Friday, February 05, 2010

New NJ Legislation Strengthens False Claims Act

The New Jersey legislature has passed a bill amending the state’s False Claims Act, aligning it with the Deficit Reduction Act. This will strengthen the recovery efforts for Medicaid fraud cases.

Click here to read the full article, “Anti-fraud bill now law"

Qui Tam Lawsuit Ends in $3.76 Million Resolution for Alleged Medicare Fraud

Medical device manufacturer, Atricure Inc., will pay the United States $3.76 million to resolve claims of Medicare fraud and violations of the Food, Drug and Cosmetic Act.

Allegations included promoting its medical devices for uses which are not approved by the U.S. Food and Drug Administration. The West Chester, Ohio-based company was also accused of paying kickbacks and promoting unnecessary and expensive heart surgery using devices developed by the company.

The case began with a qui tam, or whistleblower, lawsuit by an unnamed private citizen, who will receive $625,000 from the total settlement.

Click here to read the full article, “Atricure to Pay U.S. $3.76 Million to Resolve Medicare Fraud Allegations"

U.S. Will Collect $10 Million from Former Los Angeles Medical Center Owners for False Claims Scheme

The United States will receive $10 million from a Los Angeles businessman and a physician for a Medicare and Medi-Cal fraud scheme. The consent judgment will resolve a civil lawsuit filed against the two individuals who formerly owned the Los Angeles City of Angels Medical Center.

The scheme involved paying ‘recruiters,’ who were employed at homeless shelters in the city, to send homeless individuals to the City of Angels Medical Center to receive unnecessary medical treatments. Medicare and Medi-Cal were then billed for the services.

The defendants, Robert Bourseau and Dr. Rudra Sabaratnam, also pleaded guilty to violating the Anti-Kickback Statute and are currently awaiting sentence. Two recruiters involved in the scheme, and a former executive of the medical center, have also pleaded guilty.

The case was filed by the United States and the State of California in the U.S. District Court for the Central District of California.

Click here for the full article, “Former Los Angeles Medical Center Owners Agree to $10 Million Consent Judgment For Medicare and Medi-Cal Fraud Scheme"

Friday, January 22, 2010

FORBA Pays U.S. $24 Million in Settlement based on Three Qui Tam Lawsuits

The United States and FORBA Holdings LLC agreed on a $24 million settlement to resolve allegations that FORBA caused reimbursement claims for unnecessary dental procedures performed on low-income children to be submitted to Medicaid.

FORBA, a dental management company which provides management and business services to clinics nationwide known as “Small Smiles Centers,” will pay the U.S. and affected states, and will provide information about individual dentists that may have been involved. That investigation is ongoing.

The government’s case was based on three lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act. The whistleblowers will share more than $2.4 million of the settlement.

The allegedly medically unnecessary procedures performed on children, included pulpotomies (baby root canals) and placing crowns, among others.

Click here to read the full article, “National Dental Management Company Pays $24 Million to Resolve Fraud Allegations"

U.S. Files Suit Against J&J for Paying Kickbacks Based on Whistleblower Suits

Drug manufacturer Johnson & Johnson, of New Brunswick, N.J., and two of its subsidiaries are the targets of a complaint filed by the U.S. government under the False Claims Act.

The government alleges that J&J paid millions of dollars in kickbacks to Omnicare Inc., to increase the purchase and recommendation of J&J drugs to nursing home pharmacies. Omnicare is the nation’s largest pharmacy that specializes in supplying nursing home patients with necessary drugs.

According to the complaint, J&J allegedly paid kickbacks to Omnicare by various means, including in the form of payments purportedly for “data,” “grants,” and “educational funding.”

In November 2009, Omnicare agreed to pay $98 million to settle a False Claims Act lawsuit with the U.S. and several states, for taking kickbacks from J&J, among other allegations.

This case is based on two combined whistleblower lawsuits from the District of Massachusetts.

Click here to read the full article, “U.S. Files Suit Against Johnson & Johnson for Paying Kickbacks to Nation’s Largest Nursing Home Pharmacy"

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