The California Division of Workers’ Compensation (DWC) announced new suspensions twice in October. It suspended eight medical providers from participating in the state’s workers’ compensation system in early October and then three more shortly after. The total suspensions for 2017 are now up to 49. These suspensions are part of…
In early October, a California federal judge dismissed without prejudice a False Claims Act (FCA) lawsuit against UnitedHealth Group Inc. (UHG). The suit, U.S. ex rel. Swoben v. Secure Horizons, et al., alleged UHG ignored questionable diagnoses that led to higher reimbursements through the Medicare Advantage program. This is significant…
On Sept. 22, the U.S. Department of Justice announced that drug manufacturer, Aegerion Pharmaceuticals Inc., a subsidiary of Novelion Therapeutics Inc., has agreed to plead guilty to criminal charges and pay a multi-million settlement of to resolve allegations of civil false claims. The Criminal Charges The criminal charges against Aegerion…
There is a misconception that the U.S. Department of Justice (DOJ) is mainly interested in health care fraud and violations of the False Claim Act (FCA) from large corporations like major insurers or pharmaceutical manufacturers. However, this is not true. The DOJ is on a mission to uncover health care…
In early September, the U.S. Department of Justice announced that Galena (Galena) Biopharma Inc. will pay more than $7.55 million in a False Claims Act (FCA) settlement. The U.S. alleges that Galena paid various types of kickbacks to encourage physicians to prescribe Abstral, which is a fentanyl-based drug, also known…
In early September, the U.S. Department of Justice (DOJ) announced pharmaceutical manufacturer Novo Nordisk Inc. has agreed to pay $58.65 million for failing to comply with a Food and Drug Administration (FDA) mandated Risk Evaluation and Mitigation Strategy (REMS) program. The REMS was for Novo Nordisk’s Type II diabetes medication…
CHRISTUS St. Vincent Regional Medical Center, located in Santa Fe, New Mexico, and CHRISTUS Health, located in Irving, Texas, have agreed with the U.S. Department of Justice to resolve allegations of violating the federal False Claims Act (FCA) with a settlement of $12.24 million plus interest. A Qui Tam Suit…
Whistleblower George Gage has made it clear he is not happy with the current judge for his qui tam case, U.S. District Judge Sam Sparks. Gage claims that throughout his False Claims Act (FCA) case against Rolls-Royce North America Inc., Judge Sparks has handed down orders that attempt to divest…
The U.S. Department of Justice (DOJ) announced August 18 that the owner and operator of five home health agencies located in the Houston area, Godwin Oriakhi, 61, was sentenced to 480 months in prison for conspiring to defraud Medicare and the Texas’ Medicaid programs: Home and Community-Based Service (HCBS) and…
Pharmaceutical companies Mylan Inc. and Mylan Specialty L.P. agree to pay $465 million to settle a lawsuit brought under the False Claims Act (FCA). According to the FCA-based suit brought by a whistleblower, Mylan intentionally misclassified EpiPen as a generic drug – knowing it was a brand name drug –…