Wednesday, January 17, 2007

Illinois joins whistleblower suit against radiology centers

Illinois Attorney General Lisa Madigan has intervened in a whistleblower lawsuit alleging that Chicago area readiology centers paid illegal kickbacks to referring doctors.

The suit was originally filed by a private plaintiff on behalf of the state. It alleges violation of the Consumer Fraud and Deceptive Business Practices Act, as well as Illinois’ anti-kickback law, the Insurance Claims Fraud Prevention Act.

The Attorney General's press release was issued on January 17, 2007.

Qui tam suit filed against Alabama doctor for unnecessary surgeries

An Alabama doctor, currently awaiting trial on criminal charges of receiving illegal kickbacks for medical equipment, has also been charged in a civil False Claims Act suit.

The civil suit, filed on behalf of the federal government under the qui tam provisions of the Act, alleges that Dr. Patrick Chan violated the False Claims Act by performing unnecessary surgeries on Medicare and Medicaid patients and for receiving kickbacks from medical device suppliers.

The Daily Citizen reported on the charges on January 9, 2007.

Institute for Cancer Prevention settles False Claims Act suit

The Institute for Cancer Prevention has announced that it will pay $2.3 million to settle charges that it violated the False Claims Act. The suit had charged that IFCP unlawfully used federal grant money to pay bills that were not eligible for reimbursement under its federal grants. The company had derived nearly all of its revenue from federal grants and contracts.

The company, based in Valhalla, NY, declared bankruptcy in 2004 and is no longer operating.

The North Country Gazette ran a story on the settlement on January 16, 2007.

Tuesday, January 09, 2007

Former acute-care hospital settles qui tam suit for $7.5 million

SCCI Houston, a former acute-care hospital based in Dallas, has paid $7.5 million to the federal government to resolve allegations of Medicare fraud.

The defendant, which has since been acquired by Triumph Healthcare, allegedly entered into illegal financial relationships with three physicians in violation of self-referral statutes, and submitted or caused false claims to be submitted to the Medicare program.

The original suit was brought by whistleblowers acting under the qui tam provisions of the federal False Claims Act. The whistleblowers will share $1.7 million of the settlement.

The Houston Chronicle reported on the settlement in its January 5, 2007 issue.

Tennessee cardiologists will pay $2.9 million to settle FCA suit

Cardiologists with East Tennessee Heart Consultants (ETHC) have agreed to pay $2.9 million to settle claims that they kept overpayments from patients, federal health care programs, and insurance companies since 1995.

The suit began as a qui tam action, filed by whistleblowers under the provisions of the federal False Claims Act and the Tennessee Medicaid False Claims Act.

ETHC will repay the United States $1,498,896; the State of Tennessee $201,104; $1,043,629 to 11,220 patients; and $167,449 to other insurance companies.

The Sevierville, TN, Mountain Press ran a January 6, 2007 story on the settlement.

Qui tam suit accuses doctor of receiving kickbacks for medical equipment

A whistleblower suit filed under the qui tam provisions of the federal False Claims Act accuses an Arkansas doctor of defrauding Medicare and Medicaid. The suit alleges that Dr. Patrick Chan performed unnecessary surgeries on Medicare and Medicaid patients and received illegal kickbacks from medical device companies.

In addition to Chan, defendants include Bailey Management Group, the Foundation for Orthopedic and Spine Education and Research, Innovative Health Solutions, Motiontek, Blackstone Medical and Synthes, Inc.

The Arkansas Daily Citizen of January 8, 2007 reported on the suit.

Friday, January 05, 2007

State False Claims Act review page from HHS OIG

The Office of the Inspector General of the U.S. Dept. of Health & Human Services has announced the creation of a state False Claims Act review page.

The page states:

"As enacted by section 6031 of the Deficit Reduction Act of 2005, section 1909 of the Social Security Act (Act) provides a financial incentive for States to enact false claims acts that establish liability to the State for the submission of false or fraudulent claims to the State’s Medicaid program. If a State false claims act is determined to meet certain enumerated requirements, the State is entitled to an increase of 10 percentage points in its share of any amounts recovered under a State action brought under such a law."

The state law must meet certain requirements, enumerated at the HHS OIG website.

The page lists those states whose False Claims Acts have been reviewed by the OIG and provides a link to the letter setting forth the findings.

As of today, the following states' laws have been reviewed: California, Florida, Illinois, Indiana, Louisiana, Massachusetts, Michigan, Nevada, Tennessee, and Texas.

DOJ files suit alleging fraud against Small Business Administration

The U.S. Dept. of Justice has filed a False Claims Act suit that accuses three investors and Sovereign Bancorp. Inc. of defrauding the Small Business Administration.

The suit alleges that they disguised their ownership stake in Acorn Technology Fund, failed to disclose conflicts of interest and awarded themselves improper management fees, cheating the government out of $32 million.

The Boston Globe ran the story on December 30, 2006.