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UPDATE: Tuomey Healthcare Escapes Historic $237M False Claims Verdict with More Manageable $72M

Posted by on Tuesday, November 3rd, 2015

Tuomey Healthcare recently settled a $237 million False Claims verdict entered by the U.S. District Court for the District of South Carolina. | Image Source: Wikimedia Commons

Tuomey Healthcare recently settled a $237 million False Claims verdict entered by the U.S. District Court for the District of South Carolina. | Image Source: Wikimedia Commons

Things may be looking up for Tuomey Healthcare System. Back in 2013, this South Carolina-based healthcare provider was slapped with an initial whopping $276 million fine regarding accusations of physician kickbacks. In a surprising turn of events, the Department of Justice recently announced that it settled with Tuomey for a much lower price tag.

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The False Claims Act in Fiscal Year 2015: Nearly $3 Billion Recovered on Behalf of Taxpayers

Posted by on Monday, November 2nd, 2015

Upon the conclusion of FY 2015, whistleblowers are credited with recovering nearly $2 billion on behalf of the government. | Image: Wikimedia Commons

Upon the conclusion of FY 2015, whistleblowers are credited with recovering nearly $2 billion on behalf of the government. | Image: Wikimedia Commons

In a recent article published by the whistleblower advocacy organization Taxpayers Against Fraud (TAF), an unofficial tabulation of False Claims Act settlements shows a lucrative fiscal year with over $3 billion recovered on behalf of taxpayers, with $2 billion of that represented by whistleblower-initiated cases.

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Warner Chilcott Pleads Guilty to Healthcare Fraud

Posted by on Friday, October 30th, 2015

The U.S. Attorney’s Office for the District of Massachusetts recently announced a $125 million settlement with Warner Chilcott. | Image Source: Wikimedia Commons

The U.S. Attorney’s Office for the District of Massachusetts recently announced a $125 million settlement with Warner Chilcott. | Image Source: Wikimedia Commons

Following an intensive investigation into the practices of pharmaceutical giant Warner Chilcott U.S. Sales LLC, the company has agreed to settle criminal and civil allegations of healthcare fraud for $125 million as well as plead guilty to one felony count of healthcare fraud. In October 2015, the former president of the company, Carl Reichel, was arrested in a related matter pertaining to healthcare fraud and faces similar charges stemming from allegations of illegal kickbacks and other financial misdeeds.

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How to Recognize Fraud: Applying the False Claims Act to Off-Label Marketing

Posted by on Thursday, October 29th, 2015

Off-label marketing is an ongoing problem for healthcare fraud regulators, particularly with regard to Medicare and Medicaid patients. | Image Source: Wikimedia Commons

Off-label marketing is an ongoing problem for healthcare fraud regulators, particularly with regard to Medicare and Medicaid patients. | Image Source: Wikimedia Commons

When it comes to pharmaceutical marketing, it may seem like the options are virtually endless for a company seeking to boost sales and increase exposure of its product. However, despite the relentless television commercials and internet ads, there are a number of restrictions placed on the marketing practices of drug companies. Hefty fines and penalties await those that attempt to market their product for purposes other than those approved by the FDA.

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UPDATE: Novartis Agrees to Pay Mega $390 Million Settlement Amid False Claims Allegations

Posted by on Wednesday, October 28th, 2015

Novartis Pharmaceuticals has agreed to pay $390 million to the Department of Justice in order to settle allegations of fraud. | Image Source: Wikimedia Commons

Novartis Pharmaceuticals has agreed to pay $390 million to the Department of Justice in order to settle allegations of fraud. | Image Source: Wikimedia Commons

With just one week before the start of a False Claims Act trial involving drug manufacturer Novartis Pharmaceuticals, the company decided to avoid the unpredictability of a jury in favor of a calculated $390 million settlement. The company is facing several False Claims Act lawsuits involving a number of different drugs.

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Shipping Subsidiary APL Settles Allegations of Defense Contractor Fraud for $9.8 Million

Posted by on Tuesday, October 27th, 2015

Defense contractor APL has agreed to settle claims it overcharged the government for GPS tracking of shipping containers. | Image Source: Flickr User

Defense contractor APL has agreed to settle claims it overcharged the government for GPS tracking of shipping containers. | Image Source: Flickr User

In yet another case of defense contractor fraud, a company known as APL, Ltd. has agreed to pay $9.8 million to the federal government amid allegations of false billing. APL is a Scottsdale, Arizona-based subsidiary of Singapore’s Neptune Orient Lines Limited, a global shipping company engaged in the transcontinental transport of shipping containers.

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Louisiana’s Westwood Mental Health, LLC Settles Healthcare Fraud Allegations

Posted by on Monday, October 26th, 2015

After following the self-disclosure protocol implemented by the Office of Inspector General, Westwood Mental Health agreed to pay $3.5 million to settle False Claims Act violations with the Department of Justice and the U.S. Attorney’s Office for the Western District of Louisiana. | Image Source: Wikimedia Commons

After following the self-disclosure protocol implemented by the Office of Inspector General, Westwood Mental Health agreed to pay $3.5 million to settle False Claims Act violations with the Department of Justice and the U.S. Attorney’s Office for the Western District of Louisiana. | Image Source: Wikimedia Commons

In some cases, a company facing possible liability under the False Claims Act may opt to self-report and self-disclose the potential violations, which typically results in a lesser fine and may help offset some of the statutory penalties awaiting violators of the Act. In today’s case, we review a recent settlement out of Louisiana arising after Westwood Mental Health, LLC and its parent company followed the self-disclosure protocol implemented by the Department of Health and Human Services to allow companies the opportunity to voluntarily reveal information that may involve violations of the FCA and other statutes. Accordingly, today’s case does not involve a whistleblower. However, the conduct alleged against Westwood is not unlike that seen in other cases involving healthcare fraud.

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Arizona’s Serenity Hospice and Palliative Care Settles Fraud Allegations for $2.2 Million

Posted by on Friday, October 23rd, 2015

In a case within the U.S. District Court for the District of Arizona, a palliative care provider has agreed to pay $2.2 million to resolve allegations it unlawfully billed for non-terminal patients. | Image Source: Flickr User julep67

In a case within the U.S. District Court for the District of Arizona, a palliative care provider has agreed to pay $2.2 million to resolve allegations it unlawfully billed for non-terminal patients. | Image Source: Flickr User julep67

Under federal regulations, government healthcare programs like Medicare and Medicaid are only available to cover end-of-life services once a patient has reached a terminal point in their illness or injury. Unlike curative care, palliative care is only designed to make a patient more comfortable. Program regulations state that curative methods should not be used for patients receiving hospice services.

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Alabama Hospice Center Loses First Round of Contentious False Claims Act Trial

Posted by on Thursday, October 22nd, 2015

An Alabama jury recently ruled in favor of the whistleblower on a pivotal issue in an ongoing trial against hospice provider AseraCare, Inc. | Image Source: Wikimedia Commons

An Alabama jury recently ruled in favor of the whistleblower on a pivotal issue in an ongoing trial against hospice provider AseraCare, Inc. | Image Source: Wikimedia Commons

Ideally, False Claims Act lawsuits are resolved via a negotiated settlement between the whistleblower, the defendant, and the government. However, if a settlement agreement cannot be reached, the parties must press on toward a trial – an option that sets up both sides for a greater amount of unpredictability and risk.

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Nurses’ Registry Agrees to Pay $16 Million to Settle Medicare Fraud Allegations

Posted by on Wednesday, October 21st, 2015

A Medicare fraud case, which recently settled in the U.S. District Court for the Eastern District of Kentucky, involved significant and extensive allegations of Medicare fraud for home health services. Image Source: Wikimedia Commons

A Medicare fraud case, which recently settled in the U.S. District Court for the Eastern District of Kentucky, involved significant and extensive allegations of Medicare fraud for home health services. Image Source: Wikimedia Commons

A Kentucky-based company known as Nurses’ Registry and Home Health Corp. has agreed to pay $16 million to settle False Claims Act allegations that it defrauded the Medicare program. The case was originally filed by two whistleblowers – former employees of the company – who suspected it was exaggerating the home healthcare needs of the patients.

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