Health Care Fraud Lawyers | Tycko & Zavareei LLP

Whistleblower to receive $5 million in Medicare fraud lawsuit

Posted on December 29th, 2011 No Comments

A division of GE Healthcare, Amsersham Biosciences, was accused of Medicare fraud in 2006. A Michigan man acted as the whistleblower in the case when he informed the government about the company providing false information regarding the radiopharmaceutical agent, Myoview.

The whistleblower claimed that Amsersham Biosciences committed fraud when they relayed false information to the Medicare program between 2000 and 2003. The company was charged with diluting the agent as well as increasing the prices for the product.

The lawsuit has been settled and GE Healthcare has agreed to pay $30 million. The whistleblower who shed light on the fraud will receive $5 million for his part in the lawsuit.

If you have information regarding health care fraud and are interested in filing a Qui Tam lawsuit, please contact the health care fraud lawyers of Tycko & Zavareei, LLP by calling 202-973-0900 today.

Medicare fraud cases increase in 2011

Posted on December 16th, 2011 No Comments

The fiscal year 2011 brought with it an increased number of health care fraud cases that federal prosecutors brought to court.

This year in the United States there were 1,235 cases of health care fraud. Miami, Florida was the first in the nation for the number of Medicare fraud cases, followed by Houston, Texas. Those two cities combined accounted for one out of every five cases of health care fraud.

Government officials believe that health care fraud costs the government $70 billion annually.

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Seven States Intervene in Qui Tam Medicaid Fraud Lawsuit

Posted on August 2nd, 2011 No Comments

Seven states have intervened in a qui tam lawsuit filed against Amgen pharmaceuticals.

According to court documents, Amgen is accused of defrauding Medicaid to boost sales of its anemia treatment Aranesp. The whistleblower lawsuit was filed by former Amgen employee Kassie Westmoreland. She claims the company put up to 19 percent more of the Aranesp medication into each single-dose vial as a bonus and then encouraged health care providers to bill the overage to Medicaid. Westmoreland also alleges that Amgen and the drug’s other marketers and distributors offered sham consulting agreements and luxurious retreats to encourage providers to buy Aranesp.

U.S. District Judge William Young dismissed the qui tam lawsuit saying that the plaintiffs failed to identify state laws that conditioned Medicaid payment on compliance with anti-kickback statutes. A federal appeals court rejected Young’s reliance on this requirement, however, ruling that the plaintiffs only needed to show that each state’s program preconditions claim payment on the understanding that no kickbacks influenced the claim.

“The question here is whether claims submitted to the seven state Medicaid programs misrepresented compliance with a precondition of payment recognized by those particular programs,” Chief Judge Sandra Lynch wrote in the court’s decision.

If you have information on Medicaid fraud, please contact a Medicaid fraud lawyer of Tycko & Zavareei, LLP, by calling 202-973-0900.

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Medicare Fraud Lawsuit Alleges Doctor Implanted Unnecessary Heart Stents

Posted on July 5th, 2011 No Comments

A doctor in Tennessee is the subject of a qui tam lawsuit claiming he implanted heart stents into patients when they were not medically necessary.

According to court documents, the United States Department of Justice is investigating Dr. Elie Hage Korban, of the Heart and Vascular Center of West Tennessee, for performing unnecessary cardiac operations. The investigation stems from a qui tam lawsuit filed by Dr. Wood Deming of Regional Cardiology Consultants against officials at Jackson-Madison County General Hospital.

The qui tam lawsuit claims Korban conducted unneeded cardiac tests, performed unnecessary angioplasty, and inserted unnecessary stents in patients since 2003. Deming contends that, by conducting the unnecessary surgeries and procedures, Korban defrauded the government by filing false Medicare reimbursement claims.

The lawsuit alleges Korban would order unnecessary tests which would come back negative, but he would falsify records to indicate that the patient had symptoms that would require coronary stents and other surgeries.

If you have information regarding healthcare fraud, please contact the Medicare fraud lawyers of Tycko & Zavareei, LLP, by calling 202-973-0900.

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WellCare settles Medicaid fraud lawsuit

Posted on June 17th, 2011 No Comments

Last month, Florida-based company WellCare settled a lawsuit filed against them accusing them of Medicaid fraud. The lawsuit was filed by 5 qui tam whistleblowers. 9 states, the Civil Division of the U.S. Department of Justice, and the Office of Inspector General of the U.S. Department of Health and Human Services joined in the allegations.

In their settlement, WellCare agreed to pay the Department of Justice $137.5 million. Furthermore, WellCare agreed to hire a third party to track the company’ compliance with federal and state laws. Also, the settlement says that the company does not admit or deny the fraud allegations.

WellCare was first accused of $40 million in fraud by multiple police departments in 2008.

To discuss a qui tam heathcare fraud case with an experienced attorney, contact the Qui Tam lawyers of Tycko & Zavareei LLP at 202-973-0900 today.

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$241M Settlement in CA Healthcare Fraud Qui Tam Lawsuit

Posted on June 1st, 2011 No Comments

Quest Diagnostics has agreed to pay $241 million to settle a qui tam lawsuit alleging the company overcharged California’s Medi-Cal program.

California Attorney General Kamala D. Harris announced the settlement on Friday, saying it was the largest recovery in the history of California’s False Claims Act. “In this time of shrinking budgets, this historic settlement affirms that Medi-Cal exists to help the state’s neediest families, rather than to illicitly line private pockets,” Harris said. “Medi-Cal providers and other who try to cheat the state through false claims and illegal kickbacks should know that my office is watching and will prosecute.”

The settlement with Quest is the result of a qui tam lawsuit filed in 2005 which claimed the company systematically overcharged the state’s Medi-Cal program for more than 15 years. The lawsuit also alleged that Quest gave illegal kickbacks in the form of discounted or free testing to doctors, hospitals, and clinics that referred Medi-Cal patients and other business to the labs.

California laws states that no provider can charge Medi-Cal “for any service more than would have been charged for the same service to other purchasers of comparable services under comparable circumstance.”

If you have information on healthcare fraud, please contact the Qui Tam Attorneys of Tycko & Zavareei, LLP, at 202-973-0900.

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Nursing Home Complaint Center Encourages Healthcare Fraud Lawsuits

Posted on March 30th, 2011 No Comments

The Nursing Home Complaint Center is urging healthcare workers to step forward with information pertaining to Medicare or Medicaid fraud.

According to a Nursing Home Complaint Center press release, Medicare fraud is a “$60 billion a year business in the United states.” The agency is encouraging healthcare professionals to come forward with information regarding fraud, saying the Qui Tam provision of the False Claims Act could entitle them to a reward.

“We honestly believe there are 1000’s of US healthcare, or medical industry managers, or executives, who are sitting on a jackpot,” the press release says. “They have clear, and significant proof their employer is knowingly defrauding the federal, or state government’s Medicare, or Medicaid programs, out of millions.”

If you have information regarding healthcare fraud, please contact the Healthcare fraud lawyers of Tycko & Zavareei LLP by calling 202-973-0900.

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Bristol-Myers Squibb Co. Named in Qui Tam Lawsuit

Posted on March 22nd, 2011 No Comments

Bristol-Myers Squibb Co. bribed doctors to prescribe the company’s drugs, according to a qui tam lawsuit filed by the California insurance commissioner.

Insurance Commissioner Dave Jones said at a press conference last week that sales people with Bristol-Myers Squibb Co. provided physicians with trips to basketball camps and other kickbacks to boost prescriptions of its drugs, including Plavix and Pravachol. The lawsuit is the largest health insurance fraud case ever pursued in California, Jones said.

According to court documents, California insurance companies spent $3.5 billion to cover the costs of the drugs involved in the lawsuit. The lawsuit seeks $10,000 for each fraudulent insurance claim caused by the alleged kickbacks, as well as the disgorgement of illegal profits, and triple the amount of damages.

“This sort of fraud has long plagued our health insurance system, leading to billions of dollars annually in added healthcare costs nationally,” Jones said in a statement.

Bristol-Myers spokesman Laura Hortas said the company “believes this lawsuit has no merit and the company will defend itself vigorously.”

If you have information pertaining to healthcare fraud, please contact a Qui Tam Lawyer of Tycko & Zavareei, LLP, by calling 202-973-0900.

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Government Intervenes in Depakote Qui Tam Lawsuits

Posted on March 15th, 2011 No Comments

Federal prosecutors are intervening in three qui tam lawsuits against Abbott Laboratiories that claim the drug maker illegally promoted the epilepsy medication Depakote.

According to officials with the United States Department of Justice, the government has decided to intervene in whistleblower lawsuits brought by former Abbott employees who claim that the company gave doctors seminars in off-label use of Depakote and then lied about what the seminars were about. The lawsuits claim Abbott told doctors they could use Depakote to treat dementia and Alzheimer’s disease.

Depakote is an anti-seizure drug approved by the FDA for the treatment of epilepsy. The drug is not approved for the treatment of dementia or Alzheimer’s disease. It is illegal for drug companies to promote “off-label” uses that have not been approved by the FDA.

The details of the qui tam complaints have been sealed by the Justice Department.

If you have information regarding healthcare fraud, please contact the Qui Tam Lawyers of Tycko & Zavareei, LLP, by calling 202-973-0900.

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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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