whistleblower

Omnicare to Settle False Kickback Claims for $4.19M; Whistleblower to Get $398K

February 28, 2014
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Ohio-based Omnicare Inc. has agreed to pay the federal government $4.19 million to resolve allegations that the company engaged in a kickback scheme in violation of the False Claims Act, the U.S. Department of Justice announced yesterday.  Omnicare provides pharmaceuticals and services to long-term care facilities and residents and other senior populations.

The settlement resolves allegations that Omnicare solicited and received kickbacks from the drug manufacturer Amgen Inc. in return for implementing “therapeutic interchange” programs that were designed to switch Medicaid beneficiaries from a competitor drug to Amgen’s product Aranesp.  The government alleged that the kickbacks took the form of performance-based rebates that were tied to market-share or volume thresholds, as well as grants, speaker fees, consulting services, data fees, dinners and travel. 

The lawsuit was originally filed by an unnamed whistleblower under the whistleblower provision of the False Claims Act.  The Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The whistleblower in this case will receive $397,925 as his portion of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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DIG to Settle False Health Care Claims for $15.5M; Whistleblowers to Get $2.3M

February 26, 2014
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Diagnostic Imaging Group (DIG) has agreed to pay $15.5 million to settle allegations that the company knowingly submitted or caused the submission of false claims to state and federal health care programs in connection with medical tests that were not performed or were medically unnecessary, the U.S. Department of Justice announced yesterday.

The settlement resolves allegations that DIG submitted claims to Medicare, as well as the New Jersey and New York Medicaid Programs, for 3D reconstructions of CT scans that were never performed or interpreted.  Additionally, DIG allegedly bundled certain tests on its order forms so that physicians could not order other tests without ordering the additional bundled tests, which were not medically necessary.  The settlement also resolves allegations that DIG paid kickbacks to physicians for the referral of diagnostic tests.  According to the government, the kickbacks were in the form of payments that DIG made to physicians ostensibly to supervise patients who underwent nuclear stress testing.  These payments allegedly exceeded fair market value and were, in fact, intended to reward physicians for their referrals.     

DIG operates a chain of diagnostic testing facilities through its subsidiary, Doshi Diagnostic Imaging Services, which is headquartered in Hicksville, N.Y.  DIG previously operated chains in New Jersey and Florida through subsidiaries Doshi Diagnostic Imaging Services of New Jersey and Signet Diagnostic Imaging Services. 

The settlement resolves three lawsuits originally filed under the whistleblower provision of the False Claims Act.  The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The three whistleblowers—Dr. Mark Novick, Rey Solano, and Dr. Richard Steinman—will receive $1.5 million, $1.07 million, and $209,250, respectively, as their portions of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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Endo to Settle False Health Care Claims for $172M

February 25, 2014
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Delaware-based Endo Health Solutions Inc. and its subsidiary Endo Pharmaceuticals Inc. (Endo) have agreed to pay $171.9 million to settle allegations that the company improperly marketed the prescription drug Lidoderm for uses not approved by the Food and Drug Administration (FDA), resulting in false claims submitted to federal health care programs such as Medicaid, the Department of Justice announced last week.  Endo will pay an additional $20.8 million in penalties and forfeiture of profits, bringing the total payment to $192.7 million.

The government charged that Endo Pharmaceuticals Inc. introduced into interstate commerce Lidoderm that was misbranded under the Federal Food, Drug and Cosmetic Act (FDCA).   The FDCA requires a company, such as Endo Pharmaceuticals Inc., to specify the intended uses of a product in its new drug application to the FDA.   Once approved, a drug may not be introduced into interstate commerce for unapproved or “off-label” uses until the company receives FDA approval for the new intended uses.   During the period of 2002 to 2006, Lidoderm was approved by the FDA only for the relief of pain associated with post-herpetic neuralgia (PHN), a complication of shingles.   The information alleges that, during the relevant time period, the Lidoderm distributed nationwide by Endo Pharmaceuticals Inc. was misbranded because its labeling lacked adequate directions for use in the treatment of non-PHN related pain, including lower back pain, diabetic neuropathy and carpal tunnel syndrome.   These uses were intended by Endo Pharmaceuticals Inc. but never approved by the FDA.   The information further alleges that certain Endo Pharmaceuticals Inc. sales managers provided instruction to certain sales representatives concerning how to expand sales conversations with doctors beyond PHN and encouraged promotion of Lidoderm in workers’ compensation clinics.

In a deferred prosecution agreement to resolve the charge, Endo Pharmaceuticals Inc. admitted that it intended that Lidoderm be used for unapproved indications and that it promoted Lidoderm to health care providers for those unapproved indications.   Under the terms of the deferred prosecution agreement, Endo Pharmaceuticals Inc. will pay a total of $20.8 million in monetary penalties and forfeiture.   Endo Pharmaceuticals Inc. further agreed to implement and maintain a number of enhanced compliance measures, including making publicly available the results of certain clinical trials and requiring an annual review and certification of its compliance efforts by the Chief Executive Officer of its parent company, Endo Health Solutions. 

In addition, Endo agreed to settle its potential civil liability in connection with its marketing of Lidoderm.   The government alleged that Endo caused false claims to be submitted to federal health care programs, including Medicaid, a jointly funded federal and state program, by promoting Lidoderm for unapproved uses that were therefore covered by the federal health care programs.   Of the $171.9 million Endo has agreed to pay to resolve these civil claims, Endo will pay $137.7 million to the federal government and $34.2 million to the states and the District of Columbia.  

Also as part of the settlement, Endo Pharmaceuticals Inc. has agreed to enter into a Corporate Integrity Agreement (CIA) with the Department of Health and Human Services Office of Inspector General that requires Endo to implement measures designed to avoid or promptly detect conduct similar to that which gave rise to this resolution.   Among other things, the CIA requires Endo to implement an internal risk assessment and mitigation program and requires numerous internal and external reviews of promotional and other practices.   The CIA also requires key executives and individual board members to sign certifications about compliance, and it requires the company to publicly report information about its financial arrangements with physicians.

The settlement resolves three lawsuits originally filed by two former Lidoderm sales representatives and one physician under the whistleblower provision of the False Claims Act.  The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The whistleblowers’ share of the settlement has not yet been determined.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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Govt Intervenes in Lawsuit Against Tenet Healthcare

February 21, 2014
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The U.S. government has intervened in a False Claims Act Lawsuit against Tenet Healthcare Corp. and four of its hospitals in Georgia and South Carolina, as well as another hospital in Georgia that is owned by Health Management Associates (HMA), the Department of Justice announced earlier this week.  Tenet and HMA are two of the largest owner/operators of hospitals in the United States.  The government also is intervening against the clinics and related entities known as Hispanic Medical Management d/b/a Clinica de la Mama. 

The hospitals allegedly paid kickbacks to obstetric clinics serving primarily undocumented Hispanic women in return for referral of those patients for labor and delivery at the hospitals.  The hospitals then billed the Medicaid programs in Georgia and South Carolina for the services provided to the referred patients and, in some instances, also obtained additional Medicare reimbursement based on the influx of low-income patients. 

The lawsuit alleges that four Tenet hospitals, Atlanta Medical Center, North Fulton Regional Hospital, Spalding Regional Hospital and Hilton Head Hospital in South Carolina, and one HMA facility, Walton Regional Medical Center (since renamed Clearview Regional Medical Center), paid kickbacks to Hispanic Medical Management d/b/a Clinica de la Mama (Clinica) and related entities in return for Clinica’s agreement to send pregnant women to their facilities for deliveries paid for by Medicaid, in violation of the federal Medicare and Medicaid Anti-Kickback Statute.  The kickbacks were disguised as payments for a variety of services allegedly provided by Clinica.

The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded programs.  The Anti-Kickback Statute is intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives and is instead based on the best interests of the patient. 

The lawsuit was originally filed by an unnamed whistleblower under the whistleblower provision of the False Claims Act.  The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The False Claims Act also allows the government to intervene in the lawsuit, which it has elected to do in this case.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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Abbott Labs Settles Medicare Fraud Claims for $5.5M; Whistleblowers to Get $1M

December 27, 2013
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Illinois-based Abbott Laboratories has agreed to pay the United States $5.475 million to resolve allegations that the company violated the False Claims Act by paying kickbacks to induce doctors to implant the company’s vascular products, the Justice Department announced today.  Abbott is a global pharmaceuticals and health care products company.

The settlement resolves allegations that Abbott knowingly paid prominent physicians for teaching assignments, speaking engagements and conferences with the expectation that these physicians would arrange for the hospitals with which they were affiliated to purchase Abbott’s carotid, biliary and peripheral vascular products.  As a result, the United States alleged Abbott violated the Anti-Kickback Act and caused the submission of false claims to Medicare for the procedures in which these Abbott products were used.

The lawsuit was originally brought by Steven Peters and Douglas Gray, former Abbott employees, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  Peters and Gray will receive over $1 million between them as their portion of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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Sonoma Whistleblower Wins $1.35M in Wrongful Termination Lawsuit

December 16, 2013
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After a decade-long legal battle, Dr. Van Pena won $1.35 million from the California’s state-run Sonoma Developmental Center for wrongful termination in connection with his attempts to report “gross medical negligence” in 2000, Petaluma360 reported.

Dr. Pena had worked at Sonoma Developmental Center, a full time care facility for over a thousand developmentally disabled adults, for ten years.  In 2000, he reported “gross medical negligence” to center officials and, after receiving no response, turned to the media and state lawmakers.  Later that year he was fired, supposedly for refusing to perform CPR on a 90-year-old patient, but Dr. Pena maintained it was for his whistleblowing activities.  California law prohibits the termination of an employee for reporting improper governmental activity.

The Sonoma Developmental Center was the subject of a series of articles by California Watch, detailing abuse, neglect and sexual assault of the patients there.  The center was stripped of its license to operate last year, although it continues to operate under a new director.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

 

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Jury Finds JM Eagle Liable for Pipe Fraud

December 6, 2013

A federal jury has found that JM Eagle, the nation’s largest manufacturer of plastic pipe, violated the False Claims Act when it knowingly sold defective pipes to states and municipalities for use in drinking water, firefighting, irrigation and other public systems, the New York Times reported.

JM Eagle, formerly J-M Manufacturing, allegedly cut costs by using shoddy manufacturing practices to create weaker but more profitable polyvinyl chloride (PVC) pipe, and lied about whether or not it met strength and durability standards required by the government.  JM Eagle may have to pay triple damages, plus additional penalties for each false claim submitted to a state or municipal government.  The settlement has not yet been determined.

The lawsuit was originally filed by John Hendrix, a former JM Eagle employee, under the False Claims Act.  The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.

JM Eagle plans to appeal.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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Omnicare Settles Medicare Fraud Case for $120M; Whistleblower May Get $36M

November 13, 2013
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Ohio-based pharmacy service provider Omnicare Inc. has agreed to pay $120 million to settle allegations that the company violated the Anti-Kickback Statute and the False Claims Act.  Omnicare is one of the nation’s largest providers of pharmacy services to the elderly.

Omnicare allegedly offered skilled nursing facilities steep discounts for drugs for their Medicare Part A patients, sometimes even below cost, in order to induce referrals of those facilities’ non-Medicare Part A patients. The skilled nursing facilities, meanwhile, were reimbursed by Medicare at a flat fee. The Anti-Kickback Statute prohibits remuneration, in cash or in kind, to induce referrals for items or services that will be paid by a federal health care program, such as Medicare.  This remuneration resulted in false claims being submitted to Medicare that Medicare would not have paid, had it known that the claims were premised upon illegal kickbacks.

The lawsuit was filed by Donald Gale, a former Omnicare employee, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows private parties with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  The government elected not to intervene in this case, and Gale may receive up to 30 percent of the recovery, or up to $36 million.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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Imagimed Settles Healthcare Fraud Claims for $3M; Whistleblower to Get $565K

September 4, 2013

New York-based Imagimed LLC and its former owners, William B. Wolf III and Dr. Timothy J. Greenan, and its former radiologist, Dr. Steven Winter, have agreed to pay $3.57 million to resolve allegations that they knowingly submitted or caused the submission of false claims to federal healthcare programs for magnetic resonance imaging (MRI) services, the U.S. Department of Justice announced last week.  Imagimed owns and operates 15 MRI facilities under the name “Open MRI.”

Imagimed, Greenan, Wolf and Winter allegedly submitted claims to Medicare, Medicaid and TRICARE for MRI scans performed with a contrast dye without the direct supervision of a qualified physician.  Since a potential adverse side effect of contrast dye is anaphylactic shock, federal regulations require that a physician supervise the administration of contrast dye.  Imagimed, Greenan, Wolf and Winter also allegedly submitted claims for services referred to Imagimed by physicians with whom Imagimed had improper financial relationships.  In exchange for these referrals, Imagimed entered into sham on-call arrangements, provided pre-authorization services without charge and provided various gifts to certain referring physicians, in violation of the Stark Law and the Anti-Kickback Statute.

The lawsuit was originally filed by Dr. Patrick Lynch, a local radiologist, under the whistleblower provisions of the False Claims Act.  The False Claims Act allows private citizens with knowledge of fraud against the government to sue on behalf of the government and share in the recovery.  Dr. Lynch will receive $565,000 as his share of the settlement.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.

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