Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
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Top-10 False Claims Act Kickback Recoveries For 2015
Posted 01/7/16
By the C|C Whistleblower Lawyer Team
Here is our look-back at the top-10 Department of Justice False Claims Act recoveries in 2015 for violations of the Anti-Kickback Statute and/or the Stark Law.
10. AA ADVANCED CARE -- Felix Gonzalez, owner of Miami home health care company AA Advanced Care, was ordered to pay $21.4 million in restitution (and sentenced to 113 months in prison) for billing Medicare...
December 18, 2015
Pharmaceutical company Warner Chilcott entered in to a $23.3 million settlement with the California Department of Insurance to resolved allegations contained in a whistleblower lawsuit brought by three former employees alleging drug marketing fraud in violation of state law. The suit alleged that Warner Chilcott executives violated the California Insurance Code False Claims Act, which prohibits anyone from defrauding private insurance companies by using kickbacks or other inducements to procure or steer clients or patients. CADecember 17, 2015
Connecticut and other states have joined a global settlement with Novartis Pharmaceuticals to resolve allegations that Novartis provided kickbacks to certain specialty pharmacies in exchange for recommending the drug Exjade to Medicaid and Medicare patients. Novartis has paid the states and the federal government $390 million to resolve these allegations. CT, IL, NY, MI, WADOJ Catch of the Week -- Operation Spinal Cap
Posted 11/25/15
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to the doctors and other healthcare professionals caught up this week in the government's "Operation Spinal Cap" dragnet. In a series of related cases the DOJ announced yesterday, the former CFO of Long Beach, California-based Pacific Hospital, two orthopedic surgeons and two others have been charged in long-running...
In Their Own Words — Jones
Posted 11/25/15
-- “Injured workers were treated like livestock by doctors and hospitals who paid or accepted kickbacks and bribes in exchange for referrals.”
California Insurance Commissioner Dave Jones commenting on the recent round of criminal charges in the Justice Department’s ongoing fight against fraud in the spinal surgery industry, code-named “Operation Spinal Cap.”November 24, 2015
In a series of related cases, a former hospital CFO, two orthopedic surgeons and two others have been charged in long-running health care fraud schemes that illegally referred thousands of patients for spinal surgeries and generated nearly $600 million in fraudulent billings over an eight-year period. The schemes involved tens of millions of dollars in illegal kickbacks to dozens of doctors, chiropractors and others. As a result of the illegal payments, thousands of patients were referred for spinal surgeries at California hospitals. Many of the fraudulent claims were paid by the California worker’s compensation system and the federal government. CADOJ Enforcement Spotlight -- Novartis Settles Whistleblower Kickback Case for $390M
Posted 11/23/15
By the C|C Whistleblower Lawyer Team
The Department of Justice continues its recent streak of False Claims Act wins with its $390 million settlement Friday with Novartis Pharmaceuticals Corp. resolving charges the pharmaceutical giant gave kickbacks to specialty pharmacies in return for recommending two of its drugs, Exjade and Myfortic. Of the $370 million, roughly $287 million will go to the federal government...
A Legally-Compliant Practice: Necessary but Insufficient for Good Medicine?
Posted 11/16/15
By Tim McCormack and Molly Knobler (published on SCCE’s Compliance and Ethics blog)
Front page headlines denouncing “bad medicine” typically only hit when a physician is indicted for fraud or a major provider settles a multi-million dollar case for unnecessary services or defective goods. But two recent reports indicate that being in compliance with the law may be insufficient for truly “good...
There's No Such Thing as a Free BBQ: Kickbacks Cost Physicians Too
Posted 11/11/15
By Tim McCormack and Molly Knobler (published on the Huffington Post blog)
On October 29th, pharma giant Warner Chilcott pled guilty to a felony healthcare fraud charge, agreeing to pay $125 million to settle allegations that it had paid illegal kickbacks to doctors and engaged in other illegal marketing behavior to sell its drugs Actonel®, Asacol®, Atelvia®, Doryx®, Enablex®, Estrace,® and Loestrin®. ...