Whistleblower Case Archives - Page 21 of 111

May 4, 2021

Delaware-based pharmaceutical company Incyte Corporation has agreed to pay $12.6 million to resolve allegations of violating the Anti-Kickback Statute and False Claims Act in connection with its myelofibrosis drug, Jafaki. Despite federal laws against illegal remuneration to federal healthcare program beneficiaries, Incyte allegedly wielded its influence as the sole donor of a foundation to coerce the foundation into illegally covering the copays of Medicare and TRICARE patients taking Jafaki. The misconduct continued from 2011 through 2014 before it was revealed in a qui tam suit by former compliance executive turned whistleblower, Justin Dillon. Dillon will receive approximately $3.59 million for his efforts. DOJ; USAO EDPA

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Other Government Health Programs, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

May 3, 2021

Two medical device distributorships, Medical Designs LLC and Sicage LLC, and their neurosurgeon owner, Wilson Asfora, have agreed to pay $4.4 million to resolve allegations of illegally inducing the use of certain medical devices, submitting false claims to federal healthcare programs for medically unnecessary procedures, and failing to disclose Asfora’s ownership interests or illegal payments made to him. The settlement was not the first involving Asfora; the United States previously settled with Sanford Health for $20.25 million and Medtronic for $9.21 million on similar claims. The whistleblowers in this case, Drs. Carl Dustin Bechtold and Bryan Wellman, will receive a $800,000 share of the settlement proceeds, while the defendants will all be excluded from participating in federal healthcare programs for six years. DOJ; USAO SD

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Whistleblower Case, Whistleblower Rewards,

April 30, 2020

CareCloud Health, Inc. has agreed to pay $3.8 million to settle kickback allegations involving sales of its electronic health records (EHR) software products and related services. In a qui tam suit filed by Ada de la Vega, the whistleblower alleged that between 2012 and 2017, CareCloud offered and provided existing clients improper incentives, including cash bonuses and equivalent credits, to recommend their product to prospective clients. For her role in the successful enforcement action, de la Vega will receive a relator’s share of over $800,000. USAO SDFL

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Whistleblower Case, Whistleblower Rewards,

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

Posted 04/30/21

On Thursday, an Alabama District Court Judge sentenced dozens of defendants to prison for participating in a massive conspiracy to swindle insurers for medically unnecessary compound drugs. The defendants included company executives and managers, a prescriber, billers, and sales representatives associated with Northside Pharmacy, which was doing business as Global Compounding Pharmacy (Global). According to the DOJ...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Compounding Pharmacy Fraud, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Pharma Fraud, Whistleblower Case,

April 29, 2021

California-based Tungsten Heavy Powder, Inc. (THP) has agreed to pay over $5.6 million to resolve a qui tam lawsuit by former employee Gregory Caputo and Global Tungsten & Powders Corporation. In violation of the False Claims Act, THP allegedly falsely certified that certain defense articles procured by the Israeli government and financed by U.S. grant funds were sourced from and manufactured in the United States, when instead they were sourced from China and manufactured in Mexico. For bringing the lawsuit, Caputo will receive a 17% share of the settlement proceeds. USAO SDCA

Tagged in: Certifications, Defense Contract Fraud, FCA Federal, Government Procurement Fraud, Whistleblower Case, Whistleblower Rewards,

April 27, 2021

Indivior plc and Indivior Inc., will pay $300 million to settle claims from all 50 states, the District of Columbia, and Puerto Rico, alleging they caused the misuse of state Medicaid funds by falsely marketing the drug Suboxone. Suboxone is used by recovering opioid addicts to reduce withdrawal symptoms. According to the governments, Indivior promoted the sale and use of Suboxone for unsafe, ineffective, and medically unnecessary purposes, including by claiming it was less susceptible to abuse even though the active ingredient, buprenorphine, is a powerful opioid itself. Additionally, the company took steps to fraudulently delay the entry of generic alternatives in order to control pricing. The settlement resolves six whistleblower suits pending in New Jersey and Virginia. Indivior previously paid $600 million to resolve federal claims, and former parent company Reckitt Benckiser previously paid $1.4 billion to resolve the same. CA AG; FL AG; MI AG

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medicaid, Misrepresentations, Whistleblower Case,

April 21, 2021

Tennessee-based Anesthesia Services Associates, PLLC d/b/a Comprehensive Pain Specialists (CPS) and its four majority owners have agreed to pay a total of $4.1 million to resolve allegations of violating the federal False Claims Act and Tennessee Medicaid False Claims Act. According to the government, CPS billed Medicare and TennCare for medically unnecessary or non-reimbursable genetic tests, psychological tests, specimen validity tests, and urine drug tests, as well as medically unnecessary or non-reimbursable acupuncture. For bringing a successful qui tam suit, the whistleblowers in this case will receive a relator’s share of over $610,000. USAO MDTN

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Laboratory and IDTF, Medicaid, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

April 20, 2021

In order to resolve a whistleblower suit alleging violations of the False Claims Act, Massachusetts Eye and Ear and its related entities have agreed to pay over $2.6 million. Over an eight-year period ending in 2020, Massachusetts Eye and Ear allegedly made a habit of submitting false claims to Medicare and Medicaid for office visits that were not reimbursable under program rules. Altogether, the government programs were defrauded of over a million dollars. As a reward for blowing the whistle, the unnamed relator will receive a 15% share of the settlement proceeds. USAO MA

Tagged in: FCA Federal, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

April 8, 2021

South Carolina’s largest urgent care provider, Doctors Care, P.A., and its management company, UCI Medical Affiliates of South Carolina, Inc. (UCI), have agreed to pay $22.5 million and enter into a Corporate Integrity Agreement to resolve a whistleblower suit alleging violations of the False Claims Act. From 2013 to 2018, UCI allegedly submitted false claims to Medicaid, Medicare, and TRICARE by linking services rendered by Doctors Care providers who lacked proper billing credentials—which are separate from a degree or license to practice medicine—to providers who did hold the proper credentials. Under the Corporate Integrity Agreement, UCI will retain an independent claims reviewer for the next five years. USAO SC

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Whistleblower Case,

April 5, 2021

New York's Service Station Vending Equipment, Inc., which provides self-service, coin-operated air machines used to inflate automobile tires, and its principal, William McCabe, will pay $4.25 million to resolve an action initiated by a whistleblower under the New York State False Claims Act alleging that they evaded sales taxes, under-reported sales, and paid workers off the books. NY

Tagged in: FCA State, Tax Fraud, Whistleblower Case,

Have a Claim?

Click here for a confidential contact or call:

Tags

Whistleblower Case