Medicaid Fraud

April 24, 2014
CRC Health Corp. has agreed to pay $9.25 million to settle allegations that the company knowingly submitted or caused the submission of false claims to Medicaid and Tennessee Medicaid, the U.S. Department of Justice announced last week.  CRC is a nationwide provider of substance abuse and mental health treatment services. CRC owns and operates a residential substance...
April 15, 2014
Kansas-based Hope Cancer Institute and its owner Dr. Raj Sadasvian have agreed to pay $2.9 million to resolve allegations that they knowingly submitted or caused the submission of false claims to Medicare, Medicaid, and the Federal Employee Health Benefits Program, the U.S. Department of Justice announced yesterday. The settlement resolves allegations that Sadasivan and Hope...
February 26, 2014
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...
February 25, 2014
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...
February 21, 2014
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...
January 31, 2014
Prime Healthcare Services Inc. (PHS) is being sued by an employee whistleblower, Karin Berntsen, for allegations under the False Claims Act that they knowingly falsified patients’ admission information, Law360 announced earlier this month. PHS allegedly directed hospital staff to falsify patients’ diagnoses in order to charge the highest amount to Medicare and...
January 27, 2014
Two orthopedic clinics, Tennessee Orthopaedic Clinics P.C. and Appalachian Orthopaedic Clinics P.C., will pay a combined $1.85 million to resolve allegations under the False Claims Act that they knowingly billed state and federal health care programs for re-imported osteoarthritis medications, known as viscosupplements, the Department of Justice announced last week. ...
January 17, 2014
BioScrip has agreed to pay $15 million to resolve allegations under the False Claims Act that they received kickbacks from Novartis in exchange for recommending refills to patients, the Department of Justice announced earlier this week. Novartis allegedly provided kickbacks to BioScrip, in the form of patient referrals and in the guise of rebates, in exchange for BioScrip...
December 19, 2013
Cardiologist Dr. Elie H. Korban (Korban) will pay $1.15 million to resolve False Claims Act allegations that he billed Medicare and Medicaid for medically unnecessary cardiac stent placements, the Justice Department announced today. Cardiac stents are mesh tubes placed in coronary arteries of patients to keep their arteries open during the treatment of coronary heart disease....
December 4, 2013
Caremark LLC (Caremark) has agreed to pay the government more than $4.2 million to settle allegations, under the False Claims Act, that they knowingly failed to reimburse Medicaid for prescription drug costs, the Justice Department announced earlier this week. Caremark is operated by CVS Caremark Corp., one of the largest pharmacy benefit management (PBM) company and...