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Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Posted 11/15/21

Person Handing Hundred Dollar Bill to Another Person

The Department of Justice regularly highlights the areas of fraudulent conduct it intends to target as enforcement priorities. These identified enforcement priorities tend to cover burgeoning areas of fraud or particular misbehavior especially ripe or prevalent because of the particular times we live in. As might be expected, DOJ's current listing of priorities includes fraud related to the pandemic, opioids, the

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Medical Devices and DME, Pharma Fraud, Provider Fraud,

Catch of the Week: Bayada Home Health Care Settles Kickback Allegations for $17 Million in Case Demonstrating that Kickbacks Come in Many Forms

Posted 09/17/21

Last week, Bayada Home Health Care, Inc., a national home health company with more than $1.5 billion in reported revenues and offices in twenty-two states, agreed to pay the United States $17 million to settle allegations that it violated the federal Anti-Kickback Statute (AKS). The AKS prohibits paying illegal remuneration in any form to induce business or referrals paid for with federal health care dollars, and...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Home Health and Hospice, Whistleblower Case,

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Posted 09/3/21

telemedicine doctor on computer with patient

Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.

Healthcare fraudsters have a track record of exploiting health crises for personal gain. The COVID-19 pandemic created new telemedicine opportunities for patients to receive care without having to see doctors in person. As expected, fraudsters seized on...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Contract Non-Compliance, FCA Federal, Government Programs Fraud, Healthcare Fraud, Improper Medical Facility, Lack of Medical Necessity, Provider Fraud,

Catch of the Week: Waived Copayments and “Free” Glucometers Result in $160 Million Recovery in Whistleblower Action Against Previously-Barred Arriva Medical

Posted 08/4/21

Woman using glucometer and diabetes testing strips

Mail-order diabetes supply company Arriva Medical has agreed to pay $160 million to resolve a False Claims Act case filed in 2013 by a whistleblower who worked for ten months in one of the company’s call centers. The government intervened in the whistleblower’s action in early 2019, and the case had been set for trial in June 2022. The settlement is the latest in a long string of actions against Arriva and...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

Catch of the Week: EEG Testing Company and Private-Investment Company to Pay $15.3M for Kickback and False-Billing Allegations

Posted 07/23/21

man holding money in hand and another hand with one finger over mouth

Whistleblowers came forward with six False Claims Act actions against a national EEG testing company and an investment company for allegedly paying kickbacks and falsely billing government healthcare programs. Texas-based provider Alliance Family of Companies (now Stratus) and private investor Ancor Holdings together will pay $15.3 million to resolve the cases. For their actions in coming forward, two...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Improper Medical Personnel, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

Fifth Circuit Affirms Government Dismissal Of Cases Brought By Corporate Whistleblower

Posted 07/16/21

Last week, a three-judge panel of the Court of the Appeals for the Fifth Circuit sided with the government in its bid to dismiss a whistleblower case brought by a limited liability company against pharmaceutical giants Eli Lilly and Bayer. The case offers another example of the government flexing its dismissal power in the wake of the Granston Memo, a 2018 Department of Justice directive to winnow False Claims Act...

Tagged in: Anti-Kickback and Stark, Court Decision, FCA Federal, Government Decision, Healthcare Fraud, Importance of Whistleblowers, Whistleblower Case,

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted 05/7/21

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Pharma 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,

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Posted 04/16/21

Ivan Andre Scott, a 36-year-old Florida man, just landed a 10-year prison sentence for organizing a $3.3 million Medicare fraud scheme involving two of the hottest healthcare trends – telemedicine and genetic testing to assess the likelihood of future cancer. The conspiracy targeted vulnerable Medicare beneficiaries for pricey cancer screening genetic tests, prosecutors said. Claims for these tests were falsely...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

Catch of the Week: Roche and Humana Agree to Settle Kickbacks in the Medicare Advantage Program

Posted 02/9/21

A recent settlement of a whistleblower case might be a sign of things to come for litigation under the False Claims Act (FCA) in the whistleblower program. Pharmaceutical company, Roche, and Medicare Advantage insurer, Humana, have agreed to pay $12.5 million to resolve allegations that the companies violated the anti-kickback statute. This is the first FCA settlement resulting out of a pharmaceutical company...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Managed Care, Medicare, Whistleblower Case,

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Recent Settlements Show Kickbacks are Always a DOJ Enforcement Priority

Catch of the Week: Bayada Home Health Care Settles Kickback Allegations for $17 Million in Case Demonstrating that Kickbacks Come in Many Forms

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.

Catch of the Week: Waived Copayments and “Free” Glucometers Result in $160 Million Recovery in Whistleblower Action Against Previously-Barred Arriva Medical

Catch of the Week: EEG Testing Company and Private-Investment Company to Pay $15.3M for Kickback and False-Billing Allegations

Fifth Circuit Affirms Government Dismissal Of Cases Brought By Corporate Whistleblower

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

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

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Catch of the Week: Roche and Humana Agree to Settle Kickbacks in the Medicare Advantage Program

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