Healthcare Fraud
This archive displays posts tagged as relevant to healthcare fraud.
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July 13, 2022
Solera Specialty Pharmacy and its CEO, Nicholas Saraniti, has agreed to pay $1.31 million and enter into a three-year integrity agreement to resolve allegations of defrauding Medicare. Solera allegedly submitted fraudulent claims for Evzio—a high-priced version of naloxone, which reverses opioid overdoses—based on prior authorization requests that contained false clinical information, that were not actually approved by physicians, and that improperly listed Solera’s contact information as if it were the physician’s. In connection with a criminal information, Solera has also entered into a deferred prosecution agreement. The whistleblower in this case, a former employee of Evzio manufacturer kaléo Inc. named Rebecca Socol, will receive a $262,000 share of the settlement. DOJJuly 7, 2022
A hospital in West Virginia, Weirton Medical Center, has agreed to pay $1.5 million to settle allegations of submitting or causing to be submitted claims to Medicare that resulted from an improper financial relationship. In violation of the Stark Law, Weirton allegedly paid referring physicians compensation based on volume and that exceeded fair market value. USAO NDWVJuly 1, 2022
MCS Advantage, Inc. has agreed to pay $4.2 million in order to resolve allegations of submitted or causing to be submitted false claims to Medicare. In violation of the Anti-Kickback Statute and False Claims Act, MCS allegedly distributed 1,703 gift cards totaling $42,575 to administrative assistants working under healthcare providers in order to induce referrals of Medicare beneficiaries to its plan. USAO PRJuly 1, 2022
Reliance Medical Systems LLC and its owners Bret Berry and Adam Pike will pay $1 million to resolve allegations of False Claims Act violations by paying doctors to use their medical devices in spinal surgeries. Through its physician-owned distributorships (PODs), Reliance paid physicians for referrals, made false statements, and terminated physicians who didn’t refer enough patients, in one instance offering a surgeon a share of profits after he proved his “loyalty” to the POD. DOJJune 29, 2022
Citadel Care Centers LLC and Plaza Rehab and Nursing Center will pay $7.85 million for switching their elderly residents’ Medicare coverage to maximize the Medicare payments the centers would receive--a blatant False Claims Act violation. Citadel directed Plaza employees to disenroll residents from Medicare Advantage Plans and enroll them in Original Medicare instead—without the residents’ knowledge or consent—to maximize their reimbursements. USAO SDNYJune 28, 2022
Fifteen additional doctors affiliated with a kickback scheme involving Rockdale Hospital d/b/a Little River Healthcare, True Health Diagnostics LLC, and/or Boston Heart Diagnostics Corporation, have agreed to pay a cumulative $2.8 million to settle allegations of violating the Anti-Kickback Statute and Stark Law by accepting improper remuneration in exchange for ordering tests from those laboratories. According to the press release, the government has now recovered over $32 million from settlements with thirty-three doctors, two executives, and one laboratory in connection with this scheme. USAO EDTXA recent case could undermine the rules that have been protecting taxpayer money from fraud since the time of Lincoln
Posted 06/24/22
Constantine Cannon whistleblower lawyers Eric Havian, Mike Ronickher, and Ari Yampolsky were published in Fortune.com on the Supreme Court's consideration of the SuperValu decision.
We’re whistleblower lawyers who spend our careers speaking in legalese. But every once in a while, a case comes along that is so alarming, yet so couched in jargon, that an issue of great importance can easily escape notice. When that...American hospitals have been resistant to whistleblowers. Here’s how they can save money and lives by embracing them.
Posted 06/21/22
