Anti-Kickback and Stark Archives - Page 49 of 61

May 20, 2016

New Jersey announced that a chiropractor from Morris County pleaded guilty to taking more than $250,000 in illegal kickbacks from doctors and other individuals in return for referring patients to their practices, clinics and medical imaging centers. Dr. Alexander Dimeo, 61, of Budd Lake, N.J., and Fort Myers, Fla., pleaded guilty to two separate accusations before Superior Court Judge Michael A. Toto in Middlesex County. Dimeo retired last year, but he formerly operated Passaic Chiropractic & Therapy Center PC in Passaic. In pleading guilty, Dimeo admitted that between 2009 and 2015, he received approximately $254,500 in illegal kickbacks for patient referrals. NJ

Tagged in: Anti-Kickback and Stark, Chiropractic, Healthcare Fraud,

April 29, 2016

Hollister Inc., a manufacturer of disposable health care products, and Byram Healthcare Centers Inc., a supplier of medical products, agreed to respectively pay roughly $11.4 million and $9.4 million to resolve allegations they violated the False Claims Act through an illegal kickback scheme. According to the government, Hollister paid kickbacks to Byram in return for marketing promotions, conversion campaigns and other referrals of patients to Hollister’s ostomy and continence care products. The government claimed that Byram also received kickbacks from three other manufacturers of ostomy and continence care products, namely Coloplast Corp., Montreal Ostomy and Safe N’ Simple. The allegations originated in a whistleblower lawsuit filed by two former employees and one current employee of Coloplast under the qui tam provisions of the False Claims Act. They will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

April 18, 2016

Miami physician Henry Lora was sentenced to 108 months in prison for his role in a Medicare fraud scheme that caused approximately $30 million in losses. Lora was the medical director of Miami-area clinic Merfi Corporation and admitted that in exchange for kickbacks and bribes, he and his co-conspirators wrote prescriptions for home health care and other services for Medicare beneficiaries that were not medically necessary or not provided. He also admitted falsifying patient records to make it appear as if the beneficiaries qualified for these services. In March 2014, Merfi owner was sentenced to nine years in prison for conspiracy to commit health care fraud. DOJ

Tagged in: Anti-Kickback and Stark, Healthcare Antitrust, Lack of Medical Necessity, Medicare,

April 11, 2016

Tennessee-based drug urine screening company PremierTox 2.0, Inc. (previously called Nexus) agreed to pay $2.5 million to resolve allegations it violated the False Claims Act by submitting false claims when billing Medicare, TennCare and Kentucky Medicaid for drug urine screening services. According to the government, PremierTox had a swapping arrangement under which Nexus gave below cost discounts on its urine drug screen tests to patients in Tennessee without insurance, in exchange for physicians’ referring their patients with Medicare or TennCare coverage to Nexus. The government also contended that in Tennessee Nexus submitted excessive claims to Medicare and TennCare for laboratory testing that was beyond what was medically reasonable and necessary. The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by a former office manager of a pain clinic and the former CEO of PremierTox. The office manager will receive a whistleblower award of $361,250, and the former CEO will receive a whistleblower award of $56,250. DOJ (MDTN)

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

May 3, 2016

Pennsylvania joined with other states and the federal government in a $306 million civil settlement that resolves allegations that Olympus America, Inc. and some of its subsidiaries paid illegal kickbacks to healthcare providers. The settlement was the result of a whistleblower lawsuit – United States et al., ex rel. John Slowik v. Olympus America, Inc., et al – filed in New Jersey. The lawsuit alleged that Olympus used improper financial incentives to induce doctors and hospital executives to buy a wide ranging array of its endoscopes and other surgical equipment, and to thereby unlawfully increase sales and gain market share. PA, NY

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Devices and DME, Whistleblower Case,

March 25, 2016

Damian Mayol, the president of Miami-based transportation company Transportation Services Providers Inc. was sentenced to 60 months in prison and to pay $26.8 million in restitution (and forfeit the same amount) for his role in a health care fraud scheme involving three mental health centers that resulted in the submission of approximately $70 million in false Medicare claims. According to evidence presented at trial, Mayol and his co-conspirators used his company to coordinate the payment of illegal kickbacks to recruiters, who in return referred patients to three now-defunct community mental health centers -- R&S Community Mental Health Inc., St. Theresa Community Mental Health Center Inc. and New Day Community Mental Health Center LLC -- for costly partial hospitalization program services that were not medically necessary or not actually provided. DOJ

Tagged in: Anti-Kickback and Stark, Lack of Medical Necessity, Medical Billing Fraud, Medicare,

March 23, 2016

Pennsylvania-based Respironics Inc. agreed to pay $34.8 million to resolve charges it violated the False Claims Act and Anti-Kickback Statute by paying kickbacks in the form of free call center services to durable medical equipment (DME) suppliers that bought its masks for patients with sleep apnea. Respironics allegedly provided DME companies with call center services to meet their patients’ resupply needs at no charge as long as the patients were using masks that Respironics manufactured; otherwise, the DME companies would have to pay a monthly fee based on the number of patients who used masks manufactured by a competitor of Respironics. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Gibran Ameer, who has worked for different DME companies. He will receive a whistleblower award of $5.38 million from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Medical Devices and DME, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

March 17, 2016

Carlos Medina, owner of Miami-area medical clinics Doral Community Clinic Inc. and Advanced Medical of Doral Inc. was sentenced to 82 months in prison for his role in a Medicare fraud scheme that caused more than $3 million in losses. The clinics purportedly provided medically necessary services to Medicare beneficiaries, but in reality charged cash kickbacks in exchange for prescriptions for home health care services. Some of the beneficiaries who frequented the clinics did not meet Medicare’s criteria for the prescribed services and some of the services prescribed by the medical professionals at Doral and Advanced Medical were never provided by the home health agencies to which the patients were referred. DOJ

Tagged in: Anti-Kickback and Stark, Home Health and Hospice, Medicare,

March 2, 2016

Mark T. Conklin, the former owner and operator of Florida-based Recovery Home Care Inc. and Recovery Home Care Services Inc. (RHC) agreed to pay $1.75 million to resolve charges of violating the False Claims Act by paying illegal kickbacks to doctors who agreed to refer Medicare patients to RHC for home health care services. Conklin sold RHC to National Home Care Holdings in October 2012. According to the government, Conklin ran a scheme under which RHC paid dozens of physicians thousands of dollars per month to serve as sham medical directors who performed little or no work in exchange for referring their patients to RHC. The allegations originated in a whistleblower lawsuit filed by former RHC employee Gregory Simony under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of up to $315,000 from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Whistleblower Case, Whistleblower Rewards,

March 1, 2016

Olympus Corp. of America, the country’s largest distributor of endoscopes and related equipment, agreed to pay $623.2 million to resolve alleged violations of the False Claims Act and Anti-Kickback Statute through a scheme to pay kickbacks to doctors and hospitals. It is the largest payout ever by a medical device company for violations of the Anti-Kickback Statute. In addition, Olympus subsidiary Olympus Latin America Inc. also agreed to pay $22.8 million to resolve separate charges relating to violations of the Foreign Corrupt Practices Act. The allegations originated in a whistleblower lawsuit filed by John Slowik, Olympus’ former chief compliance officer, under the qui tam provisions of the federal and various state False Claims Acts. He will receive a whistleblower award of roughly $51 million from the proceeds of the government’s recovery. Whistleblower Insider

Tagged in: Anti-Kickback and Stark, FCA Federal, FCPA, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

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