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May 12, 2015 Healthcare Fraud

Manhattan District Attorney Announces $60 Million Settlement With Accredo Over Illegal Kickbacks

In a somewhat alarming set of facts, self-proclaimed promoter of “specialty pharmacy solutions” Accredo has agreed to pay $60 million to resolve claims that it engaged in unlawful kickbacks with pharmaceutical company Novartis, Inc. According to the details of the settlement, which were recently unsealed by U.S. District Judge Colleen […]
May 11, 2015 Healthcare Fraud

Medical Center of Central Georgia to Settle Allegations of Illegal Upcoding for $20 Million

Illegal billing practices are one of the most common components of a False Claims Act lawsuit. Oftentimes, healthcare facilities engage in years’ worth of fraudulent billing practices before a courageous whistleblower comes forward with allegations of misconduct. At that time, the federal government may opt to intervene in the matter […]
May 8, 2015 Healthcare Fraud

Office of Inspector General Offers Guidance in Addressing Healthcare Fraud Risk

In yesterday’s post, we introduced a recent effort by the U.S. Department of Health and Human Services’ Office of Inspector General, along with several healthcare advocacy groups and agencies, designed to inform and educate healthcare governing boards as to the importance of maintaining thorough compliance measures. We looked at the […]
May 7, 2015 Healthcare Fraud

Office of Inspector General Offers Guidance in Avoiding Illegal Billing Practices

On April 20, 2015, the DHHS OIG, along with the Association of Healthcare Internal Auditors, the American Health Lawyers Association, and the Healthcare Compliance Association, published a first of its kind educational manual designed to help boards avoid the costly and dangerous practices of upcoding, illegal billing, and submitting false […]
May 6, 2015 Grant Fraud

Vancouver’s nLight Photonics, Inc. to Settle Allegations of Grant Fraud for $420,000

Federal grant money can be used in a variety of ways, including research, product development, enhancement of programs, and to fund projects calculated to benefit the public interest. However, grant funds are a limited source funded by taxpayers and are subject to strict eligibility and award criteria. Not only that, […]
May 5, 2015 SEC Fraud

The SEC’s Whistleblower Awards Program Has Proven to be a “Game Changer”

SEC Chairwoman Marry Jo White in a speech on April 30, 2015 noted that “[t]he program, while clearly developing, has proven to be a game changer.” White noted the increasing volume and quality of tips as well as the powerful incentives to come to the SEC with evidence of wrongdoing. […]
May 5, 2015 Healthcare Fraud

Florida Fertility Clinic Settles Upcoding Allegations With Department of Justice

The Jacksonville Center for Reproductive Medicine (JCRM) recently settled with the Department of Justice amid allegations it billed the government for fertility services at rates above and beyond those allowable under TRICARE guidelines.
May 4, 2015 Healthcare Fraud

Health Labs Agrees to Pay $48.5 Million to Settle Allegations of False Claims

In yet another case of healthcare fraud, Richmond, Virginia-based Health Diagnostics Laboratory and Alameda, California-based Singulex, Inc. have agreed to pay a combined $48.5 million to settle allegations of rampant False Claims Act violations. The case involves two issues under the False Claims Act. First, the labs are alleged to […]
May 1, 2015 Healthcare Fraud

Texas Medical Center Settles Healthcare Fraud Allegations for $21.75 Million

Known as the “Heart Hospital,” the county-owned Citizens Medical Center has agreed to pay a staggering $21.75 million amid allegations it engaged in unlawful kickback schemes with several of its cardiology and emergency medicine practitioners. Under both the False Claims Act and the Stark Law, it is considered unlawful to […]
April 30, 2015 Healthcare Fraud

Pennsylvania Retirement Community Settles With Government Amid Medicare Fraud Allegations

According to a press release by the Department of Justice released on April 15, 2015, Pittsburgh’s Asbury Health Center has agreed to pay $1,331,837.96 to settle claims it did not follow proper protocol with regard to post-hospital skilled nursing services. Under applicable Medicare Part A rules, a patient may be […]
April 29, 2015 Healthcare Fraud

Health and Human Services & DOJ Report Record Healthcare Fraud Year

In yesterday’s post, we began examining the recent report offered jointly by the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) with regard to their accomplishments in combatting wasteful healthcare fraud. In fiscal year 2014, a whopping $3.3 billion was recovered on behalf of taxpayers […]
April 28, 2015 Healthcare Fraud

Health and Human Services Issues Its FY 2014 Healthcare Fraud Report

Over the course of the next two posts, we will examine the recent report released by the Department of Health and Human Services detailing its successes in combating healthcare fraud during fiscal year 2014. With regard to False Claims Act settlements, healthcare fraud remains one of the top issues impacting […]
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