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Florida Dermatologist Settles Medicare Fraud, Kickback Complaints

A Florida federal judge has entered a judgement against a dermatologist and his medical practice, ordering them to pay more than $18 million for allegedly pocketing tens of millions of dollars from Medicare by ordering medically unnecessary biopsies, falsely diagnosing patients with cancer, performing unnecessary radiation treatments on patients, and illegally billing the government for those biopsies and radiation treatments. The allegations were originally made in two separate False Claims Act lawsuits filed in December 2013 and June 2014 by Dr. Theodore Schiff, a dermatologist who is the medical director and managing partner of Water’s Edge Dermatology LLC, a dermatology ... Read More

California Sleep Clinic Chain Pays $2.6 Million To Resolve Whistleblower’s Medicare Fraud Allegaitons

The owners of a chain of northern California sleep clinics have agreed to pay the U.S. government $2.6 million to settle a False Claims Act lawsuit that originated with a whistleblower who accused them of Medicare fraud through false billing. Anooshiravan Mostowfipour and Tara Nader, who own and operate Bay Sleep Clinic, billed Medicare for sleep tests performed by technicians who lacked the proper licenses and certificates required by the Medicare program, the whistleblower suit alleges. Mostowfipour and Nader, both 58 and residents of Saratoga, Calif., own Amerimed Corporation and Qualium Corporation, which do business as Bay Sleep Clinic and ... 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

N.J. Heart Monitoring Company Pays $1.35 Million To Settle Whistleblower Allegations

A New Jersey company that remotely monitors cardiac devices implanted in heart patients has agreed to pay the U.S. $1.35 million to settle allegations it paid kickbacks to doctors to coax them to use its services. Mednet Healthcare Technologies entered into “fee-for-service” or “direct-bill” agreements with certain hospital and physician customers. MedNet charged a fee to the customers for cardiac monitoring services. But the company allegedly allowed the customers to bill Medicare directly for these same services and retain the reimbursements they received, which exceeded the fee that MedNet charged. This scheme, which lasted from March 2006 to January 2004, effectively ... Read More

Pennsylvania Whistleblower Awarded $124K of False Claims Act Settlement

A whistleblower who brought a False Claims Act lawsuit against three Pennsylvania physicians and a number of health care facilities has been awarded $124,000 after the defendants agreed to pay $700,000 to settle the complaint’s allegations of Medicare fraud. Margaret Reynard filed the False Claims Act lawsuit on behalf the federal government, accusing Dr. Yasin Khan, Dr. Elizabeth Khan, Dr. Dong Ko, Westfield Hospital, Lehigh Valley Pain management, and affiliated clinics of overcharging government programs and charging for services that did not qualify for reimbursement. Ms. Reynard alleged that the Lehigh Valley practitioners billed Medicare, the Federal Employees Health Benefits program, and ... Read More

Medical Device Maker Pays $36 Million to Resolve Criminal liability and Whistleblower Allegations

Pennsylvania-based medical device manufacturer Biocompatibles Inc., a unit of BTG plc, pleaded guilty Monday to misbranding its embolic device LC Bead and will pay more than $36 million to resolve criminal and civil liability, the Justice Department announced today. According to the Justice Department, about $25 million of the settlement will resolve a federal False Claims Act lawsuit filed by Ryan Bliss, a former Biocampatibles marketing director. The remaining $11 million is a criminal fine for illegally promoting its LC Bead device for off-label uses even after it assured the U.S. Food and Drug Administration (FDA) it wouldn’t. The FDA ... Read More

Nursing Home Company Pays $145 Million To Settle Medicare Fraud Allegations

The nation’s largest private nursing home company and its owner have agreed to pay the U.S. government $145 million to settle a False Claims Act lawsuit initiated by a pair of whistleblowers who claim that the company defrauded Medicare and TRICARE by misclassifying patients and billing for services that were not needed or never provided. Life Care Centers of America, a Tennessee company, will also enter into a corporate integrity agreement with federal regulators, an arrangement that puts its government billings under close regulatory scrutiny and independent monitoring to ensure compliance with billing rules. “This resolution is the largest settlement ... Read More

Tenet Hospitals Pay $513 Million To Settle Whistleblower Suit Alleging Kickbacks, Medicaid Fraud

Tenet Healthcare Corporation and two of its Atlanta-area subsidiaries have agreed to pay the U.S. government $513 million to settle criminal and civil allegations that they entered into illegal kickback and bribery schemes designed to boost the volume of low-income patients on Medicaid. Under the settlement, Atlanta Medical Center Inc. and North Fulton Medical Center Inc. agree to plead guilty to conspiracy to defraud the U.S government and violate federal anti-kickback laws by providing kickbacks and bribes to prenatal clinics in exchange for obstetric referrals. The Tenet hospitals set their sights on prenatal clinics serving mostly low-income, undocumented Hispanic women ... Read More

Ortho Clinics Settle Whistleblower Lawsuit Alleging They Charged U.S. For Reimported Drugs

Three orthopedic clinics will pay a combined $2.39 million to resolve federal and state False Claims Act allegations brought by a whistleblower who accused the clinics of buying deeply discounted pain medications from foreign countries, then billing them to Medicare, Medicaid, and other taxpayer-funded health care programs at regular domestic rates to boost profits. According to Acting U.S. Attorney Phillip A. Talbert of the Eastern District of California, Orthopedic Associates of Northern California, located in Chico, will pay $815,794; San Bernardino Medical Orthopaedic Group Inc., doing business as Arrowhead Orthopaedics, headquartered in Redlands, will pay $971,903; and Reno Orthopaedic Clinic, ... Read More

U.S. Backs Whistleblower Lawsuit Accusing DOE Nuclear Contractor of Fraud

The U.S. Department of Justice (DOJ) has chosen to intervene in a False Claims Act lawsuit filed by a whistleblower against a government contractor hired by the Department of Energy (DOE) to work on a South Carolina nuclear waste treatment facility. According to the Justice Department, the DOE paid Energy & Process Corporation (E&P), of Tucker, Ga., a premium to supply rebar that met stringent regulatory standards for a treatment facility within the Savannah River Site nuclear reservation near Aiken, S.C. The quality of the materials used in the construction of the nuclear waste site was critical for safety reasons, ... Read More