Wednesday, November 25, 2009

Justice Department Announces Recovery of $2.4 Billion in False Claims Act Suits Since 1986

The Justice Department announced today that the United States secured $2.4 billion in settlements and judgments involving fraud against the government in this fiscal year. Since 1986, after Congress strengthened the False Claims Act, the total recoveries have been more than $24 billion.

When Congress amended the False Claims Act in 1986, the partnership between private citizens and the government was strengthened. The qui tam provisions were revised, encouraging whistleblowers to come forward with allegations of fraud.  The Act was further improved and clarified by amendments in 2009.

Of the $2.4 billion in settlements and judgments obtained in fiscal year 2009, nearly $2 billion was recovered in lawsuits filed under the False Claims Act’s qui tam provisions.

Click here to read the full article “Justice Department Recovers $2.4 Billion in False Claims Cases in Fiscal Year 2009; More Than $24 Billion Since 1986"

Friday, November 20, 2009

Kaiser Foundation Hospitals Settle False Claims Act Liability for $1.83 Million

Kaiser Foundation Hospitals have agreed to pay the U.S. $1,830,322.41 to settle False Claims allegations of billing Medicare for uncertified hospice services.

The hospitals, Kaiser Sunnyside Medical Center, Kaiser Foundation Health Plan Northwest and Northwest Permanente P.C., were supposed to acquire written certifications of terminal illness for each hospice patient in order to legally bill Medicare to help ensure that the hospice care was medically necessary.

Kaiser NW submitted a report explaining that between October 2000 and March 2004, there were individual instances where these certificates were not obtained prior to billing Medicare.

The case was handled by the Justice Department’s Civil Division, the Acting U.S. Attorney for the District of Oregon and the Office of Inspector General of the Department of Health and Human Services.

Click here to read the full article “Oregon Hospice Pays U.S. $1.83 Million to Settle False Claims Act Liability"

NJ Hospital to Pay $3.02 Million in Settlement of Qui Tam Lawsuit for Allegations of Medicare Fraud

The U.S. government will intervene in a lawsuit involving a New York Hospital and allegations of defrauding Medicare and has entered into a settlement with a New Jersey Hospital this week.

The United States settled for $3.02 million, plus interest, with Trinitas Regional Medical Center.

Both hospitals had lawsuits brought against them by a whistleblower, Tony Kite, in 2005 under the qui tam provision of the False Claims Act. Kite will receive about $679,000 plus interest out of the recovery from Trinitas Hospital.

Both hospitals allegedly fraudulently inflated their charges to Medicare patients to obtain larger reimbursements from Medicare.

Click here to read the full article “New Jersey Hospital to Pay $3 Million to Resolve Allegations of Medicare Fraud"

Friday, November 06, 2009

Largest U.S. Nursing Home Pharmacy to Pay $98 Million for Alleged Kickback Schemes

The nation’s largest nursing home pharmacy will pay $98 million to resolve allegations that it engaged in several kickback schemes. Omnicare Inc. of Covington, KY, allegedly received kickbacks from several parties, including IVAX Pharmaceuticals of Weston, Florida, which will pay an additional $14 million.

In addition, a complaint has been filed against two large Atlanta-based nursing home chains, Mariner Health Care Inc and SavaSeniorCare Administrative Services LLC, and their principals, for accepting kickbacks from Omnicare.

The Kentucky based pharmacy also allegedly received kickbacks from the pharmaceutical company, Johnson & Johnson.

Omnicare is the nation’s largest pharmacy, which specializes in providing drugs to nursing home patients.

The original complaint was initially filed under the qui tam provisions of the False Claims Act in the District of Massachusetts.

Click here to read the full news release, “Nation’s Largest Nursing Home Pharmacy and Drug Manufacturer to Pay $112 Million to Settle False Claims Act Cases"

Texas Hospital Group to Pay $27.5 Million to Settle False Claims Act Violation Claims

A Texas hospital group will pay the United States $27.5 million to settle claims that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute between 1999 and 2006. The McAllen, Texas group allegedly paid illegal kickbacks to doctors in order to convince them to refer patients to hospitals within the group.

The government alleges that a series of sham contracts were created to disguise the payments.

The settlement resolves a qui tam or whistleblower lawsuit filed in 2005 by Bruce Moilan, a former employee of the defendants, who will receive $5.5 million for his participation.

Click here to read the full article, “Texas Hospital Group Pays U.S. $27.5 Million to Settle False Claims Act Allegations"

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