Monday, March 29, 2010

New Jersey Hospital to Pay $6.35 Million in Medicare False Claims Act Settlement

The New-Jersey based Robert Wood Johnson University Hospital Hamilton will pay $6.35 million to settle allegations that it defrauded Medicare.  Allegedly, the hospital fraudulently inflated charges to its Medicare patients so that the federal health care program would provide them with larger reimbursements. 

Two lawsuits were filed claiming that the hospital inflated its charges in order to obtain additional outlier payments from Medicare.  These payments are provided in cases where the cost of patient care is unusually high so that hospitals have an incentive to treat patients requiring such care.

The two lawsuits were filed under the qui tam, or whistleblower, provisions of the False Claims Act.  Under the civil settlement, the whistleblowers will receive $1,111,250 out of the total recovery. 

Click here to read the full article, “New Jersey Hospital to Pay $6.35 Million to Resolve Allegations of Inflating Charges to Obtain Higher Medicare Reimbursement"

Christ Hospital of Greater Cincinnati to Pay Appx. $110 Million in False Claims Settlement

Christ Hospital and the Health Alliance of Greater Cincinnati will pay about $110 Million in a federal whistleblower lawsuit settlement.  While this amount has not been formally announced, it is contained in a memorandum to the Trustees at the University of Cincinnati discussing the settlement terms.  UC will now be the only owner of the alliance.

Harry Fry, a retired cardiologist, sued the hospitals in 2003 and alleged that Christ Hospital assigned doctors to the lucrative Heart Station as a reward for generating the most money for the hospital, and induced doctors to assign cardiac patients to the Station.  As the whistleblower, Fry will receive millions of dollars from the settlement. 

Click here to read the full article, “Memo: Whistleblower settlement at $110M"

Alpharma Inc. to Pay $42.5 Million in False Claims Act Settlement

Alpharma Inc., an American pharmaceutical manufacturer, will pay $42.5 million to settle False Claims Act allegations. 

The settlement resolves allegations that Alpharma paid health care providers to promote or prescribe Kadian, a drug used to treat moderate to severe chronic pain.  The company is also alleged to have misrepresented the safety and efficacy of the drug.

The settlement proceeds will be split between the federal government and several states, with the federal government receiving approximately $33.6 million and the states receiving approximately $8.9 million to resolve their respective claims.

This lawsuit was brought by whistleblower Debra Parks under the qui tam or whistleblower provisions of the False Claims Act.  Under the civil settlement, Ms. Parks will receive $5.33 million of the federal government’s recovery.

Click here to read full article, “Alpharma to Pay $42.5 Million to Resolve False Claims Act Allegations in Connection With Promotion of Drug Kadian"

Tuesday, March 23, 2010

Dey L.P. and Dey Inc. to Pay Florida $6.5 Million in Medicaid Fraud Settlement

Dey L.P. and Dey Inc. will pay Florida $6.5 million to resolve Medicaid fraud allegations of drug price manipulation. 

Allegedly, Dey set and reported inflated prices for Albuterol inhalants, solutions and related products that pharmacies and other providers dispense.  The Florida Medicaid program reimbursed these inflated prices which caused them to overpay millions of dollars in pharmacy reimbursements. 

The allegations, which constitute violations of the Florida False Claims Act, were filed by whistleblower Ven-A-Care of the Florida Keys, Inc. on behalf of the State of Florida.  The Attorney General’s Office investigated the claims and later intervened in the lawsuit. 

Of the settlement funds, $3.3 million will go to the State’s General Revenue Fund, $1.3 million will reimburse the Agency for Health Care Administration for overcharges it paid Dey, and $369,999 will go to the Attorney General’s Medicaid Fraud Informant Program to reward people who give information that leads to Medicaid fraud convictions. 

Click here to read the full article: “McCollum: Florida Recovers $6.5 Million From Pharmaceutical Company in Medicaid Fraud Settlement"

Drug Maker Actavis Elizabeth Pays $3.6 Million to Settle Massachusetts False Claims Act Case

Boston Attorney General Martha Coakley’s Office reached a $3.6 million settlement with Actavis Elizabeth LLC, a New Jersey-based pharmaceutical manufacturer, to resolve a Massachusetts False Claims Act case. 

While Actavis has not admitted any wrongdoing, the lawsuit alleged that Actavis reported inflated prices to drug industry reporting services.  This allegedly resulted in the Massachusetts Medicaid Program, MassHealth, paying inflated prices for ingredients for Medicaid recipient prescriptions.  All money recovered will be returned to MassHealth. 

Actavis is one of 13 generic drug manufacturers that the Commonwealth sued for allegedly inflating prices via national pharmaceutical reporting services.  The Commonwealth has settled with nine other defendants in this case, recovering $16.7 million for the Massachusetts Medicaid program.  Three other defendants have cases pending in Boston’s federal court. 

Click Here to Read the Full Article, “Attorney General Martha Coakley’s Office Reaches $3.6 Million Settlement with Drug Manufacturer Actavis Elizabeth"

Printer Friendly Page