Thursday, May 29, 2008

DOJ Fact Sheet on Efforts to Combat Health Care Fraud and Abuse

The Department of Justice has helped guide the efforts of the National Health Care Fraud and Abuse Control Program (HCFAC) since its inception in 1997.  The program was designed to coordinate federal, state, and local law enforcement on cases of health care fraud and abuse as part of the Health Insurance Portability and Accountability Act (HIPAA).  Working closely with partners at the Department of Health and Human Services and state and local law enforcement, the Department of Justice continues to successfully investigate and prosecute individuals and companies who commit health care fraud.

During Fiscal Year 2007, the Department opened 776 new civil health care fraud investigations, and had 743 civil health care fraud investigations pending at the end of the fiscal year. 

Click here to read the The Department of Justice Fact Sheet on Efforts to Combat Health Care Fraud and Abuse.

Tuesday, May 27, 2008

Florida Dermatologist Settles Qui Tam Lawsuit

Dr. Michael Rosin, a former Sarasota dermatologist, has agreed to pay $11 million to the federal government for Medicare fraud.  The doctor has been convicted of performing unnecessary surgeries on hundreds of his elderly patients.  Prosecutors said that Rosin made cancer diagnoses for nearly every patient who came into his office, performing surgeries on patients whose biopsy slides showed no sign of cancer.  He almost always removed four layers of skin during surgeries which allowed him to bill Medicare for higher amounts.

One of Rosin’s former patients, Ellen Murray, underwent surgery eight times before reporting Rosin to the government in 2004.  Former Rosin office manager Carolyn Ferrara joined the lawsuit until the goverment took over in 2007.  Both women stand to receive at least $800,000 each from the settlement of the qui tam lawsuit.

Click here to read Todd Ruger’s article in the Herald Tribune, Doctor to pay millions for fraud.

Friday, May 23, 2008

Medtronic Spine LLC Settles Fraud Charges for $75M

Medtronic Spine LLC has agreed to pay the federal government $75 million to settle allegations that the company falsely submitted claims to Medicare.  The allegations were brought by two former employees who will receive a total of $14.9 million in the qui tam suit.

The government alleged that Kyphon Inc, which was bought by Medtronic Spine, was involved in submitting fraudulent claims for it’s kyphoplasty procedure.  The minimally invasive surgery is used to treat compression fractures of the spine caused by osteoporosis, cancer, or benign lesions.  Kyphon engaged in a seven-year marketing scheme that resulted in certain hospitals falsely billing Medicare for certain kyphoplasties performed on an inpatient basis rather than less costly and clinically appropriate outpatient kyphoplasty treatment.

Click here to read the full article in Business First of Buffalo, Medtronic Spine LLC pays $75M to settle gov’t charges.

Tuesday, May 20, 2008

South Carolina Hospital Settles Fraud Allegations

South Carolina’s Marion County Medical Center has settled a lawsuit that alleged the hospital falsely submitted Medicare claims in 2006.  The settlement requires the hospital to pay $36,404 to the federal government.  This amount was originally provided in 2006 to a Medicare beneficiary in the hospital’s emergency room.  Katherine Pugh, a nurse and a former employee of the hospital, alerted the federal government of the false claim, and will receive $9,101 as her share of the settlement.

Click here to read Jamie Durant’s article, Marion County Medical Center agrees to settle fraud allegations.

Thursday, May 15, 2008

Computer Sciences Corp. Settles Kickback Allegations

Computer Sciences Corp. has agreed to settle a 2004 complaint filed by whistleblowers Norman J. Rille and Neal Roberts under the False Claims Act.  The complaint alleged that CSC knowingly solicited and received payments from a number of companies with whom it had alliance relationships, amounting to kickbacks and undisclosed conflicts of interest.

CSC has agreed to pay $1.37 million to settle the case.  Rille and Roberts will receive a portion of this payment, to be determined in the near future. 

The settlement is part of a larger, ongoing federal investigation of government technology vendors that has resulted in the filing of complaints against Sun Microsystems, Hewlett-Packard Co. and Accenture Ltd.

Click here to read the AP article, CSC to pay $1.37 million to settle federal probe.

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