Tagged Articles

Anti-Kickback statute 29 articles

Whistleblower Helps U.S. Recover $8.1 Million from California Hospital Group

A whistleblower lawsuit accusing a Los Angeles-based hospital group of engaging in unlawful financial arrangements has led to an $8.1 million settlement with the U.S. Government. Avanti Hospitals LLC and six of its owners agreed to pay the U.S. $8.1 million to settle whistleblower allegations that they violated the Anti-Kickback Statute, the Physician Self-Referral Law (also known as the Stark Law), and the False Claims Act. The lawsuit, filed by Dr. Joshua Luke, the former CEO of Gardena Hospital, alleged that Avanti, Gardena Hospital, and at least two other Avanti affiliates bribed a high-referring physician with payments that exceeded the ... Read More

Actelion Pays $360 Million To Resolve Fraudulent Medicare Kickback Case

Actelion Pharmaceuticals has agreed to pay $360 million to resolve claims that it used a charity to pay illegal kickbacks to Medicare patients to boost sales of its pulmonary arterial hypertension drugs. In a Dec. 7 announcement, the U.S. Department of Justice said that Actelion, which became a unit of Johnson & Johnson last year, arranged to pay the Medicare co-pay obligations for thousands of patients taking its pulmonary arterial hypertension drugs Tracleer, Ventavis, Veletri, and Opsumit. Medicare requires beneficiaries to partially pay for some prescription drugs as a way to keep prescription drug costs in check, including the prices ... Read More

Whistleblowers Help U.S. Recover $3.8 Million From Vascular Care Company

Two whistleblowers who alleged that a Philadelphia-based vascular health company and several of its subsidiaries were cheating Medicare and engaging in illegal kickback schemes have helped the U.S. recover more than $3.8 million. The whistleblowers filed separate lawsuits alleging Vascular Access Centers LP and 23 of its subsidiary companies violated the federal False Claims Act and Anti-Kickback Statute, both of which are intended to protect U.S. taxpayer money from being squandered and misspent. The U.S. Department of Justice investigated the whistleblowers’ claims and chose to intervene, thereby taking over their litigation. ‘ According to the Justice Department, Vascular Access Centers ... 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

Whistleblowers Help U.S. Recover $7.5 Million From Dallas Hospital

A Dallas-based hospital will pay the U.S. $7.5 million to settle a False Claims Act lawsuit brought by two whistleblowers who accused the hospital of engaging in an illegal kickback scheme. According to the U.S. Department of Justice, whistleblowers Suzanne Scott and Savannah Sogar claimed that Pine Creek Medical Center, a physician-owned hospital serving the Dallas/Fort Worth area, provided physicians with valuable kickbacks in exchange for surgical referrals. Both women were formerly employed in Pine Creek’s marketing department. Supporting the whistleblowers’ allegations, federal prosecutors alleged that Pine Creek would pay for advertisements and other promotional materials benefitting the physicians with ... Read More

Hospice Provider Settles Whistleblower Suit alleging It Paid For Patient Referrals

Vitas Healthcare Corporation Midwest, part of a national hospice care provider, and related companies agreed to pay the U.S. $200,000 to resolve allegations it violated the False Claims Act and Anti-Kickback Statute by paying a convicted cancer doctor for patient referrals. According to U.S. Attorney Barbara L. McQuade, whose office prosecuted the case alongside the Department of Health and Human Services, Eastern District of Michigan, Vitas paid Swan For Life Cancer Foundation, a charity established by Dr. Farid Fata, several thousand dollars in exchange for patient referrals. Dr. Fata, the former owner of Michigan Hematology and Oncology, is serving a ... Read More

Whistleblower lawsuit against Florida nursing home leads to record $17-million settlement

A whistleblower lawsuit filed against Miami, Fla.,-based Hebrew Homes Health Network by its former Chief Financial Officer ended with a settlement requiring the company to pay the U.S. $17 million. The U.S. Justice Department said the settlement was the largest ever involving Anti-Kickback Statute violations by a skilled nursing home. The U.S. Justice Department, which investigated the case and chose to intervene, said Stephen Beaujon accused Hebrew Homes, its former president and executive director, and its subsidiaries and affiliates of operating a “sophisticated kickback scheme” in which the nursing facility hired and paid numerous doctors into “ghost positions” that paid ... Read More

Kentucky cardiologists settle health care fraud charges brought by whistleblowers

Two Kentucky cardiologists have agreed to pay $380,000 to settle allegations made by whistleblowers that they violated the U.S. False Claims Act, federal Anti-Kickback Statute, and the Stark Law by making “sham agreements” with a London, Ky., hospital that resulted in referrals for cardiology procedures and other health care services. According to the U.S. Justice Department, Dr. Satyabrata Chatterjee and Dr. Ashwini Anand jointly own Cumberland Clinic, a physician group that provides cardiology services. The government alleged that St. Joseph Hospital of London, Kentucky had agreements with the doctors under which the hospital paid the physicians to provide fictitious management ... Read More

Preparation is key to a successful whistleblower case

Fraud, abuse, mismanagement, and other forms of wrongdoing are all too common in both the private and public sectors of society these days – an unfortunate fact that elevates the role of the whistleblower in the fight against misconduct and corruption. With lawyers seeing more and more potential whistleblower cases pour in, it’s vital that whistleblowers properly document and state their case before taking it to a lawyer for review. After whistleblowers select experienced and competent legal counsel for their False Claims Act case, they should prepare a concise and well documented “pitch.” The Taxpayers Against Fraud (TAF) Education Fund ... Read More

CVS Caremark to pay $6 million to settle whistleblower allegations of Medicaid false claims

Caremark LLC, a pharmacy benefit management giant operated by CVS Caremark Corporation, will pay the U.S. $6 million to settle allegations brought by a whistleblower under the False Claims Act that the company knowingly defrauded federal and state Medicaid programs by failing to reimburse the taxpayer-funded programs for drug expenses that should have been paid by the private insurer. Individuals who are covered by both Medicaid and a private health plan are classified as “dual eligible.” U.S. law mandates that the private insurer, rather than taxpayer-funded government programs, must assume the costs of health care for dual eligible beneficiaries. Should Medicaid erroneously ... Read More