Medicare
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July 6, 2017
Pennsylvania hospice company Compassionate Care of Gwynedd Inc., and a subsidiary of New Jersey-based Compassionate Care Hospice Group Inc., agreed to pay $2 million to resolve allegations it violated the False Claims Act by providing unnecessary hospice services. The government alleged the company admitted patients by using a diagnosis of “debility” that was not medically justified. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. The whistleblowers will receive an award of more than $350,000 from the proceeds of the government's recovery. DOJ (DNJ)July 5, 2017
Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities agreed to pay roughly $8.4 million to settle charges they violated the False Claims Act by billing Medicare for unnecessary physical, speech, and occupational therapy to nursing home residents. DOJ (EDMO)June 30, 2017
Dawn Bentley, a Detroit-area medical biller, was sentenced to 50 months in prison and to pay roughly $3.3 million for her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed. DOJJune 29, 2017
Innovative Therapies, Inc. and its parent company Cardinal Health, Inc. agreed to pay roughly $2.7 million to settle charges they violated the False Claims Act by submitting false claims to Medicare through their marketing of certain negative pressure wound treatment devices as durable medical equipment when they knew these devices did not have the expected life of a durable device. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former ITI employee. The whistleblower will receive an award of $488,700 from the proceeds of the government's recovery. DOJ (MDTN)June 28, 2017
Charles G. Landry, D.O. agreed to pay $133,464 to resolve allegations he violated the False Claims Act by knowingly submitting claims for certain evaluation and management services not eligible for Medicare payment. DOJ (DME)June 26, 2017
Dr. Miguel Burgos, the medical director of four Florida infusion clinics, and Yosbel Marimon, the owner of the clinics, were sentenced respectively to 64 months and 90 months in prison for their roles in a $13.7 million Medicare fraud conspiracy that involved submitting claims for expensive infusion-therapy drugs that were never purchased, never provided and not medically necessary. DOJJune 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. DOJCelgene 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...