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Pharma Fraud

This archive displays posts tagged as relevant to pharmaceutical fraud. You may also be interested in our pages:

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February 25, 2020

In a global settlement agreement with states and local entities, Mallinckrodt, the largest generic opioid manufacturer in the United States, has agreed to pay at least $1.6 billion in cash to a trust that would help fund treatment for opioid addiction.  Mallinckrodt also agreed to be subject to stringent injunctive terms, including prohibitions on the marketing of its opioid products and safeguards to prevent them from ending up in the wrong hands.  The pharmaceutical company had earlier paid $35 million to the DOJ for other opioid related charges.  CA AG; FL AG; GA AG; VA AG

Catch of the Week: Guardian Elder Care

Posted  02/21/20
person holding elder's hand
This week's DOJ Catch of the Week goes to Guardian Elder Care.  On Wednesday, the operator of more than 50 nursing homes in Pennsylvania, Ohio and West Virginia agreed to pay roughly $15.5 million to resolve allegations it violated the False Claims Act by billing the government -- Medicare and the Federal Employees Health Benefits Program -- for medically unnecessary rehabilitation therapy services.  According to...

February 14, 2020

Veterinary drug distribution company Animal Health International Inc. pled guilty to charges that it introduced misbranded drugs into interstate commerce, including by distributing wholesale veterinary drugs to end users and unlicensed individuals.  AHI's parent company, Patterson Companies, Inc., entered into a deferred prosecution agreement with specific compliance program guidelines.  AHI will forfeit $46.8 million, and pay fines totaling $6 millionUSAO WD VA

February 3, 2020

Senthil Kumar Ramamurthy of Texas has been sentenced to 10 years in prison for participating in two fraud schemes that amounted to $9.6 million in losses by Medicare and TRICARE.  In the first scheme, which ran for 10 months in 2014, Ramamurthy and his co-conspirators were paid millions of dollars by compounding pharmacies to get TRICARE beneficiaries to sign up for medically unnecessary compounded prescription drugs.  To get beneficiaries to sign up, defendants had falsely represented that the drugs would be free, when in fact co-payments were required.  In the second scheme, which ran from 2015 onward, Ramamurthy and his co-conspirators paid doctors to refer Medicare beneficiaries—without first examining them—for needless genetic cancer screening tests.  Many of Ramamurthy's co-conspirators have plead guilty and face sentencing later this month.  USAO SDFL

Top Ten State Healthcare and Financial Fraud Recoveries of 2019

Posted  01/30/20
mount-rushmore-and-state-flags
Here at Constantine Cannon, our attorneys represent whistleblowers reporting a wide variety of healthcare fraud and financial fraud, including government contract fraud, unlawful kickbacks, tax evasion, and more. While such wrongful conduct often violates federal laws, state governments are also important enforcement authorities. For whistleblowers, state enforcement can offer additional opportunities.  New York,...

Catch of the Week: Practice Fusion Pays $145 Million for EHR Kickbacks and Misrepresentations about Software

Posted  01/28/20
Healthcare providers talk about the importance of behavioral “nudges” – gentle pushes to encourage healthy choices and positive behaviors. In our Catch of the Week, healthcare providers were nudged to prescribe highly addictive extended-release opioids in a manner that was not consistent with accepted medical standards. Who nudged them? Their own electronic health records system, which was paid to do so by the...

January 27, 2020

Practice Fusion, Inc., a provider of electronic health records systems, will pay $145 million to resolve criminal and civil charges that it accepted unlawful kickbacks from pharmaceutical companies and misrepresented the capabilities of its EHR software.  As part of the settlement, the defendant entered into a deferred prosecution agreement, paying $26 million in criminal fines and forfeitures, agreeing to compliance policies and monitoring, and admitting that it accepted payment from an unnamed opioid manufacturer in exchange for including "clinical decision support" alerts within its EHR system that were designed to increase prescriptions for the pharma company's drugs.  The civil settlement – $119 million for the federal government and up to an additional $5.2 million for states that choose to opt in – resolves the kickback allegations related to the opioid manufacturer and 13 other such arrangements, as well as allegations that Practice Fusion knowingly misrepresented the capabilities of its EHR system in order to secure federal certification for the software and secure eligibility for federal incentive payments for providers adopting its software.  DOJ; USAO VT

Constantine Cannon Whistleblower Team’s Top-Ten “Staff Picks” of 2019

Posted  01/27/20
best of the year letters on a stamp
From cybersecurity, cryptocurrency, and “big data” to private-equity backed healthcare, private detention facilities, and the essential whistleblower experience – your prolific and relentless CC WB bloggers have chosen some of their favorite 2019 posts (and one from 2018) – don’t miss these insider-favorite gems!
    1. Your worst nightmare – private data exposed to the unscrupulous – could be curbed...

Top Ten Healthcare Fraud Recoveries of 2019

Posted  01/24/20
Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2019 stemmed from healthcare fraud matters.  And again, most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act.  Not surprisingly, seven of the top ten spots in our list involved false claims act lawsuits against drug companies...

January 21, 2020

Patient Services, Inc., a foundation that operated pharmaceutical patient assistance programs, will pay $3 million to resolve claims that it unlawfully enabled pharmaceutical companies to pay kickbacks to Medicare patients in the form of co-payment assistance for patients who took the companies’ drugs.  PSI was alleged to have worked with the drugmakers to funnel their “contributions” to patients who took the company’s drugs, instead of using the contributions for purposes not tied to specific drugs and patients.  PSI was alleged to have worked with Insys on copayment assistance for Subsys patients; with Aegerion on copayment assistance for Juxtapid patients; and, with Alexion on copayment assistance for Soliris patients.  USAO Mass
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