A former office manager for a Tennessee pain clinic filed a qui tam lawsuit under the federal False Claims Act accusing her former employer of falsely billing Medicare and TennCare for unnecessary painkillers, upcoding claims, and billing Medicare for improper nurse...
Month: January 2018
Whistleblower to receive $225,000 in False Claims Act reward
San Diego-based Scripps Health, a health care system, has agreed to settle False Claims Act allegations for $1.5 million. According to the Department of Justice, Scripps Health violated the Act by billing Medicare and TRICARE for physical therapy services performed by...
Former Wells Fargo insurance broker sued on non-compete agreement
Non-compete agreements serve an important purpose: To protect a company's interests after an employee departs. An issue involving non-compete agreements recently entered the news in New York. USI Insurance Services, L.L.C., is suing a former broker at Wells Fargo...
DOJ: Production incentives led to false dental claims
The Department of Justice and a large number of states collaborated on a settlement with dental management company Benevis LLC and over 130 Kool Smiles dental clinics that Benevis provided services for. The clinics and Benevis have agreed to settle allegations of...
Pharmaceutical company to pay $210 million in FCA kickbacks case
Medicare beneficiaries are often required to make a copayment, use coinsurance or pay a deductible when buying prescription drugs. These are collectively referred to as "copays." Congress mandates certain copays, which rise with the expense of the drug, in order to...
False Claims Act recovers $3.7 billion in the 2017 fiscal year
Health care fraud and false claims pose a serious financial threat to the federal government and tax payers alike. The Department of Justice (DOJ) works in conjunction with ordinary citizens and public servants to pursue justice against those committing the fraud. By...
Insurance coverage for fines and penalties for False Claims Act
Companies in New York routinely purchase directors' and officers' liability insurance to limit costs if someone's mistake or purposeful action triggers a lawsuit against the company. Litigation regarding securities or shareholder derivatives represents the primary...