In an undercover story for ABC News, a Medicare patient in good health left the doctor’s office diagnosed as homebound and suffering from Type 2 diabetes, two internal infections, incontinence, and severe shortness of breath. The doctor never tested for diabetes, though, and the patient specifically told the doctor that she did not suffer from…
Beth Israel to Pay $13 Million
Beth Israel Medical Center has agreed to pay more than $13 million to settle allegations that the hospital “turbocharged” its billing for Medicare patients in order to take advantage of Medicare outlier payments. Medicare allows additional outlier reimbursement for patients whose treatment is more costly than the average patient. The hospital admitted that it inflated…
Two Pharmaceutical Settlements for NY, Companies to Pay $28 Million
The NY Attorney General’s Office announced settlements with two pharmaceutical companies accused of violating the False Claims Act. Dava Pharmaceuticals will pay $11 million to resolve allegations that it underpaid rebates owed under the Medicaid Prescription Drug Rebate Program by fraudulently classifying its drugs as non-innovator drugs. KV Pharmaceutical company will pay $17 million for…
DOJ Intervenes in American Commercial College Case
The DOJ has intervened in a False Claims Act case against American Commercial College, Inc., a for-profit college. According to the complaint, the college failed to comply with federal regulations that require a college receive no more than 90% of its income from federal student aid. Similar suits have been filed against other for-profit colleges,…
Mylan Settles Average Wholesale Price Case for $57 Million
Mylan Inc. has agreed to pay $57 million to resolve allegations that it fraudulently increased the reimbursement amount for its drugs by reporting inflated prices. This case is one of several average wholesale price fraud cases brought by corporate whistleblower Ven-A-Care. The whistle-blowing company has recovered over $3 billion for the federal government. Read the…
NY AG and Manhattan USAO Investigating State Street
According to a recent disclosure by the company, State Street Corp. has received inquiries from both the New York Attorney General’s office and the U.S. Attorney’s Office in New York regarding its foreign exchange business. California filed a suit against State Street in 2009 alleging that the company had charged its standing instruction clients, such…
Dallas Doctor Arrested for Submitting $375 Million in Fake Bills
The FBI arrested a Dallas physician for healthcare fraud. According to the indictment, the physician was responsible for over $375 million in fraudulent billings. The physician and his office assistant allegedly obtained signatures from random individuals, including homeless people who were each paid $50, in order to bill for services that were never provided. Over…
Hospital Administrator Charged in $116 Million Kickback Case
A hospital administrator in Texas has pled guilty to conspiracy to commit health care fraud and conspiracy to pay kickbacks for his role in a $116 million kickback scheme. Mr. Mohammed Khan paid kickbacks to patient recruiters and owners of nursing homes to encourage them to refer patients to Riverside General Hospital’s mental health clinics. …
Judge Ups Whistleblower Reward in Verizon Case
A federal judge has increased the share that a whistleblower will receive from a $93.5 million settlement that resulted from his efforts. The whistleblower filed a qui tam case in 2007 alleging that Verizon had impermissibly charged the federal government for surcharges which were already included in its telecommunications contract. The government had minimized the…
French Energy Company to Pay $15 Million for Underreporting Gas Royalties
French energy company Total has agreed to pay $15 million to settle a False Claims Act suit alleging that it underpaid royalties by reporting processed gas as unprocessed gas. BP and Royal Dutch Shell settled related suits brought by the same whistleblower last year for $20.5 million and $2.3 million respectively. Read the entire article,…