Medicare
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Freedom Health, Optimum Healthcare and Its Former COO to Pay $32.5 Million to Settle False Claims Act Allegations of Medicare Fraud
Posted 05/31/17
By the C|C Whistleblower Lawyer Team
Yesterday, the Department of Justice and Constantine Cannon, LLP announced that they had reached a settlement with Freedom Health and Optimum Healthcare, two large health insurers and operators of Medicare managed healthcare insurance plans controlled by Dr. Kiranbhai “Kiran” C. Patel and based in Tampa, Florida, to resolve allegations of systemic Medicare and Medicaid...
May 30, 2017
Posted 05/31/17
Constantine Cannon serves as lead counsel representing whistleblower Dr. Darren Sewell in largest successful whistleblower settlement for claims of risk adjustment fraud at $16.7 million. Total settlement against Freedom Health and Optimum Healthcare, two Florida Medicare Advantage plans, and former Chief Operating Officer Sidd Pagidipati exceeds $32 million. Read the Constantine Cannon press release, the Dept....
May 16, 2017
Omnicare Inc. agreed to pay $8 million to settle charges it violated the False Claims Act by submitting claims for generic drugs different from those actually dispensed to Medicare and Medicaid beneficiaries. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Elizabeth Corsi and Christopher Ezzie. They will receive a whistleblower award of more than $2 million from the proceeds of the government's recovery. DOJ (DNJ)United States Files Complaint-in-Intervention in Constantine Cannon Whistleblower’s Case Against UnitedHealth Group
Posted 05/17/17
The Department of Justice announced yesterday that it has filed a complaint-in-intervention against UnitedHealth Group (UHG) in a case brought by Constantine Cannon client Ben Poehling. The government’s complaint alleges that UHG knowingly obtained inflated risk adjustment payments from Medicare Advantage based upon false information regarding the health of beneficiaries in its plans.
UHG is the nation’s...
May 1, 2017
Kansas City area chiropractor Brian Schnitta and his clinic, Natural Way Chiropractic Center, agreed to pay roughly $1 million to settle allegations they violated the False Claims Act by charging Medicare for treatments for peripheral neuropathy not medically necessary or not otherwise covered by the program. DOJ (DKS)April 25, 2017
Braden Partners, L.P. (d/b/a Pacific Pulmonary Services) agreed to pay $11.4 million to resolve allegations against it and its general partner, Teijin Pharma USA LLC, for violating the False Claims Act by submitting claims for reimbursement to Medicare and other federal healthcare programs for oxygen and related equipment supplied in violation of program rules, and for sleep therapy equipment supplied as part of a cross-referral kickback scheme with sleep clinics. According to the government, Pacific Pulmonary submitted claims to the Medicare, TRICARE and Federal Employee Health Benefits programs for home oxygen and oxygen equipment without obtaining the required physician authorization. The government further charged that certain of the company’s patient care coordinators agreed to make patient referrals to sleep testing clinics in exchange for those clinics’ agreement to refer patients to Pacific Pulmonary for sleep therapy equipment in violation of the Anti-Kickback Act. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Manuel Alcaine, a former sales representative of Pacific Pulmonary. Mr. Alcaine will receive a whistleblower award of roughly $1.8 million from the proceeds of the government's recovery. DOJDOJ: Chicago Chiropractor Billed over $10 Million for Nonexistent Services
Posted 03/28/17
By the C|C Whistleblower Lawyer Team
Seeking to crackdown on fraud within the chiropractic field, the Department of Justice recently announced the indictment of Chicago-based chiropractor Henry Posada on 18 counts of health care fraud. The government alleges that from 2008 to 2016, Posada fraudulently billed over $10 million in chiropractic services to both Medicare and private insurers. According to the...