Whistleblower Case Archives - Page 94 of 111

November 16, 2015

HCA Holdings, Inc. (including affiliated entities Hospital Corporation of America; Parallon Business Solutions, LLC; West Florida Regional Medical Center, Inc.; HCA Health Services of Florida, Inc.; Regional Medical Center Bayonet Point; HCA Health Services of Florida, Inc.; New Port Richey Hospital, Inc.; and Medical Center of Trinity) agreed to pay $2 million to resolve charges of violating the False Claims Act through billing Medicare for unnecessary lab tests and double billing for fetal testing. The allegations first arose in a whistleblower lawsuit by HCA employee Kelly Oxendine under the qui tam provisions of the False Claims Act. The whistleblower will receive a whistleblower award of roughly $400,000 from the government’s recovery. DOJ(SC)

Tagged in: Bundling and Unbundling, FCA Federal, Hospital Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

November 4, 2015

AstraZeneca LP and Cephalon, Inc. agreed to pay $54 million to settle government charges they violated federal and state False Claims Acts by overcharging state Medicaid programs for their pharmaceutical products. AstraZeneca will pay $46.5 million and Cephalon, the wholly-owned subsidiary of Teva Pharmaceutical Industries. Ltd., will pay $7.5 million. According to the government, the two pharmaceutical companies underpaid drug rebates owed the states under the Medicaid Drug Rebate Program, which requires drug makers to periodically return to the government a portion of their Medicaid proceeds. The allegations first arose in a whistleblower lawsuit filed by Virginia pharmacist and attorney Ronald Streck under the quit tam provisions of the Federal False Claims Act, New York False Claims Act and other state false claims statutes. Mr. Streck will receive a yet-to-be-disclosed whistleblower award from a portion of the government’s recoveries. Whistleblower Insider

Tagged in: Drug and DME Pricing, FCA Federal, FCA State, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

November 2, 2015

Massachusetts-based telecom software company NetCracker Technology Corp. agreed to pay $11.4 million, and Virginia-based information technology company Computer Sciences Corp. agreed to pay $1.35 million to settle charges they violated the False Claims Act by using individuals without security clearance on a government defense contract. The allegations first arose in a whistleblower lawsuit filed by former NetCracker employee John Kingsley under the qui tam provisions of the False Claims Act. Mr. Kingsley will receive a whistleblower award of $2,358,750 as his share from the government’s recovery in this case. Whistleblower Insider

Tagged in: Contract Non-Compliance, Defense Contract Fraud, FCA Federal, Whistleblower Case, Whistleblower Rewards,

October 30, 2015

The Department of Justice reached 70 settlements involving 457 hospitals in 43 states for more than $250 million related to cardiac devices implanted in Medicare patients in violation of Medicare coverage requirements. The devices, called implantable cardioverter defibrillators (ICDs), are electronic devices implanted near and connected to the heart to detect and treat chaotic, extremely fast, life-threatening heart rhythms, called fibrillations, by delivering a shock to the heart, restoring the heart’s normal rhythm. Only patients with certain clinical characteristics and risk factors qualify for an ICD covered by Medicare. According to the government, from 2003 to 2010 each of the settling hospitals implanted ICDs during periods prohibited by the Medicare’s National Coverage Determination. Most of the settlements originated from allegations first raised in a whistleblower lawsuit brought under the qui tam provisions of the False Claims Act by Leatrice Ford Richards, a cardiac nurse, and Thomas Schuhmann, a health care reimbursement consultant. They have so far received a combined whistleblower award of more than $38 million from the settlements. The Department of Justice is continuing to investigate additional hospitals and health systems. DOJ

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

October 29, 2015

Warner Chilcott US Sales LLC, a subsidiary of pharmaceutical manufacturer Warner Chilcott PLC, agreed to plead guilty to a felony charge of health care fraud as part of a global settlement in which Warner Chilcott agreed to pay $125 million to resolve its criminal and civil liability arising from illegally marketing the drugs Actonel, Asacol, Atelvia, Doryx, Enablex, Estrace and Loestrin in violation of the False Claims Act and Anti-Kickback Statute. Specifically, the government charged that between 2009 and 2013, Warner Chilcott paid physicians to induce them to prescribe Warner Chilcott drugs. The government also alleged that Warner Chilcott employees submitted false or misleading prior authorization requests and other coverage requests to federal health care programs for the osteoporosis medications Atelvia and Actonel. The government further claimed that Warner Chilcott employees were instructed by members of the company’s management team to make unsubstantiated superiority claims when marketing the drug Actonel. The allegations first arose in a whistleblower lawsuit by two former Warner Chilcott sales representatives filed under the qui tam provisions of the False Claims Act. The whistleblowers will receive a whistleblower award of approximately $22.9 million from the federal share of the civil recovery. Whistleblower Insider

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Billing Fraud, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

October 19, 2015

Millennium Health (formerly Millennium Laboratories) agreed to pay $256 million to the federal and state governments to resolve charges it billed Medicare for medically unnecessary urine drug and genetic testing. According to the government, Millennium caused physicians to order excessive numbers of urine drug tests, in part through the promotion of “custom profiles,” which instead of being tailored to individual patients were in effect standing orders that caused physicians to order large number of tests without an individualized assessment of each patient’s needs. The government further alleged that Millennium’s provision of free point of care urine drug test cups to physicians — expressly conditioned on the physicians’ agreement to return the urine specimens to Millennium for hundreds of dollars’ worth of additional testing — violated the Stark Law and the Anti-Kickback Statute. The case originated from several whistleblower lawsuits filed under the qui tam provisions of the False Claims Act. Whistleblowers in the underlying cases will receive awards totalling roughly $32 million. DOJ GA , FL, WA

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

October 16, 2015

South Carolina-based Tuomey Healthcare System agreed to pay $72.4 million to settle charges of violating the False Claims Act by billing Medicare for services referred by physicians with whom the hospital had improper financial relationships. Under the settlement, Tuomey also will be sold to Palmetto Health, a multi-hospital healthcare system based in Columbia, South Carolina. According to the government, Tuomey violated the Stark law by entering into contracts with 19 specialist physicians that required them to refer their outpatient procedures to Tuomey in exchange for compensation that far exceeded fair market value and included part of the money Tuomey received from Medicare for the referred procedures. The settlement follows a jury trial where the court entered judgement against Tuomey for more than $237 million. The case arose from a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Michael K. Drakeford, an orthopedic surgeon who was offered, but refused to sign, one of the illegal contracts. Dr. Drakeford will receive a whistleblower award of roughly $18.1 million from the settlement. Whistleblower Insider

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

October 14, 2015

Chicago-based aerospace and defense industry giant Boeing Company agreed to pay $18 million to settle charges it violated the False Claims Act by submitting false claims for labor charges on maintenance contracts with the US Air Force. The allegations originated in a whistleblower lawsuit brought by former Boeing employee James Thomas Webb under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of roughly $3 million from the government’s recovery. Whistleblower Insider

Tagged in: Defense Contract Fraud, Falsifying Invoices, FCA Federal, Whistleblower Case, Whistleblower Rewards,

October 9, 2015

Cincinnati-based West Chester Hospital and its parent company, UC Health, agreed to pay $4.1 million to settle allegations that West Chester Hospital violated the False Claims Act by billing federal health care programs for medically unnecessary spine surgeries. The challenged surgeries were performed between 2009 and 2013 by Dr. Abubakar Atiq Durrani, a surgeon from Mason, Ohio, who had admitting privileges at West Chester Hospital and who was arrested in July 2013 but allegedly fled the country and remains a fugitive. The allegations first arose in a whistleblower lawsuit filed by former patients of Durrani under the qui tam provisions of the False Claims Act. They will receive a whistleblower award of approximately $800,000 from the federal share of the settlement. DOJ

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

October 7, 2015

Kentucky-based nursing home pharmacy PharMerica Corp. agreed to pay $9.25 million to resolve allegations it violated the False Claims Act by soliciting and receiving kickbacks from pharmaceutical manufacturer Abbott Laboratories in exchange for promoting the anti-epileptic prescription drug Depakote for nursing home patients. The settlement is part of the continuing fallout of the $1.5 billion settlement Abbott entered into with the government in May 2012 to resolve Abbott’s liability under the False Claims Act for alleged kickbacks to nursing home pharmacies, including PharMerica. The settlement partially resolves allegations raised in two whistleblower lawsuits brought by former Abbott employees Richard Spetter and Meredith McCoyd under the qui tam provisions of the False Claims Act. Ms. McCoyd will receive a whistleblower award of $1 million from the federal share of the settlement amount. Whistleblower Insider

Tagged in: Anti-Kickback and Stark, FCA Federal, Multiple Whistleblowers and First-to-File, Off-Label and Unapproved Use, Pharma Fraud, SNF, Whistleblower Case, Whistleblower Rewards,

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