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DOJ Announces $1.3 Billion Health Care Fraud Enforcement Action

Thu, 13 Jul 2017 19:54:39 +0000

The Department of Justice has announced that charges have been filed against 412 defendants, across 41 districts, to recoup approximately $1.3 billion in false billings to the Medicare, Medicaid and TRICARE programs. Defendants include doctors, nurses, pharmacists and other licensed medical professionals. The allegations target healthcare fraud schemers who allegedly defrauded federal healthcare programs at the […]

Nationwide Study of OIG Home Health Fraud Cases Reveals Hotspots

Tue, 09 May 2017 18:28:04 +0000

Home health care has long been seen as a program area vulnerable to fraud, waste, and abuse with physicians playing a central role. The Medicare home health benefit covers skilled nursing care, home-based assistance, and therapeutic services for qualifying homebound individuals. Home healthcare represents a significant part of the Medicare program with $18.4 billion paid […]

Drexel University Study Shows Two Thirds of US Patients See Physicians Paid by Drug Companies

Fri, 31 Mar 2017 18:30:15 +0000

In a recently released study conducted by Genevieve Pham-Kanter, PhD , an assistant professor in Drexel’s Dornsife School of Public Health, 65% of patients visited a physician within the last year who had received payments or gifts from pharmaceutical or medical device companies; yet only 5 percent of those surveyed knew that their doctor had […]

Walgreen Accepts Responsibility for $50 Million Kickback Case

Fri, 24 Mar 2017 15:00:37 +0000

The United States Attorney for New York, Preet Bharara announced a settlement of $50 million against Walgreen Co. (“Walgreens”), the national retail drug chain which owns and operates thousands of retail stores across the United States. The settlement resolves allegations that Walgreens violated the federal Anti-Kickback Statute and False Claims Act by providing government beneficiaries […]

Update on Pharmaceutical Company Insys Kickback Investigation

Tue, 21 Mar 2017 17:58:26 +0000

On June 25, 2015, the New York Times reported that Heather Alfonso, a Connecticut advanced practice registered nurse, had pled guilty to federal charges of accepting $83,000 in kickbacks from Insys Therapeutics, an Arizona drug company that sells Subsys, a powerful painkiller used by cancer patients. The article quoted Marcella Auerbach, former federal prosecutor who […]

Government Uncovers TRICARE $100M Compounding Fraud Scheme

Wed, 01 Mar 2017 20:32:30 +0000

Recently, twelve defendants including doctors, pharmacy owners and marketers were charged in a $100 million TRICARE compounding fraud scheme according to John Parker, U.S. Attorney in the Northern District of Texas.  TRICARE is an insurance program for active-duty and retired military and their family members. “The indictments and arrests in this investigation highlight another step […]

Baxter pays more than $18 million to resolve cGMP Criminal and Civil Liability

Tue, 07 Feb 2017 20:26:55 +0000

DOJ recently announced that Baxter Healthcare Corporation agreed to pay $18.158 million to resolve its criminal and civil liability arising from Baxter’s failure to follow current Good Manufacturing Practices (cGMP) when manufacturing sterile drug products in North Carolina. The resolution includes a deferred prosecution agreement and penalties and forfeiture totaling $16 million and a civil settlement under the False […]

Lab Fraud: Will a $256 Million Settlement Stop It?

Tue, 17 Jan 2017 20:30:12 +0000

In fiscal year 2016, Millennium Health (formerly Millennium Laboratories), agreed to pay the Government $256 million to resolve alleged violations of the False Claims Act.  The allegations included medically unnecessary urine, drug and genetic testing and as providing of free items to physicians who agreed to refer expensive laboratory testing business to Millennium in violation […]

The 2017 Healthcare Whistleblower: Agent of Change

Fri, 13 Jan 2017 18:55:28 +0000

New research by Jaron H. Wilde at the University of Iowa’s Tippie College of Business concludes that: …after truth tellers come forward with information about wrong doing inside their operations… [and after investigation, there was a] sharp and lasting drop in financial wrongdoing… Part of Mr. Wilde’s study explored large samples of companies to see if there […]

Kickbacks Crackdown Worldwide: Will Pharma Finally Get the Message?

Mon, 29 Aug 2016 20:45:22 +0000

The Wall Street Journal recently reported that six employees of Novartis have been indicted in South Korea amidst allegations that the company paid $2.3 million to physicians in order that they prescribe the company’s drugs. Although the company said, “Novartis does not tolerate misconduct and we are already implementing a remediation plan in Korea based […]