A Texas doctor will receive $4.9 million as a reward for blowing the whistle on seven ambulance industry defendants who allegedly paid kickbacks to municipal entities in several states in exchange for lucrative ambulance business. The alleged kickbacks violated the federal Anti-Kickback Statute, which prohibits offering, paying, soliciting or receiving remuneration in order to induce referrals. The scheme allegedly resulted in false claims being submitted to Medicare and Medicaid, which violated the False Claims Act.
"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."
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.
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.
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.
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.
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.
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.
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.
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.