WellCare Health Plans, Inc. reached a settlement with the federal government this week over allegations that the company to Medicare, Medicaid, and other government health programs, all in violation of the False Claims Act. The Tampa-based health insurer will pay $137.5 million to the United States, nine individual states, and four…
Cayuga Medical Center, located in Ithica, New York, recently settled False Claims Act allegations that the medical center submitted false claims for payment under Medicare and Medicaid. The government’s investigation was initiated and aided by Daniel S. Jorgenson, a physician practicing in the Ithica area who came forward as a whistleblower under the…
A new trend in healthcare fraud enforcement reflects a willingness by hospitals to be more forthcoming. Detroit Medical and St. Mary’s Medical Center in Pennsylvania recently reported improper financial relationships with physicians — voluntarily. Detroit Medical entered into a $30 million settlement agreement with the U.S. government stemming from violations…
The Justice Department recently announced the $280 million settlement of a False Claims Act case against Dey Pharmaceuticals, of which $67.2 million will be awarded to whistleblower Ven-A-Care. The case accused Dey of reporting false and inflated prices for four drugs used to treat asthma and respiratory conditions. Federal health…
Jeffrey Friedlander, physician at the Neurology & Pain Center in Tampa, was recently convicted of Medicare fraud and drug conspiracy through his participation in a “pill mill.” Friedlander facilitated a drug-trafficking scheme by signing blank prescriptions, used to obtain powerful pain killers that were then sold on the street. Centers…
In wake of many of the recent, massive pharmaceutical fraud settlements, government officials are exploring the possibility of holding pharmaceutical executives criminally liable for their company’s off-label promotion efforts. Despite the occurrence of massive settlements, many commentators and legal analysts believe they are simply the cost of doing business within…
The federal government has elected to intervene in a False Claims Act against the Mayo Clinic. Over the course of ten years, Mayo allegedly filed false claims to Medicare and Medicaid for surgical pathology services that were never performed. The Clinic is also accused of failing to comply with federal…
The Department of Justice (DOJ) has settled a False Claims Act case against Minnesota based Center for Diagnostic Imaging which accused the company of Medicare fraud. The radiologic imaging company has agreed to pay the U.S. government $1.2 million to settle part of the allegations in the lawsuit that related…
The Department of Justice (DOJ) is seeking to intervene in a qui tam lawsuit against St. Jude Medical Inc., a manufacturer of pacemakers and other heart devices. The DOJ initially began its investigation in 2005, and this past December decided not to intervene in the case. However, after talking to…
A qui tam action under the False Claims Act brought in South Carolina would not be particularly interesting except for one small fact: the case is actually going to trial. In fact, the case is going to trial for the second time, after a jury found that Tuomey Healthcare System…