By Steve Kardell | Published March 21, 2023 | Posted in Fraud, Whistleblower Litigation | Tagged Tags: Biogen, healthcare fraud, Medi-Cal, recoveries |
Government enforcement agencies spent 2022 investigating claims of healthcare fraud, thanks to whistleblowers. The government recovered billions of dollars from healthcare providers, pharmaceutical companies and more. Most of the cases below involve violations of the federal Anti-Kickback Statute, while whistleblowers are protected under the qui tam provisions of the False Claims Act. Here are some Read More
Read MoreA doctor and a healthcare facility have agreed to pay more than $2.6 million to settle False Claims Act allegations. They were accused of improperly billing both state and federal healthcare programs, as well as receiving illegal kickbacks. Case background Kevin P. Greene, M.D., and Feel Well Health Center of Southington, P.C. were accused of Read More
Read MoreThe former Vice President of Product Management at Modernizing Medicine, Inc., has led to a $45 million settlement for a healthcare kickback scheme. Amanda Long filed a whistleblower action in 2017, which was amended in May 2021. The company was found to have created a healthcare kickback scheme that violated the False Claims Act. Case Read More
Read MoreThe COVID-19 pandemic highlighted the importance of nurses and other healthcare professionals in a whole new way. Nurses are on the “front lines” of healthcare, often the first people to notice and report a problem. What happens when you speak up, and your employer retaliates? Fortunately, whistleblower laws exist to protect nurses from retaliation from Read More
Read MoreEpic, a medical billing software service, has been accused of prompting hundreds of hospitals across the country to double-bill Medicaid and Medicare for anesthesia services. This resulted in hundreds of millions of dollars in fraudulent payments. The recently unsealed lawsuit was originally filed in 2015, and the federal government declined to intervene in the case. Read More
Read MoreTwo pharmacy owners were recently convicted of trying to defraud pharmacy benefit managers of tens of thousands of prescriptions, which were submitted to both private and federally-funded healthcare programs. The PBMs paid claims to the conspirator-owned pharmacies in a multimillion dollar scheme. They face up to 17 years in prison and $50 million in restitution. Read More
Read MoreThe Department of Justice recently charged 36 defendants in 13 federal districts for “alleged fraudulent telemedicine, cardiovascular and cancer genetic testing and durable medical equipment (DME) schemes.” Criminal charges were levied against medical equipment companies, lab owners and executives, medical professionals, marketing firms and more. Other government agencies took additional administrative actions against 52 more Read More
Read MoreA rehabilitative therapy business in Georgia, along with its founder, has been ordered to pay $9.6 million in damages for submitting nearly 800 false health care claims. Case background Middle Georgia Family Rehab LLC, along with owner/CEO Brenda Hicks, are jointly liable for 796 false claims submitted to TRICARE and Medicaid. The defendants were paid Read More
Read MoreThe U.S. Department of Justice recently revealed that 2021 was a major year for False Claims Act settlements and judgments. According to the DOJ, the federal government took in more than $5.6 billion in settlements and judgments, the largest since 2014 and the second-largest amount ever recorded. This number includes the gigantic $2.8 billion Purdue Read More
Read MoreThe U.S. Department of Justice recently announced a $3.8 million settlement with Catholic Medical Center (CMC) to resolve allegations that it violated the False Claims Act by providing free call coverage to a cardiologist in exchange for patient referrals. Government attorneys said these actions violated the Anti-Kickback Statute. Case background The federal government alleged CMC Read More
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