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False Claims Act Lawsuit Settled Against South Carolina’s Covan World Wide Movers, Inc.

Posted by on Friday, August 7th, 2015

In a recent false claims settlement, South Carolina’s Covan World Wide Moving, Inc. has agreed to pay a hefty sum to settle claims it inflated invoices.

False claims occur in virtually every aspect of federal contract work. In today’s case, we look at a recent multi-faceted settlement, the details of which have been ongoing for most of 2015, involving relocation services for U.S. military members. The case was brought to light by several employees of the moving companies after noticing suspicious billing practices with regard to the weight of the freight hauled under the government contract. The overall settlement topped $1.2 billion, and the most recent component of the agreement was reached between the defendant – Covan World Wide Movers, Inc. – and the District of South Carolina, where the company maintains several offices and hubs.

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OIG Raises Concerns Over Possible Abuse of Controlled Substances Within Medicare Part D

Posted by on Thursday, August 6th, 2015

According to a recent report by the OIG, certain geographic hotspots are believed to be engaging in Medicare fraud through unlawful disbursement of controlled and non-controlled substances.
Image source: Wikimedia Commons

In yesterday’s post, we introduced a possible correlation between the growth of Medicare spending on highly-addictive prescription drugs and potential Medicare fraud by wayward retail pharmacies. As a bit of review, spending for Medicare Part D administration has increased 136 percent overall since 2006. However, spending for opioids – including OxyContin and Morphine – has increased over 156 percent within the same time period, leaving authorities to inquire as to how or why spending in this area has increased so rapidly.

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New Report Highlights Growing Trend of Medicare Part D Fraud & Opioid Abuse

Posted by on Wednesday, August 5th, 2015

Medicare Part D provides prescription drug coverage for enrollees. However, a recent report highlights possible abuse and fraud – particularly pertaining to addictive opioids.
Image source: Wikimedia Commons

Over the next two posts, we will examine a recent report published by the Office of Inspector General, along with the U.S. Department of Health and Human Services. In the report, which is entitled “Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D,”1 authorities review the alarming epidemic of drug diversion and prescription drug abuse, particularly among the elderly population eligible for Medicare benefits.

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  1. http://oig.hhs.gov/oei/reports/oei-02-15-00190.pdf

UPDATE: Georgia Hospital Settles Amid Allegations of Unlawful Kickbacks in Exchange for Obstetric Referrals

Posted by on Tuesday, August 4th, 2015

The government recently settled with a Georgia hospital chain amid allegations it was exploiting the surrounding population of undocumented women in need of prenatal obstetric care.
Image source: Wikimedia Commons

In 2014, we covered the government’s decision to intervene in a False Claims Act lawsuit involving several Central Georgia-area hospitals and possible Medicaid fraud. As a bit of review, the case involved several hospitals, including Tenet Healthcare, Health Management Associates, and Clinica de la Mama, an OB/GYN facility geared toward undocumented and migrant Hispanic women.

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Berger & Montague, P.C. Exploring Possible Fraud Within Indexed Universal Life Insurance Policies

Posted by on Monday, August 3rd, 2015

In a class action investigation, Berger & Montague, P.C. has unearthed evidence to suggest that Indexed Universal Life Insurance policies may be based on fraudulently inflated return evaluations.
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An indexed universal life insurance policy is a financial product designed to offer policyholders a variable return rate on their insurance funds, usually tied to the daily rates as set by entities like Standard & Poor’s. More specifically, these policies – which are predominantly similar to traditional universal life insurance policies – allow policyholders to allocate cash values to certain equity index accounts with the goal of achieving maximum possible returns and, ultimately, a higher yield for the insurance policy beneficiary.

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Multiple Whistleblower Lawsuits Against Novartis Could Amount to $3 Billion in Fines and Penalties

Posted by on Thursday, July 30th, 2015

Novartis is facing a record $3.35 billion in fines and penalties from the Department of Justice over improperly marketing certain high-potency, high-risk drugs.
Image source: Wikimedia Commons

In one of the largest potential whistleblower settlements1 to date, drug maker Novartis is facing a staggering $3.35 billion in fines and penalties from the Department of Justice over two of its best-selling prescription medications: Exjade and a treatment for kidney transplant patients. In a separate concurrent whistleblower lawsuit against the “repeat offender,” a whistleblower has alleged that the company wrongfully promoted two high-potency cancer drugs known to cause severe side effects. Overall, the company is looking at a historic penalty and possible exclusion from all further participation in federal and state healthcare insurance programs.

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  1.  http://taf.org/blog/costly-kickbacks-novartis-potentially-faces-3-billion-fines

UPDATE: Tuomey Healthcare System Loses Appeal; Owes Quarter-Billion in False Claims Act Verdict

Posted by on Tuesday, July 28th, 2015

In a recent South Carolina appeal, Tuomey Healthcare System lost its bid to overturn a $237 million False Claims Act verdict.
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In 2013, we covered a historic False Claims Act verdict entered by the U.S District Court for the District of South Carolina against Tuomey Healthcare System. In that case, a whistleblower-physician alleged that the company was requiring doctors to agree to referral schemes that violated both the False Claims Act and the Stark Law, as kickbacks are expressly prohibited under both statutes.

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VMWare Settles FCA Allegations for $75 Million Following Five Year Investigation

Posted by on Monday, July 27th, 2015

Software company VMWare has agreed to pay $75 million to settle claims it engaged in illegal price-fixing misconduct.
Image source: Wikimedia Commons

Government contract work can be extremely lucrative, providing companies with a regular stream of income and dependable job security for their employees. Accordingly, the risk for rampant fraud and abuse of taxpayer resources is also very common, particularly when it comes to adhering to the ironclad provisions in the government’s contractual agreements.

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Indianapolis Health Network Agrees to Settle False Claims Act Allegations for $20 Million

Posted by on Friday, July 24th, 2015

Indianapolis Heath Network false claims

Indiana’s Community Health Network has agreed to settle claims it intentionally overbilled Medicare and Medicaid for procedures at ambulatory surgery centers.
Image source: Wikimedia Commons

When it comes to reimbursement for surgical procedures, Medicare and Medicaid maintain strict guidelines with regard to the location of the surgery and whether it took place in a hospital or independent facility. Recognizing that hospitals have a much higher overhead rate, and generally cost more to operate and maintain, surgical procedures performed in a hospital setting can be reimbursed at a higher rate than those performed in an office or ambulatory surgical center.

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The Children’s Hospital Agrees to Pay Nearly $13 Million to Settle False Claims Act Allegations

Posted by on Thursday, July 23rd, 2015

Children's Hospital False Claims Act settlement

A prominent pediatric care hospital is accused of committing healthcare fraud against the government, resulting in a $12.9 million False Claims Act settlement.
Image source: Wikimedia Commons

Proving that healthcare fraud truly knows no bounds, the Children’s National Medical Center – through its Children’s Hospital Medical Graduate Program – is accused of engaging in costly and wasteful healthcare fraud involving various pediatric patients enrolled in the Medicaid program. Consequently, the hospital has agreed to pay a staggering $12.9 million in lieu of defending the claims, but has not admitted to any wrongdoing in the matter.

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