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$26M Settlement in CareSource Qui Tam Lawsuit

Posted on February 3rd, 2011 No Comments

CareSource, the largest Medicaid managed care organization in Ohio, has agreed to pay $26,000,000 to settle a Qui Tam lawsuit filed by two former employees.

The United States Department of Justice and Ohio Attorney General Mike Dewine on Wednesday announced the settlement, which acknowledges that the claim of the United States is valued at $59 million. The Department of Justice and Ohio agreed to the reduced amount after CareSource demonstrated that paying the full amount could compromise its ability to provide services to Ohio’s Medicaid population.

The Qui Tam lawsuit alleged that CareSource “knowingly failed to provide required screening, assessment, case management services, data submissions, data reconcilliations, and other case management-related requirements for child enrollees with special health care needs for adults.” The lawsuit also says the defendant “submitted false data to the State of Ohio so that it appeared they were providing these required services” allowing CareSource to “fraudulently retain the incentive portion of the capitation payments, and avoid penalties.”

If you have information pertaining to Medicaid fraud, please contact the Health care fraud attorneys of Tycko & Zavareei by calling 202-973-0900.

Additional $6.3M Recovered in Medicare Fraud Lawsuit

Posted on January 20th, 2011 No Comments

The ongoing Qui Tam lawsuit against a collection of hospitals for an allegedly fraudulent billing practice that cost Medicare millions of dollars has recovered an additional $6.3 million.

The latest whistleblower settlement brings the total amount recovered to $101 million collected from 25 hospitals around the country. The Justice Department announced the latest settlement January 4.

The Qui Tam lawsuit was originally brough by two former employees of Kyphon Inc., now known as Medtronic spine LLC. The lawsuit alleges that kyphoplasty, a type of back surgery that, in most cases, can be safely performed as an outpatient procedure, was costing millions of dollars extra after hospitals routinely kept patients overnight.

The US Department of Justice alleged that retaining kyphoplasty patients overnight benefited hospitals financially, but carried no benefit for the patient.

If you have information pertaining to Medicare fraud, please contact the Medicare fraud attorneys of Tycko & Zavareei by calling 202-973-0900.

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Woman enters guilty plea for Medicare fraud

Posted on January 12th, 2011 No Comments

A Newton, Mississippi woman has pleaded guilty to Medicare fraud in U.S. District Court, admitting to defrauding the government of more than $1.25 million.

51-year-old Patricia Young, then of Chicago, owned and operated a business that claimed to provide psychotherapy services to individuals with Medicare. Through her company, Healthy People 2000, Inc., she allegedly billed Medicare for services never rendered.

Young’s false claims billed to Medicare totaled more than $5 million, of which she received about $1.25 million.

Young could be penalized with up to 10 years in prison and up to $250,000 in fines. She is also required to pay full restitution for the amount defrauded.

If you have information regarding a Medicare fraud scheme against the government, don’t hesitate to contact the healthcare fraud attorneys of Tycko & Zavareei, LLP, today by calling 202-973-0900.

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Christus Settlement Part of $63M Whistleblower Case

Posted on November 9th, 2010 No Comments

Christus Health Systems has agreed to pay almost a million dollars to the federal government as part of a $62.9 million settlement in a larger lawsuit filed in 1998.

According to court documents, Mark Razin, a former employee of Healthcare Financial Advisors Inc., filed the qui tam lawsuit in 1998 claiming the company encouraged hospital to make fraudulent “adjustments” to cost reports in order to secure Medicare reimbursements. The recent Christus settlement resolves a fraudulent Medicare billings lawsuit which dates back to 1988.

According to the qui tam lawsuit, Christus hospitals billed Medicare for advertising and marketing costs, as well as administrative costs. Christus was also found to have failed to disclose the improprieties to a financial intermediary appointed to review cost reports.

Razin, a whistleblower protected under the False Claims Act, stands to receive $970,987 from the Christus settlement.

If you are a whistleblower with information of fraud on the government, please contact the Qui Tam lawyers of Tycko & Zavareei LLP by calling 202-973-0900.

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$750M Settlement in Health Care Fraud Lawsuit

Posted on November 2nd, 2010 No Comments

A Qui Tam lawsuit filed against GlaxoSmithKline has resulted in a $750 million settlement.

The whistleblower lawsuit was filed in 2004, under the False Claims Act, on behalf of former GSK Quality Assurance Manager Cheryl Eckard. The lawsuit alleged that GSK released a topical antibiotic ointment to treat skin infections, called Bactroban, that contaminated with microorganisms.

Eckard led a team of scientists to GSK’s biggest factory in 2002 in an attempt to fix manufacturing violations cited by the FDA. Eckard reported that the problems at the factory required the plant to be shut down because the company could not assure that its product was free from contamination. GSK ignored Eckard’s recommendations, which she then reported to the FDA.

A federal investigation resulted in the seizure of all contaminated pills. The FDA estimates the value of the seizure at $2 billion, the largest in the agency’s history.

If you have information of fraud on government health care programs, please contact the Qui Tam attorneys of Tycko & Zavareei LLP by calling 202-973-0900.

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Illinois Doctor to Pay $20M Qui Tam Settlement

Posted on October 25th, 2010 No Comments

A former cardiologist in Illinois has agreed to pay $20 million to settle a qui tam lawsuit, according to a Department of Justice news release.

The qui tam lawsuit was filed in 2006 against Sushil Sheth, MD. The lawsuit claimed that Dr. Sheth filed fraudulent claims between 2002 and 2007 to Medicare and Medicaid for medical services at the highest level of in-patient cardiac care. The services mentioned in the filings were never performed.

The whistleblower lawsuit was filed by Lokesh Chandra, MD, a physician who worked with Dr. Sheth. She will receive a portion of the recovery collected by the federal government and the state of Illinois under the qui tam provisions of the False Claims Act.

Sheth was sentenced last month to five years in prison for stealing millions of dollars from Medicare and 30 other public and private health care insurance programs.

If you have information about fraud on government health care programs, please contact the Health care faud lawyers of Tycko & Zavareei LLP by calling 202-973-0900.

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AARP Joins Johnson & Johnson Qui Tam Lawsuit

Posted on October 22nd, 2010 No Comments

The AARP, formerly known as the American Association of Retired Persons, has joined a qui tam lawsuit filed against Abbott Laboratories, Johnson & Johnson, and Boston Scientific.

According to court documents, the lawsuit claims the three companies deceived the United States Food and Drug Administration to receive approval for biliary stents, which the companies then illegally marketed for off-label uses. Marketed as vascular stents, the devices were incorrectly placed in senior patients to treat vascular disease without FDA approval.

The companies have also been accused of paying illegal kickbacks by discounting purchasing contracts to healthcare providers who opted to use the biliary stents as unapproved vascular stents.

The lawsuit was filed by a former sales representative and manger for Guidant, a subsidiary of Boston Scientific and Abbott Laboratories. The AARP signed on as co-counsel.

If you have information showing that a healthcare provider has committed fraud on the government, you may have the basis for a Qui Tam lawsuit. For more information on whistleblower lawsuits, please contact the Qui Tam attorneys of Tycko & Zavareei, LLP, by calling 202-973-0900.

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Christus Health Systems to Pay $1M in Qui Tam Settlement

Posted on October 6th, 2010 No Comments

Houston, Texas-based hospital chain Christus Health Systems has agreed to pay nearly $1 million to settle whistleblower allegations that it engaged in Medicare fraud.

The settlement will resolve a qui tam lawsuit filed by a whistleblower which alleged fraudulent medicare billings as far back as 1988. The lawsuit has been “under seal” and was not known to the public until Tuesday, when a federal district court judge in Los Angeles unsealed the case. Christus was accused of billing Medicare for ineligible costs and expenses, as well as failing to disclose overpayments.

Attorney Mary A. Inman, who represented the whistleblower released a statement regarding the case: “Healthcare providers must disclose to Medicare any overpayments that result from reimbursement errors,” Inman wrote. “The Medicare system depends on the honesty of hospitals and other healthcare providers. They shouldn’t be trying to game the system.”

Christus will pay the federal government a total of $970,987 to settle the lawsuit.

If you are a whistleblower and would like more information on Qui Tam lawsuits, please contact the Qui Tam Lawyers of Tycko & Zavareei, LLP, by calling 202-973-0900.

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Omnicare to Pay $21M to Settle Qui Tam Lawsuit

Posted on September 22nd, 2010 No Comments

Omnicare Inc. has agreed to pay $21 million to settle allegations that it defrauded the Medicaid programs of Massachusetts and Michigan.

A whistleblower complaint alleged that Omnicare charged Medicaid patients, in both states, higher prices for drugs than it charged private insurers. The practice generated hundreds of millions in illegal profits at the expense of the taxpayers. Omnicare has agreed to pay $9.5 million to settle Massachusetts claims and $11.6 million for Michigan claims, however the company has admitted no wrongdoing.

Massachusetts and Michigan require drug manufacturers to give the Medicaid program their “most favored customer” price for pharmaceuticals.

According to documents filed with the Securities and Exchange Commission, the settlement agreement with Michigan and Massachusetts includes a provision to dismiss claims against the company included in another qui tam lawsuit that is pending in Illinois.

If you are a whistleblower with information about health care fraud, you may be able to bring a Qui Tam lawsuit under the False Claims Act. Please contact the Qui Tam lawyers of Tycko & Zavareei, LLP, at 202-973-0900 today.

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Botox Whistleblower Case Settles for $6M

Posted on September 3rd, 2010 No Comments

Pharmaceutical manufacturer Allergan, Inc. has agreed to pay $600 million to settle a whistleblower claim they paid illegal remuneration to health care providers to induce them to prescribe the company’s products.

The whistleblowers alleged that Allergan implemented a sophisticated marketing plan with the purpose of inducing physicians to prescribe Botox Therapeutic for various off-label uses which were neither FDA-approved nor demonstrated to be safe and effective.

According to the lawsuits, Allergan understood the lack of scientific evidence that Botox was safe for these off-label uses when the company initiated the illegal marketing scheme.

To settle the lawsuit, filed under the False Claims Act, Allergan will pay the federal government $375 million in criminal fines an $210,150,000 for the civil allegations.

If you are a whistleblower with information about fraud on the government, you may be able to bring a Qui Tam lawsuit under the False Claims Act. Please contact the Qui Tam Attorneys of Tycko & Zavareei, LLP, at 202-973-0900 today.

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