Thursday, May 28, 2009

Minnesota Hospitals Pay $2.28 Million in Whistleblower Suit Settlement

Three HealthEast hospitals will pay the federal government $2.28 million in a whistleblower lawsuit settlement for overcharging Medicare on a type of spinal surgery known as kyphoplasty. The procedure can be performed as outpatient surgery, but was allegedly billed by the hospitals as inpatient from 2002 to 2007, overcharging Medicare and increasing their revenue.

The St. Louis, Minnesota-based hospitals were charged by two whistleblowers, who were former Kyphon employees, under the False Claims Act. The U.S. Attorney’s Office in Buffalo and multiple Department of Health and Human Services special agents are leading the government investigation.

Click here to read the full release, “Minnesota Hospitals Pay $2.28 Million to Settle Medicare Fraud Charges Involving Kyphoplasty"

Thursday, May 21, 2009

U.S. Joins Whistleblower Suit Against Pharmaceutical Company for Not Paying Medicaid Rebates

Two whistleblower suits against drug manufacturer, Wyeth, have been joined by 16 states and the United States, for allegedly failing to provide the government with the same discounts as it did to private purchasers of its drugs, Protonix Oral and Protonix IV.

Under the Medicaid Drug Rebate Program drug manufacturers have to report the prices they charge so those on Medicaid receive the same discounts offered to commercial customers. Wyeth offered steep discounts to hospitals that bought the two drugs together; an offer that was unavailable and unnecessary to Medicaid and therefore avoided payment, by Wyeth, of hundreds of millions of dollars in rebates.

The investigation was conducted by the Civil Division of the U.S. Department of Justice, the U.S. Attorney’s Office for the District of Massachusetts and the Office of Inspector General of the Department of Health and Human Services.

Click here to read the full article, “U.S. and 16 States Join Suits Against Pharmaceutical Giant, Wyeth"

False Claims Act Reinforcement Bill Headed to Obama's Desk for Signing

In an attempt to strengthen the False Claims Act, President Obama will be presented with a bill which will reinforce the law that encourages whistleblowers to file lawsuits on the government’s behalf. The Fraud Enforcement and Recovery Act was approved by both the Senate and the House; Obama is expected to sign the measure. The bill targets mortgage and financial fraud. Most false claims lawsuits target hospitals, physicians and pharmaceutical companies because of the amount of federal money they receive.

Click here to read the full article, “Bill to bolster False Claims Act heads to Obama"

Thursday, May 07, 2009

WellCare Pays $80 Million to Avoid Criminal Prosecution

In an effort to punish but not hurt, Florida’s largest Medicaid provider will pay $80 million to the U.S. government to avoid criminal prosecution for health care fraud. WellCare Health Plans Inc. is charged with implementing an elaborate Medicaid fraud scheme which defrauded the Florida Medicaid program and Florida Healthy Kids Corporation out of $40 million.

The fear of prosecution ending in the collapse of the company, and thus harming Floridians, hundreds of employees and shareholders that depend on the company, prompted the large restitution before prosecution began.

“In charging WellCare we have sought to punish the company for its misconduct, but we have, at the same time, tried to avoid crushing it,” said U.S. Attorney A. Brian Albritton.

Click here to read the full story, “WellCare to pay $80 million; may avoid conviction"

Friday, May 01, 2009

Forest Laboratories Income Slides with $170 Million to Go Towards False Claims Investigation

“Forest Laboratories set aside $170 million related to a Justice Department investigation into its marketing and promotion of two antidepressants in the fiscal fourth quarter, when net income slid 46 percent to $92.8 million compared with last year’s fourth quarter.”

The case is being led by the U.S. Attorney’s Office for the District of Massachusetts. The case against Forest concerns an alleged False Claims Act violation in relation to unapproved pediatric use for Celexa and Lexapro. The company allegedly paid “kickbacks” to encourage physicians to prescribe the drugs.

Click here to view the article, “Forest’s Income Slumps With Set-Aside for Justice Probe"

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