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healthcare fraud 72 articles

Whistleblower Suit Against Abbott, AbbVie Recovers $25 Million For U.S. Taxpayers

Abbott Laboratories and AbbVie Inc. have agreed to pay more than $25 million to settle a long-standing whistleblower lawsuit claiming the drug companies illegally promoted the triglyceride drug TriCor for off-label purposes and provided doctors and other prescribers with unlawful kickbacks to boost sales. Amy Bergman, a former Abbott sales representative, filed the lawsuit under the whistleblower provisions of the False Claims Act in 2009. The U.S. Department of Justice declined to intervene in the case, but it moved ahead without the government’s direct involvement, surviving attempts by Abbott and AbbVie to have the case thrown out. According to the ... Read More

Thousands of Illegal Opioid Prescriptions Dispensed by Houston Clinic

After a Houston clinic owner and physician went to prison for writing thousands of fraudulent prescriptions for opioid painkillers and other prescription drugs, Drug Enforcement Administration (DEA) agents shared with the press some of the clinic’s inner workings to demonstrate how insidious the opioid epidemic has become. Houston’s KPRC-TV featured the case of Gulfton Community Health Center, which ran an illegal opioid distribution operation that dispensed about 34,000 illegal prescriptions (about 2.1 million units of hydrocodone alone) to opioid addicts and dealers. DEA agent Wendell Campbell told KPRC that agents usually saw lines of 30-40 people at the doors of ... Read More

Houston Psychiatrist Gets 12 Years For Health care Fraud Scheme

A Houston, Texas, psychiatrist convicted by a federal jury of engaging in a $155 million health care fraud scheme has been sentenced to more than 12 years in prison. Riyaz Mazcuri, 67, a former attending psychiatrist at Riverside General Hospital in Houston, received the sentence after a five-day trial that found him guilty on five counts of health care fraud and one count of conspiracy to commit health care fraud. In addition to the prison sentence, federal Judge Vanessa Gilmore in Houston ordered Dr. Mazcuri to pay $20.6 million in restitution to Medicare and $2.25 million in restitution to Medicaid. ... Read More

Whistleblower Helps Medicare Recover $4 Million From Florida Dermatology Practice

A dermatologist who filed a whistleblower lawsuit against a Florida dermatology practice alleging it defrauded Medicare and Medicaid has helped the U.S. government recover $4 million. Dermatology Healthcare, a Tampa-based provider of dermatology care to residents of assisted living facilities, agreed to settle the government’s claims of fraud, which originated with a False Claims Act lawsuit filed by Dr. Theodore A. Schiff, according to an announcement by U.S. Attorney Maria Chapa Lopez. Dr. Schiff filed the lawsuit under the whistleblower provisions of the False Claims Act, alleging Dermatology Healthcare failed to adequately supervise the administration of superficial radiation therapy to ... Read More

Whistleblower Suit Ends in $21 Million Recovery from Ambulance Kickback Schemers

A sprawling whistleblower lawsuit implicating an ambulance company, its affiliated companies, and several municipal clients in an illegal kickback scheme has been settled, federal prosecutors announced. East Texas Medical Center Regional Healthcare System and East Texas Medical Center Regional Health Services (“the ETMC defendants”) their affiliated ambulance company, Paramedics Plus, and other defendants agreed to pay the U.S. more than $21 million to resolve the allegations, according to the U.S. Department of Justice. The government’s case against the ambulance industry defendants stems from a complaint filed by Dr. Stephen Dean under the whistleblower provisions of the False Claims Act. The ... 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

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

Opioid Use Disorder Quadruples Among Pregnant Women

Opioid use disorder (OUD) in pregnant women remains a serious concern among public health officials, who continue to fight fraud and abuse associated with the potent painkillers. Now a new study shows that the number of pregnant women with opioid abuse disorder more than quadrupled between 1999 and 2014. According to the U.S. Centers for Disease Control and Prevention (CDC), the alarming trend, published Aug. 9 in its Morbidity and Mortality Weekly Report, was measured in pregnant mothers at the time of labor and delivery. Researchers used medical data from the 28 states that keep the records relevant to the ... 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

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