CareCore National, LLC and the U.S. Department of Justice entered into a settlement agreement, according to a May announcement. CareCore will pay $54 million to resolve a False Claims Act suit based on allegations it fraudulently billed government insurance programs. The business provides pre-authorization/pre-certification services to managed care plans. It…
The U.S. Department of Justice and CVS Health Corp.’s Omnicare Inc. have settled a suit based on the federal False Claims Act for $8 million. Omnicare is the country’s largest nursing home pharmacy. It was formed in 1981 and acquired by CVS Health in 2015. Prior to this takeover, the…
The federal government has once against settled a qui tam claim based on the False Claims Act (FCA) with a medical provider. In April, the government announced it came to an agreement with dermatologist and surgeon Dr. Norman A. Brooks, M.D., for $2,681.400 based on false billings to Medicare. Dr.…
As concerned citizens and as a health care fraud law firm, our team continues to be pleased with the terrific successes whistleblowers are having using the False Claims Act, Anti-Kickback Statute and related federal and state statutes to fight fraud in the medical field. A major settlement announced this month…
By its nature, fraud is a crime of secrets. The depth and breadth of these secrets are part of the reasons why whistleblowers are such an essential part of the fight against health care fraud. The law recognizes this and both rewards and protects health care fraud whistleblowers for their…
It is a simple concept — health care should be dictated by the patient’s needs rather than the provider’s fiscal interest. While most providers adhere to this core principle, far too many do not, especially in the long-term and nursing home care arenas. Nursing home billing fraud, including rehabilitative therapy fraud,…
The relationship between health care and money is the crux of some of the biggest policy debates of our time. Still, while much is debated, there are also many principles that most Americans agree should hold true. One such maxim – Medical decisions should be based on the best interests…
One of the reasons we write about health care fraud is to make people aware of the true cost of these schemes. These crimes are ultimately financial in nature, with scammers stealing billions (not a typo!) each year from government programs that are already operating on strained budgets. As if…
When it comes to the world of health care fraud, there’s one truth we cannot emphasize enough – Honest individuals are the key to winning the fight against fraud. It is a truth we see again and again in our work as a whistleblower’s law firm. The False Claims Act…
Sometimes health care fraud is a well-known secret, something many in a company’s leadership know about and either passively or actively conceal. Likewise, a number of lower-level employees may know about and be asked to help perpetuate the fraud. Fraud takes cooperation. How does this happen when almost everyone we…