Thursday, May 29, 2008

Hartford Hospital settles cancer overbilling suit

Hartford Hospital will reimburse the Medicare program $788,960 to settle allegations that it overcharged the government for certain cancer treatments over a four-year period. The False Claims Act suit accused the hospital of billing medicare for up to six units of chemotherapy per patient visit, when only one unit is permitted.

The Hartford Courant said that Hartford Hospital was the fourth in Connecticut to settle charges based on this practice.

Bid rigging in military personnel moving expenses

The U.S. Dept. of Justice announced that it settled a lawsuit alleging a conspiracy to rig bids, fix prices and allocate the market for the transportation of household goods belonging to military and Defense Department personnel. The government has also intervened in two related suits.

The Pasha Group will pay $13 million dollars to resolve whistleblower allegations that it conspired with a Belgian company to rig bids. That company, Gosselin, and four German moving companies, are defendants in two related lawsuits in which the government has intervened.

Tuesday, May 27, 2008

Florida dermatologist will pay $11 million for Medicare fraud

Michael A. Rosin, a former dermatologist in Sarasota, Florida, will pay $11 million to resolve allegations of Medicare fraud.

The whistleblowers who originated the False Claims Act suit accused Rosin of performing unnecessary surgeries on hundreds of patients, according to the Sarasota Herald Tribune.

Among the allegations was one that the doctor once made a cancer diagnosis over a piece of chewing gum that had been placed on a slide after a patient's biopsy was lost.

Medtronic unit settles False Claims Act suit

Medtronic Inc. will pay $75 million to resolve claims that a company it purchased engaged in Medicare fraud, according to the Boston Globe and the New York Times.

The whistleblower suit was brought by two former employees of Kyphon Inc., a medical device manufacturer bought by Medtronic last November. The suit alleged that Kyphon persuaded
hospitals to bill Medicare for a spine operation at inpatient rates rather than for less costly outpatient treatment. By charging inpatient rates for the kyphoplasty procedure, hospitals could increase their Medicare reimbursement and Kyphon could charge more for its spinal equipment.

The relators were represented by Phillips & Cohen, a law firm specializing in representing whistleblowers nationwide.

Thursday, May 15, 2008

Baptist Health South Florida will pay $7.8 million to settle FCA suit

Baptist Health South Florida Inc. will pay the United States $7,775,000 to settle claims that it violated the False Claims Act and the Stark Statute between 2003 and 2005. The government alleged that the healthcare system paid excessive compensation to an oncology group that was a source of patient referrals, according to an article in the Sun Herald.

The Stark law prohibits providers from billing Medicare and Medicaid for referrals from doctors with whom the providers have a financial relationship, unless that relationship falls within certain exceptions.

Computer Sciences Corp. settles FCA suit

Computer Sciences Corporation (CSC), an information technology and business services company, will pay $1.37 million to resolve allegations that it solicited and received improper payments on technology contracts with government agencies, the Justice Department announced on May 15, 2008.

The whistleblower complaint which originated the suit alleged that CSC received payments, known as alliance benefits, from a number of companies with whom it had global alliance relationships. These benefits amounted to kickbacks and undisclosed conflict of interest relationships.

FCA case alleging customs fraud settles

The U.S. Attorney's Office for the Southern District of New York announced the settlement of a customs fraud case for $2.8 million.

The suit, which originated as a whistleblower complaint, involved three importers, Intertex International Inc., J.J. Basics, Inc. and the Red Zone, Inc., that imported goods for U.S. companies, including Wal-Mart Stores, J.C. Penney, Kohls and Marshalls.

The whistleblower alleged that the companies misstated the country of origin of imported goods in order to evade quota restrictions and sometimes understated the value of the imported goods.

Monday, May 12, 2008

Connecticut attorney general calls for False Claims Act

Connecticut Attorney General Richard Blumenthal has asked the state's legislators to enact a False Claims Act. A special legislative session is starting and Blumenthal thinks the legislature should take this opportunity to pass an act, modeled on the federal False Claims Act, that would allow citizens reporting fraud to receive a portion of the damages.

Stamfordplus.com says that Blumenthal also advocates strengthening whistleblower protections.

Friday, May 09, 2008

U.S. joins qui tam suit against government contractor

The U.S. Department of Justice has joined a whistleblower suit against Materials and Electrochemical Research Corp., saying company officers created a false company and forged signatures to obtain millions in government contracts.

The suit alleges that the Tucson, Arizona, company filed falsified documents to get contracts with NASA, the Dept. of Energy and the Dept. of Defense. The contracts involved optics and nanotechnology research, according to a May 9, 2008 article in the Tucson Citizen.

Tuesday, May 06, 2008

Federal government sues NJ cardiologists

Heartwire reported on April 28, 2008 that the federal government is suing two cardiologists for their role in an alleged kickback scheme. The two are among 16 cardiologists who are alleged to have participated in a scam in which the University of Medicine and Dentistry of New Jersey (UMDNJ) gave them the titles of assistant professors and salaries in return for referrals. The "professors" did npt perform any teaching, research, or patient-care duties.

The lawsuit claims the two are guilty of violating both the federal Stark statute, which prohibits referral of Medicare patients to a hospital with which a doctor has a financial relationship, and the False Claims Act, which allows triple damages for submission of claims that are false because of a prohibited financial relationship.

New Orleans hospital settles FCA allegations

Touro Infirmary, a New Orleans hospital, will pay the United States $1.75 million to settle allegations that it submitted false claims to the Medicare program, the Department of Justice announced on April 17, 2008.

The lawsuit alleged that Toura made unlawful payments to a psychiatrist to induce her to refer patients to the hospital. Federal law prohibits the payment of kickbacks or other inducements for referrals of patients participating in federal health care programs.

Government joins qui tam suit against California radiology clinis

The U.S. Attorney's Office in Los Angeles filed a complaint in intervention in a whistleblower lawsuit brought against The Oaks Diagnostics, Inc., according to an April 14, 2008 press release.

The suit alleges that the clinic defrauded Medicare by billing for unnecessary radiological tests, such as CT scans and MRIs.

Heartland Dental settles whistleblower suit

Heartland Dental, an Illinois company that manages dental practices in several states, has agreed to pay $1.65 million to resolve allegations that it falsely billed Illinois Medicaid. The whistleblower suit, brought under the qui tam provisions of the False Claims Act, accused the company of defrauding Medicaid by miscoding uncovered procedures as though they were covered and upcoding simple procedures as though they were complex.

The company will also pay the U.S. $1.35 million to resolve allegations that newly hired dentists issued prescriptions prior to registration with the Drug Enforcement Administration as a means to generate revenue for Heartland, according to the April 11, 2008 press release from the US Attorney's Office in Springfield,