of customers for drugs including glyburide, hydralazine, and theophylline. DOJ; USAO ED PaUnited States Intervenes in Home Health Care Fraud Case
Posted 05/30/19
