Anti-Kickback and Stark

June 28, 2017

PAMC Ltd. and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, agreed to pay $42 million to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  These relationships took the form of (1) arrangements under which the defendants allegedly paid above-market rates to rent office space in physicians’ offices, and (2) marketing arrangements that allegedly provided undue benefit to physicians’ practices.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Paul Chan, who was employed as a manager by one of the defendants.  He will receive a whistleblower award of more than $9.2 million from the proceeds of the government's recovery.  DOJ

July 26, 2017

Washington recovered nearly $750,000 in Medicaid reimbursement this week from pharmaceutical company Celgene Corporation for promoting medications to treat conditions they were not approved for, including certain types of cancer. The company is also accused of paying kickbacks to doctors for prescribing the medications and helping them change billing codes to ensure Medicaid would pay for their use. Off-label marketing, fraudulent billing and providing kickbacks to doctors are all violations of the Medicaid False Claims Act. WA

July 24, 2017

New Jersey-based pharmaceutical manufacturer Celgene Corp. agreed to pay $280 million to settle charges of violating the False Claims Act by promoting two cancer treatment drugs -- Thalomid and Revlimid -- for uses not approved by the FDA.  The allegations included the use of false and misleading statements about the drugs, and paying kickbacks to physicians to induce them to prescribe the drugs.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Celgene sales manager Beverly Brown.  She will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (CDCA)

July 17, 2017

Former Olympia Therapy Inc. employee Vladimir Trakhter and former Tridia Hospice Care Inc. employees Paula Bourne and La’Tasha Goodwin will collectively receive a whistleblower award of more than $3.6 million from the roughly $19.5 million Olympia, Tridia and Foundations Health Solutions Inc. agreed to pay to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.

July 6, 2017

Cathy Morris and Josie King, former employees of Compassionate Care Hospice of Atlanta, will receive a yet-to-be-determined whistleblower award from the $24 million the company and its parent Compassionate Care Hospice Group, Inc. agreed to pay to resolve charges they violated the False Claims Act and Stark Law by engaging in improper financial relationships with contracted physicians to induce them to refer patients.  DOJ (NDGA)

June 28, 2017

Paul Chan will receive a whistleblower award of more than $9.2 million from the $42 million to be paid by PAMC Ltd. and Pacific Alliance Medical Center Inc. (which together own and operate Los Angeles acute care hospital Pacific Alliance Medical Center) to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians.  DOJ