Articles Tagged with Medicaid

U.S. Senator Charles Grassley (R-Iowa), a long-time proponent of the False Claims Act and an anti-fraud advocate, has recently criticized reports of high-volume prescribers. In particular, Grassley addresses those prescribing extremely large quantities of mental health drugs. Recently, many pharmaceutical companies have agreed to large settlements involving the off-label promotion of these drugs, many of which are the must lucrative of the companies’ offerings.

In his report to Congress, Grassley identified a Miami doctor who allegedly wrote approximately 97,000 prescriptions in 18 months for mental health drugs- averaging about 177 prescriptions per day. He also cited a Texas doctor who wrote 14,170 prescriptions for Xanax in 2009. Continue reading ›

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 to Medicare billing procedures.  The DOJ alleged that the company “upcoded” the procedures it billed to Medicare, billing procedures as if they were different, more expensive procedures. Continue reading ›

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 more witnesses and uncovering more documents, the DOJ now says it has “good cause” to intervene, according to a federal district court document filed in Boston on August 5th. Continue reading ›

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 violated the Stark Law, but did not violate the False Claims Act.  The judge later decided that deposition testimony of Tuomey’s CFO should have been allowed into evidence and the case is scheduled for a retrial. Continue reading ›

Teva Pharmaceuticals has agreed to pay $78 million to settle Medicaid fraud allegations in Florida and Texas.  Teva owes the state of Florida $27 million due to alleged violations of the Florida False Claims Act.  Teva allegedly reported inflated drug prices to Florida’s Medicaid Program, which caused Florida to overpay Teva in reimbursement payments.  The Medicaid program reimburses pharmacies for drugs based on the prices reported by drug manufacturers like Teva, and by illegally inflating the prices of its drugs, the company cost each State millions of dollars.  Competitor company Ven-a-Care reportedly provided the State Attorney General with information about Teva’s illegal practices. Continue reading ›

The Department of Justice (DOJ) announced today that it has charged 94 doctors, healthcare company owners, and executives with submitting more than $251 million in false claims to Medicare.  The arrests spread across five different states in areas the federal government has deemed fraud hotspots.  It was the largest federal crackdown on Medicare fraud since Medicare Fraud Strike Force activity began.
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An Orange County, CA based heart-monitoring services company has agreed to pay the U.S. government $3.6 million to settle allegations that the company overbilled Medicare from 1998-2004.  The complaint was first filed in 2004 against National Cardio Labs LLC, its manager Adrienne Stanman, and her husband Robert Parsons.

Specifically, the government accused National Cardio Labs of violating the False Claims Act by billing for services not actually rendered to patients, services it had already been paid for, and services which it could not perform. Continue reading ›

The United States has charged Dr. Nijam Azmat and the Satilla Regional Medical Center of Waycross, Georgia with violating the False Claims Act by billing Medicare for services that were of no medical value to federal health program patients.  The government alleges that Dr. Azmat and the medical center performed, and sought reimbursement for, services to Medicare patients that were not medically necessary, had no medical value, or even endangered the lives of patients.

Satilla enlisted the services of Dr. Azmat in 2005, and the doctor began performing endovascular procedures – highly specialized procedures that require formal training.  However, Dr. Azmat allegedly was never qualified or even competent to perform these procedures. Continue reading ›

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