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Healthcare Fraud

This archive displays posts tagged as relevant to healthcare fraud.

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Page 97 of 126

June 26, 2017

AMI Monitoring Inc. (aka Spectocor), its owner Joseph Bogdan, Medi-Lynx Cardiac Monitoring LLC, and Medicalgorithmics SA, the current majority owner of Medi-Lynx, agreed to pay roughly $13.5 million to resolve allegations they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Spectocor sales manager Eben Steele.  He will receive a whistleblower award of roughly $2.4 million from the proceeds of the government's recovery.  DOJ

August 7, 2017

Mary Inman appeared as a special guest on RAC Monitor's "Monitor Monday" radio broadcast Whistleblowers Allege the Suppression of Complaints at United Healthcare to talk about the recent unsealing of a whistleblower lawsuit accusing United Health Services, Inc. of hiding patients’ complaints of misconduct in order to improperly boost its Star ratings and receive undeserved performance bonuses from CMS.

August 4, 2017

Georgia announced a civil settlement with The Medical Center of Central Georgia, Inc., more commonly known as The Medical Center, Navicent Health (Navicent). Navicent agreed to pay to the United States and the State of Georgia $2,549,742 to resolve allegations that it violated the False Claims Act and the Georgia False Medicaid Claims Act by submitting bills for ambulance transports that were either inflated or medically unnecessary. Additionally, Navicent’s current Corporate Integrity Agreement (CIA) will be heightened and extended to cover the newly resolved conduct. A CIA is an agreement between a private provider of services and the United States whereby the provider, at its own expense, institutes and maintains a program, overseen by the OIG with reviews by an independent review organization, to insure compliance with the laws and regulations regarding participation in federally funded programs. GA

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

Celgene to Pay $280M to Resolve Fraud Allegations

Posted  07/26/17
By the C|C Whistleblower Lawyer Team Pharmaceutical manufacturer Celgene Corp. agreed to pay $280 million to settle claims that it illegally promoted two cancer drugs, Thalomid and Revlimid, for unapproved uses. The case was filed by a former Celgene sales representative under the False Claims Act, which allows individuals to sue to recover government dollars and share in any recovery. The New York Times reports...

July 24, 2017

Myra Gross, a former patient of Dr. James Norman, owner of Florida-based Norman Parathyroid Center, and her husband Dr. David Gross, will receive a whistleblower award of roughly $600,000 from the $4 million Dr. Norman agreed to pay to resolve allegations he violated the False Claims Act by billing Medicare for pre-operative examination services for which he had already received payment from the government.  DOJ (MDFL)

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)

Aftershocks of the Feds' Big Bust: Lessons Learned

Posted  07/18/17
By the C|C Whistleblower Lawyer Team Listen to RAC Monitor's broadcast program, "Aftershocks of the Feds' Big Bust: Lessons Learned," featuring Constantine Cannon Partner, Mary Inman. Ms. Inman discusses the DOJ's recent Health Care Fraud Takedown and the prosecution of medical professionals involved in opioid-related crimes as a DOJ health care enforcement priority (at 21:30 of the broadcast). Click here for more.

July 17, 2017

New York-based home health care company Visiting Nurse Service of New York and its subsidiaries VNS Choice and VNS Choice Community Care agreed to pay roughly $4.4 million to settle charges of violating the False Claims Act by improperly collecting monthly Medicaid payments for 365 Medicaid beneficiaries whom VNS Choice failed to timely disenroll from the VNS Choice Managed Long-Term Care Plan.  Once VNS disenrolled the members, it did not repay Medicaid for the funds it had improperly received. By knowingly retaining overpayments for many of these members for more than 60 days, the VNS entities violated both the federal and state false claim acts. As a result, New York State will receive $2.63 million as part of the settlement agreement.The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by an undisclosed whistleblower.  The whistleblower will receive an undisclosed whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)  NY
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