Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
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Catch of the Week: Texas Hospital Exec Sentenced to 10 Years in Prison for Medicare Fraud
Posted 09/18/19
Question of the Week — Should Drug Companies that Defraud the Government Lose Their Patents?
Posted 09/18/19
September 18, 2019
Florida-based compounding pharmacy Diabetic Care Rx LLC, also known as Patient Care America, together with two of its executives, CEO Patrick Smith and VP of Operations Matthew Smith, and the private equity firm Riordan, Lewis & Haden Inc., will pay $21.36 million to resolve a case brought by two whistleblowers under the False Claims Act alleging that they paid unlawful kickbacks to secure referrals for patients covered by TRICARE, the federal healthcare program that covers military members and their families. The pharmacy paid patient recruiters to target military members and their families for the prescription of compounded creams and vitamins formulated to ensure the highest possible reimbursement from TRICARE. The marketers in turn paid doctors who issued the prescriptions, often without seeing or even speaking to the purported patients. In addition, the pharmacy and marketing company often covered patient copayments through a sham charitable organization affiliated with the marketing company. Private equity investor RLH was alleged to have known about and agreed to the kickback scheme. Whistleblowers Marisela Medrano and Ada Lopez were, respectively, the former Director of Marketing and the Reimbursement Services Manager of PCA. They will receive a yet-to-be-determined share of the U.S. recovery. DOJ; SD FLSeptember 13, 2019
Texas hospital administrator Starsky Bomer was convicted of violating the Anti-Kickback Statute and conspiring to commit healthcare fraud for paying kickbacks to group homes and others in exchange for referrals to outpatient treatments for severe mental illness at his affiliated hospital, resulting in $16 million dollars of false claims to Medicare. The kickbacks came in the form of salary payments and payments for transportation to owners of group homes. Mr. Bomer was sentenced to ten years in prison for his involvement in the scheme. DOJCatch of the Week – South Florida Health Care Facility Owner Sentenced to 20 Years in $1.3 Billion Fraud - The Largest Health Care Fraud Scheme Ever Charged by the DOJ
Posted 09/13/19
September 12, 2019
Following his conviction earlier this year, Philip Esformes was sentenced to 20 years in prison for his role in orchestrating a Medicare and Medicaid fraud scheme through his network of assisted living and skilled nursing facilities. Esformes bribed physicians to admit patients, then provided them with inadequate, inappropriate, or unnecessary services. To ensure his facilities maintained state licenses, he bribed Florida state regulators. DOJ; USAO SD FLCatch of the Week – Mallinckrodt Pays for Kickbacks on Acthar; Investigation into Copayment Subsidies Continues
Posted 09/6/19
