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Posts tagged "Medicare/Medicaid Fraud"

Whistleblower to receive $1,402,500 in False Claims Act case

"When hospices increase their bottom lines by billing taxpayers for unneeded services, they are diverting money from vulnerable, terminally-ill individuals," said a spokesperson for the U.S. Department of Health and Human Services Office of the Inspector General. "Worse yet, these patients may not be receiving care for medical needs that would otherwise be covered in a non-hospice setting."

Hospital to pay $784,000 to resolve False Claims Act allegations

Livingston Regional Hospital, LLC, of Tennessee has agreed to settle a False Claims Act case brought against it in federal court. It will resolve the allegations for $784,000. The hospital is owned by LifePoint Health, Inc., which operates hospitals across the U.S.

Whistleblowers to get $4,276,900 reward in improper billing case

A company called Healogics, Inc., has agreed to settle False Claims Act allegations for up to $22.51 million. The Florida company, which manages almost 700 hospital-based wound care centers nationwide, is accused of knowingly causing their wound care centers to falsely bill Medicare for hyperbaric oxygen ("HBO") therapy that was either unreasonable or medically unnecessary.

Nursing home concern to pay $30 million in False Claims Act case

Skilled nursing facilities are in a position of trust. Especially when Medicare and Medicaid are involved, some nursing home patients are vulnerable. To protect them and the American taxpayer, their care should always be directed by their medical needs; never by the financial interests of the nursing home.

Whistleblower says Insys paid kickbacks for opioid prescriptions

The Justice Department and six U.S. states have joined a whistleblower's lawsuit against Insys Therapeutics, Inc. In the lawsuit, the drug maker is accused of trying to make more profit on Subsys, a spray form of the opioid fentanyl, by paying kickbacks to induce doctors to prescribe the drug. It is also accused of knowingly having insurers and federal healthcare programs to pay for Subsys when it was not medically necessary.

DOJ awards $1,645,600 in case of false billings for oxygen

Respiratory equipment supplier Rotech Healthcare, Inc., has agreed to settle False Claims Act Allegations for $9.68 million. Moreover, as part of the settlement agreement, the company admits that it knowingly billed Medicare for portable oxygen tanks (contents) that patients didn't need or use -- and regardless of whether the tanks were actually delivered.

DOJ: Alere Inc. knowingly sold unreliable diagnostic devices

A former Alere Inc. employee who blew the whistle on the medical device manufacturer will receive approximately $5.6 million as a reward. The former senior quality control analyst exposed millions of dollars in false claims against Medicare, Medicaid and other federal healthcare programs.

U.S. Attorney settles False Claims Act case with hospice provider

A private, for-profit hospice provider and its CEO have agreed to settle False Claims Act allegations brought by the federal government. The company and its head have agreed to pay $1,240,000 to resolve claims that they fraudulently billed Medicare and Medicaid.

Imaging group to pay $16.2 million in False Claims Act judgment

Orthopaedic and Neuro Imaging LLC (ONI) and its owner were accused of submitting some $6,125,947.13 in false claims to Medicare. A default judgment has been issued against them. Generally, a default judgment is entered when defendants fail to defend themselves in court.

Whistleblower to receive $246,500+ in unnecessary opioids case

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 practitioner services. The federal government and the State of Tennessee brought suit and have just settled with a chiropractor, a nurse practitioner and several now-closed pain clinics. As a result of the whistleblower's actions, she will receive more than $246,500 -- a share in the total settlements.

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