Healthcare Fraud
This archive displays posts tagged as relevant to healthcare fraud.
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Healthcare Fraud Jury Verdict Demonstrates DOJ’s Commitment to Prosecuting Kickbacks
Posted 03/13/23
February 27, 2023
Several individuals and entities involved with the Saratoga Center for Rehabilitation and Skilled Nursing Care have agreed to pay over $7.1 million to resolve allegations of violating the False Claims Act by submitting claims for essentially worthless services. From 2017 until the center closed in 2021, while receiving reimbursements from New York’s Medicaid program, the center’s owners and operators failed to provide adequate staffing, hot water, and clean linens, and failed to dispose of solid waste. As a result of these failures, conditions fell below regulatory standards, and residents suffered from unnecessary errors and neglect. NY AG; DOJFebruary 27, 2023
The University of Pittsburgh Medical Center (“UPMC”), University of Pittsburgh Physicians (“UPP”), and Dr. James Luketich have agreed to pay $8.5 million to settle a False Claims Act suit launched by a former UPMC surgeon, Dr. Jonathan D’Cunha. According to the qui tam suit, which was joined by the government, Dr. Luketich regularly billed Medicare for concurrently performed complex cardiothoracic surgeries, often as many as three at a time, in violation of statutes and regulations. The practice increased the risk of surgical complications to patients, as it meant the physician was not present for key portions of the surgeries, and patients were under anesthesia for longer than necessary. USAO WDPAFebruary 13, 2023
Spacelabs Healthcare, LLC has agreed to pay $2.5 million to settle claims of violating the False Claims Act by overcharging the Department of Veteran Affairs and Department of Defense between 2014 and 2019. According to a qui tam suit filed by two former Spacelabs employees, Marci Gebhardt and Christopher Kelley, the company agreed to contract clauses in which they would sell patient monitoring equipment to the government at lower rates. However, Spacelabs then failed to comply when billing the VA and Defense Logistics Agency. For their role in bringing a successful enforcement action, Gebhardt and Kelley will share in a $437,500 reward. DOJFebruary 8, 2023
Centene Corporation has agreed to pay $215 million to resolve allegations of violating the California False Claims Act. A government investigation revealed that for almost two years, Centene failed to disclose or pass on discounted prescription drug costs to the state’s Medicaid program, as mandated by program rules, and instead falsely reported higher costs incurred by two of its managed care plans, which together serve beneficiaries in over 20 counties. CA AGDOJ FY2022 Annual Fraud Report Shows $2.2 Billion in Total Recoveries, with $1.9 Billion Thanks to Whistleblowers - But There are Reasons for Concern
Posted 02/8/23
