Category

Consumer Fraud 1413 articles

New Opioid Fraud Lawsuits Say Medical Groups Contributed to Crisis

A number of communities in Cook County, Illinois, are taking opioid manufacturers and distributors to court for their role in fueling the deadly opioid epidemic sweeping across the U.S. Now three more Chicago-area towns have joined the fray, but adding three medical societies as defendants in addition to the usual defendants for their alleged contributions to the opioid epidemic. According to the Cook County Record, the towns of Bedford Park, Lyons, and Summit filed lawsuits last week in Cook County Circuit Court. Though filed separately, the complaints each name as defendants Purdue Pharma; Abbott Laboratories; Teva Pharmaceuticals; Cephalon, Johnson & ... Read More

Whistleblower’s False Claims Lawsuit Recovers $5.25 Million From Lincare

Lincare Inc., a major U.S. supplier of medical oxygen and other respiratory therapies, has agreed to pay the U.S. $5.25 million to settle a whistleblower lawsuit alleging it violated the federal False Claims Act and Anti-Kickback Statute by offering illegal discounts to Medicare beneficiaries. Based in Clearwater, Florida, Lincare operates about 1,000 locations across the U.S. According to a False Claims Act lawsuit filed by whistleblower Brian Thomas and supported by the federal government, Lincare attempted to gain a competitive edge in the marketplace by unlawfully waiving or reducing co-insurance, co-payments, and deductibles for beneficiaries who participated in a Medicare ... Read More

Feds Aim To Slash Opioid Production Again in 2019

From opioid production to prescription, fraud has played a key role in the opioid crisis sweeping the United States. Federal authorities have taken measures in recent years to quell the growing problem, including pursuing legal action against doctors, pharmacies, and distributors who for years have unlawfully pedaled prescription opioids for years with impunity. But on Thursday, the U.S. Justice Department announced it plans to further strike at the root of the crisis by reducing the supply of opioids, a measure that would involve limiting the amount of opioid painkillers pharmaceutical companies can manufacture next year by about 10 percent. The ... Read More

Whistleblower Doctor Who Led U.S. to $84.5 Million Settlement ‘Risked Everything’

A neuroscientist whistleblower who witnessed corruption within the Detroit-area hospital system where he worked and took legal action despite the serious risks to his career has helped the U.S. government recover nearly $85 million for the Medicare, Medicaid and TRICARE programs. Dr. David Felten filed a False Claims Act lawsuit against William Beaumont Hospitals in 2010 alleging the regional hospital system engaged in improper financial relationships with eight referring physicians, resulting in the submission of false claims to federal health care programs as well as violations of the Anti-Kickback Statute and Stark Law. Dr. Felten, a leading figure in the ... Read More

Another Tesla Whistleblower Files SEC complaint

A second Tesla whistleblower has filed a formal complaint with the U.S. Securities and Exchange Commission (SEC), alleging a Mexican drug cartel operated within the automaker’s Nevada Gigafactory, while others stole $37 million in copper and other raw materials. Instead of properly notifying investors and regulators, Tesla CEO Elon Musk responded to the predicaments by illegally wiretapping and hacking employee cell phones and computers, whistleblower Karl Hansen alleges. Mr. Hansen, who worked for Tesla’s internal security department and investigations division, says he voiced his concerns internally, urging Tesla to take proper action in responding to the issues. But instead of ... Read More

U.S. Fights Opioid Epidemic With New Newark/Philadelphia Strike Force

The federal government is expanding its efforts to combat the nation’s opioid crisis and health care fraud with a new regional Medicare Fraud Strike Force operation for the Newark and Philadelphia areas. The Newark/Philadelphia Medicare Strike Force location is the tenth region-specific operation. All of the Strike Force locations monitor health care activity in a specific region for fraud affecting government health care programs. The growing crisis of opioid abuse and addiction has not just harmed tens of thousands of individuals and their families across the U.S., it has also taken its toll on the Medicare program, which loses billions ... Read More

Whistleblower Key in Mississippi Hospital’s $1.1 Million Medicare Fraud Settlement

A Mississippi public hospital has agreed to pay the U.S. more than $1.1 million to settle a whistleblower lawsuit alleging it unlawfully billed Medicare for services patients didn’t need. Grenada Lakes Medical Center, which is operated by the University of Mississippi Medical Center, agreed to settle the government’s False Claims Act allegations accusing the hospital of falsely billing Medicare for medically unnecessary and unreasonable psychotherapy services it provided to beneficiaries of the government health care program. According to the U.S. Justice Department, starting in January 2005 and continuing until April 2013, the Grenada Lakes Medical Center submitted claims for intensive ... Read More

Wells Fargo Blames Hundreds of Home Foreclosures on Calculating Error

Wells Fargo said a software glitch in its mortgage loan modification underwriting tool led to hundreds of its customers losing their houses to foreclosure. In its latest quarterly filing with the U.S. Securities and Exchange Commission (SEC), Wells Fargo said that the calculation error caused about 625 customers to either be incorrectly denied a government-sponsored mortgage loan modification or not offered a loan modification when they would have qualified. “In approximately 400 of these instances, after the loan modification was denied or the customer was deemed ineligible to be offered a loan modification, a foreclosure was completed,” Wells Fargo said ... Read More

Whistleblower Awarded $17 Million for Exposing Medicare Fraud

A whistleblower who filed a False Claims Act lawsuit against Prime Healthcare Services, one of the nation’s largest hospital chains, and its founder and chief executive officer, has received an award of $17,225,000 for helping the U.S. recover $65 million in Medicare funds. The U.S. Department of Justice said that Karin Berntsen, the former Director of Performance Improvement at Alvarado Hospital Medical Center in San Diego, brought the suit under the whistleblower provisions of the False Claims Act. Ms. Berntsen alleged that Prime Healthcare Services, Prime Healthcare Foundation, Prime Healthcare Management, and CEO Dr. Prem Reddy routinely admitted Medicare patients ... Read More

Medicaid Fraud: NC Home Health Co. To Pay $2.9 Million For False Claims Act Violations

A North Carolina home health care company and its owners were hit with a judgment of nearly $3 million for defrauding Medicaid by billing the program for services they never provided and for services that were ineligible for reimbursement. In a July 31 announcement, U.S. Attorney for the Eastern District of North Carolina said federal judge James Dever III ordered Compassionate Home Care Services of Lumberton, North Carolina to pay the U.S. $2.9 million for the Medicaid fraud charges. The government’s False Claims Act lawsuit against Compassionate Home Care also named the company’s owner, Carol Anders, and her son Ryan ... Read More