Saturday, September 24, 2005

Medicare contractor will pay $6 million for overcharging government

AdminiStar Federal, a subsidiary of Anthem Insurance Companies, has agreed to pay $6 million to resolve charges that it interfered with Medicare evaluations and overcharged Medicare. The company provides contractual services for administration of certain aspects of the Medicare program.

The suit, the result of allegations brought by two whistleblowers, alleged that AdminiStar employees tampered with and altered Medicare files and claims information in order to improve scores on evaluations of the company.

The U.S. Dept. of Justice issued a press release on the settlement on September 20, 2005.

Friday, September 23, 2005

Glaxo will pay $150 million to settle drug price fraud suit

GlaxoSmithKline has agreed to $150 million to settle allegations it overcharged the government for two antinausea drugs.

This is the latest in a series of suits brought by whistle-blowers against drug companies that the Associated Press says have resulted in $2.4 billion in recoveries by the government.

Glaxo engaged in a scheme to inflate the price of Zofran and Kytril for the Medicare and Medicaid programs, which reimburse healthcare providers based on the manufacturers' prices. Healthcare providers who administered the drugs were charged were charged a lower price and pocketed the difference. This made them more likely to prescribe the drug again.

The Boston Globe ran the AP story on September 21, 2005.

Monday, September 12, 2005

TransTechnology settles False Claims Act suit for $1.1 million

TransTechnology, a manufacturer of lifting devices for civilian and military aircraft, has announced the settlement of a False Claims Act suit that alleged that it made false certifications to the United States military concerning the overhaul and repair of equipment.

The suit was originally brought under the qui tam provision of the federal False Claims Act, which allows private whistleblowers to bring suits on behalf of the government. According to the complaint, Breeze-Eastern, a division of TransTechnology, had contracts to repair hoists and other equipment for the military and Coast Guard. Breeze-Eastern falsely certified compliance with contractural requirements and altered serial numbers and installed used parts during these overhauls and repairs.

The United States Attorney's Office for the District of New Jersey issued a press release on September 8, 2005.

The company's press release was issued on September 9, 2005.

Thursday, September 08, 2005

Pharmacy benefit manager will pay $137.5 million to resolve fraud allegations

AdvancePCS, a subsidiary of Caremark RX, has agreed to pay $137.5 million to resolve a civil suit that alleged it solicited and received kickbacks from pharmaceutical manufacturers and paid kickbacks to potential customers to induce them to contract with AdvancePCS.

Caremark is the second largest pharmacy benefit manager in the country and its AdvancePCS subsidiary provided pharmacy services to health plans covering federal employees and senior citizens who participated in Medicare Plus Choice programs.

The investigation included allegations brought by whistleblowers who had been employed by AdvancePCS. The whistleblowers filed lawsuits on behalf of the United States under the private whistleblower provision of the False Claims Act. They also filed lawsuits under the False Claims Act statutes of eleven states and the District of Columbia. Those investigations are still pending.

The United States Attorney's Office for the Eastern District of Pennsylvania issued a press release on the settlement on September 8, 2005.
Technorati Profile

Thursday, September 01, 2005

Eisenhower Med. Center pays $8 million to settle whistleblower lawsuit

Eisenhower Medical Center has paid the federal government $8 million in settlement of a whistleblower lawsuit, which alleged the southern California hospital fraudulently overbilled Medicare and other federal health insurance programs.

The whistleblower suit was filed under the federal False Claims Act, which allows individuals to file suits on behalf of the United States against companies which are allegedly defrauding the government. The whistleblower was a consultant with Healthcare Financial Advisors, a firm which the suit claimed assited clients in preparing two cost reports, an inflated one submitted to Medicare and a more accurate internal one. The inflated reports included costs unrelated to patient care and padded doctors' administrative hours.

The U.S. attorney's office reported that suits filed by this whistleblower, Mark Razin, have led to four hospitals paying more than $34 million in settlements.

Stories on the settlement were carried in the September 1, 2005 issues of the Desert Sun and the Los Angeles Times.