Medicaid Fraud

September 10, 2013
Emory University has agreed to pay $1.5 million to settle allegations that the university violated the False Claims Act by billing Medicare and Medicaid for clinical trial services that were not permitted by the Medicare and Medicaid rules, the U.S. Department of Justice announced last month. Providers generally are not permitted to bill Medicare for medical care and services...
August 30, 2013
Shands Healthcare, which operates a network of health care providers in Florida, including a teaching hospital and a medical center, has agreed to pay $26 million to settle allegations that the company knowingly submitted or caused the submission of false claims to Medicare, Medicaid, and other federal health care programs, the U.S. Department of Justice announced last week....
August 27, 2013
The U.S. District Court for the District of Columbia has entered judgment for more than $17 million against Dr. Ishtiaq Malik and his two companies, Ishtiaq Malik M.D., P.C. and Advanced Nuclear Diagnostics, for submitting false nuclear cardiology claims to federal and state health care programs, the U.S. Department of Justice announced last month. The government’s...
June 19, 2013
New York-based Parkshore Home Health Care, dba Renaissance Home Health Care, a home health care services agency, agreed to pay $1 million to resolve allegations that it provided unqualified home health aides to home health agencies, who in turn sent these unqualified aides into the homes of Medicaid recipients throughout New York City and then billed the Medicaid program for...
May 31, 2013
Recent amendments to the federal False Claims Act have expanded whistleblower protections and increased penalties for violators.  The amendments came in the form of the federal Deficit Reduction Act, the Fraud Enforcement and Recovery Act, the Affordable Care Act, and the Dodd-Frank Act. California revamped its own False Claims Act earlier this year to bring it into...
May 24, 2013
Parkland Memorial Hospital of Dallas, Texas has agreed to pay a $1.4 million settlement to resolve allegations that they knowingly submitted or caused the submission of false claims to Medicare and Medicaid, the Dallas Morning News reported recently.  Parkland has also agreed to enter into a corporate integrity agreement with federal health regulators to monitor future...
May 17, 2013
In the largest drug safety settlement of its kind to date, generic drug manufacturer Ranbaxy USA Inc. pleaded guilty to felony charges relating to the manufacture and distribution of adulterated drugs, as well as violation of the False Claims Act, the U.S. Department of Justice announced this week.  Ranbaxy agreed to pay a criminal fine and forfeiture amounting to $150...
May 7, 2013
Adventist Health and its Los Angeles-based affiliated hospital White Memorial Medical Center have agreed to pay the United States and the State of California $14.1 million to settle allegations that they violated the Anti-Kickback Act, the Stark Statute, and the False Claims Act, the U.S. Department of Justice announced last week. Adventist Health allegedly improperly...
May 1, 2013
The United States filed a second false claims action against Novartis Pharmaceuticals Corp. alleging that they paid kickbacks to doctors to induce them to prescribe Novartis pharmaceutical products that were reimbursed by federal health care programs, the Justice Department announced last week. The government alleges that from January 2001 through November 2011, Novartis...
April 22, 2013
On April 16, the owner and another senior executive of Chicago’s Sacred Heart Hospital and four physicians affiliated with the facility were arrested in connection with a Medicare and Medicaid kickback and fraud scheme, the U.S. Department of Justice reported. Edward J. Novak, Sacred Heart’s owner and chief executive officer, and Roy M. Payawal, Sacred Heart’...