The U.S. Attorney’s Office for the Southern District of New York and New York Attorney General’s Office filed intervening complaints in a whistleblower lawsuit against Continuum Health Partners, Inc., Beth Israel Medical Center, and St. Luke’s-Roosevelt Hospital Center for failing to repay money they received after improperly billing the state’s Medicaid Program. According to the…
Government Boasts Success of Anti-Fraud Measures
The Centers for Medicare and Medicaid Services (CMS) announced that its Fraud Prevention System, a system that uses predictive analytics to identify potential fraud, prevented more than $210 million in improper Medicare payments over the last fiscal year–twice the amount the government saved in the program’s inaugural year. According to CMS’ report to Congress, using…
Omnicare Reaches $124 Million Settlement Involving Healthcare Fraud Allegations
Omnicare Inc., the nation’s largest provider of pharmaceuticals and pharmacy services to nursing homes, will pay $124.24 million for allegedly providing improper discounts to nursing facilities to induce them to select Omnicare as their pharmacy provider. The settlement resolves allegations that Omnicare submitted false claims by entering into below-cost contracts to supply its drugs to…
Omnicare Reaches $124 Million Settlement Involving Healthcare Fraud Allegations
Omnicare Inc., the nation’s largest provider of pharmaceuticals and pharmacy services to nursing homes, will pay $124.24 million for allegedly providing improper discounts to nursing facilities to induce them to select Omnicare as their pharmacy provider. The settlement resolves allegations that Omnicare submitted false claims by entering into below-cost contracts to supply its drugs to…
Government Boasts Success of Anti-Fraud Measures
The Centers for Medicare and Medicaid Services (CMS) announced that its Fraud Prevention System, a system that uses predictive analytics to identify potential fraud, prevented more than $210 million in improper Medicare payments over the last fiscal year–twice the amount the government saved in the program’s inaugural year. According to CMS’ report to Congress, using…
GAO Finds $14 Billion Spent on Improper Medicaid Billing
A growing number of state Medicaid programs are utilizing managed care organizations (MCOs) to deliver healthcare services to beneficiaries. According to a new report from the Government Accountability Office (GAO), however, gaps in oversight may have caused Medicaid programs to wrongly pay out more than $14 billion last year to MCOs for treatments or services…
CitiMortgage SVP: Lending Fraud Continued After Settlement
According to a recently unsealed qui tam case in the Southern District of New York, CitiMortgage continued to issue faulty loans backed by government insurers, even after it agreed to pay $158 million to settle similar allegations in February 2012. The complaint alleges that loan officers still fail to properly verify borrower qualifications and violate…
Jury Finds SF Garbage Company Collected $1.36 Million in Fraudulent Bonuses
On June 17, a jury found that Recology, San Francisco’s garbage collection contractor, improperly collected $1.36 million in bonus payments from the city. The lawsuit, filed by a former employee in 2010, accused Recology of manipulating waste diversion records in order to qualify for bonus payments–an incentive scheme set up by the city to award…
U.S. Intervenes in FCA Case Against IPC
The United States joined a case filed by a whistleblower alleging that IPC The Hospitalist Company, Inc. overbilled for hospital evaluation and management services. IPC is one of the largest hospitalist companies in the United States. According to the government, IPC charged Medicare, Medicaid, and other government insurers for more costly levels of care than…
SEC Settles First Dodd-Frank Retaliation Case
Paradigm Capital Management and Candace King Weir will pay $2.2 million to settle allegations that Ms. Weir’s company violated the securities laws, including retaliating against an employee who brought information to the SEC. According to the allegations, Ms. Weir arranged for trades between Paradigm Capital Management and C.L. King, another company she owned, in order…