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May 15, 2014 Healthcare Fraud

St. Jude’s Medical, Inc. Under Investigation by DOJ for Possible False Claims Act Violations

Costly fraud against the U.S. government can occur in virtually any sector; however, it is being discovered within the medical and healthcare sector with increasing consistency. In a recent filing with the Securities and Exchange Commission, St. Jude’s Medical, Inc., a global medical device manufacturer, has revealed it is under […]
May 14, 2014 Healthcare Fraud

U.S. Government Intervenes in Power Wheelchair False Claims Case Against Orbit Medical Inc.

Power wheelchair claims are one of the most costly medical device codes submitted to Medicare and Medicaid each year. So much so, that the Office of Inspector General conducted a study in 2001 to determine whether these chairs are actually “medically necessary” in most cases and, if so, whether a […]
May 13, 2014 Healthcare Fraud

Bringing the HEAT – Joint Task Force Invaluable in Fight Against Healthcare Fraud

In 2012 alone, the False Claims Act (“FCA”) was responsible for recovering over $2 billion stolen through healthcare fraud, Medicare scams, and unlawful billing practices. Ending healthcare fraud has been a non-stop pursuit over the past several years due to the implementation of several programs and task forces aimed at […]
May 12, 2014 Healthcare Fraud

Jacksonville Hospital Baptist Health Settles False Claims Act Lawsuit for $2.5 Million

Jacksonville-area hospital Baptist Health, through its parent company, has agreed to pay $2.5 million to settle a whistleblower lawsuit alleging healthcare fraud. The hospital is accused of having unlawfully exploited Medicare and Medicaid funds by billing the government for services not rendered or for services rendered that were not medically […]
May 9, 2014 Healthcare Fraud

Tennessee Substance Abuse Facility New Life Lodge Settles Allegations of Medicaid Fraud

In a recent settlement out of Tennessee, California-based CRC Health Group, Inc. has agreed to pay $9.25 million to settle allegations of Medicaid fraud involving one of its addiction treatment centers located in the city of Burns. The settlement is the result of a joint investigation by the Tennessee Attorney […]
May 7, 2014 Healthcare Fraud

Doctor Settles Allegations of Performing Unnecessary Nasal Surgery on Pediatric Medicaid Patients

In yet another healthcare fraud case, an Oklahoma-based hospital, its parent company Health Management Associates, and Dr. Daniel Castro have agreed to settle a whistleblower lawsuit filed under the federal False Claims Act and its Oklahoma counterpart. According to the allegations found in the complaint, the medical professionals involved were […]
May 6, 2014 Healthcare Fraud

Hope Center Institute Submits False Claims to Federal Government, Settles for $2.9 Million

The Kansas-based cancer center known as Hope Cancer Institute and one of its physicians recently settled with the U.S. government over allegations of fraudulent billing practices. In the healthcare industry alone, the False Claims Act has been pivotal in recovering billions of dollars on behalf of American taxpayers. In fact, […]
May 5, 2014 False Claims Act Legal News

Federal Circuit Courts Split on Pivotal “First to File” Issue

The False Claims Act is a piece of federal legislation. Therefore, lawsuits arising under its provisions are settled by the federal District, Circuit, and Supreme Courts. While FCA Supreme Court precedent is continuing to emerge each year, District and Circuit courts are regularly faced with issues directly impacting whistleblowers and […]
May 2, 2014 Healthcare Fraud

Pharmacy Company Astellas to Pay $7.3 Million in False Claims Act Settlement

The Department of Justice, in concert with several states’ attorneys general, recently announced a settlement against Astellas Pharma U.S., Inc., based in Northbrook, Illinois. The case involved substantial allegations of off-label marketing practices aimed at pediatric federal healthcare patients. As you well know, it is considered a violation of the […]
May 1, 2014 False Claims Act Legal News

Eighth Circuit Confirms $8 Million Whistleblower Reward

In a price-fixing case originating in 2004, two whistleblowers have finally reaped their reward under the False Claims Act and its qui tam provisions. In Rille, ex rel. United States v. PricewaterhouseCoopers, LLC, et al., two relators successfully defeated the DOJ’s motion to preclude recovery of the whistleblower reward citing […]
April 30, 2014 Healthcare Fraud

Louisiana-Based Home Healthcare Company Amedisys to Pay $150 Million to Settle False Claims Act Allegations

Amedisys, Inc. and its affiliates have agreed to pay $150 million to the federal government in order to settle allegations of fraud and misconduct. According to statements revealed earlier this month, the Department of Justice settled with the home healthcare and hospice provider after uncovering several years’ worth of improper […]
April 29, 2014 Mortgage Fraud

Office of Inspector General Offers Suggestions to the DOJ to Combat Mortgage Fraud

In yesterday’s post, we began examining a recent audit of the Department of Justice with regard to its mortgage fraud division. Specifically, the Office of Inspector general reviewed several reports offered by the DOJ since the 2008 housing bubble burst and questioned the Department’s record-keeping and prioritization of this devastating […]
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