Tagged: anti-kickback statute

General

23 Oct, 2024

Teva Pharmaceuticals Pays $450 Million to Resolve Anti-Kickback and False Claims Act Violations

Teva Pharmaceuticals USA Inc. (Teva USA) and Teva Neuroscience Inc. (“Teva”) agreed to pay $450 million to resolve two matters that allege Teva violated the Anti-Kickback Statute (AKS) and the False Claims Act (FCA). Teva is the largest generic drug manufacturer in the United States. The settlement resolved two alleged kickback schemes: Medicare Cost-Sharing Scheme and Copay Assistance Foundations First, Teva has agreed to resolve...

General

26 Oct, 2023

BioTek and Chaitanya Gadde, its CEO, Agreed to Pay $20 Million, and Dr. David Tabby, Agreed to Pay $480K to Resolve Anti-Kickback Violations

The reach of the Anti-Kickback Statute and the False Claims Act is broad.  As a result, AKS liability is a real and significant risk for healthcare companies and providers. Healthcare companies and providers have to resolve such claims because of the potential consequence of exclusion from “federal health care programs,” which is essentially a death sentence for any covered company that received federal reimbursement. In...

General

15 Nov, 2022

Modernizing Medicine Settles False Claims Act Violations for $45 Million

The Justice Department continues to pile up healthcare enforcement actions — false claims, anti-kickback, and fraud.  DOJ is on its way to a record year. In a recent enforcement action, Modernizing Medicine (“ModMed”), an electronic health record (“EHR”) vendor, agreed to pay $45 million for AKS and False Claims Act violations for receiving bribes in exchange for referrals and causing users to falsely report information...

General

14 Jul, 2021

Akron Ohio Health System Agrees to Pay Over $21 Million to Settle False Claims Act Violations for Improper Payments to Referring Physicians (Part IV of V)

Akron General Health Systems, a regional hospital system based in Akron, Ohio agreed to pay $21.25 million to resolve allegations under the False Claims Act that it maintained improper relationships with referring physicians, resulting in the submission of false claims to the Medicare program.  Akron General was acquired in late 2015 by the Cleveland Clinic Foundation.  The timing of the case and the investigation raise...

General

3 Nov, 2020

Merit Medical Systems Settles False Claims Act Case for $18 Million (Part I of II)

Medical device maker Merit Medical Systems (“MMS”) agreed to pay $18 million to resolve allegations that the company submitted false claims to Medicare, Medicaid and TRICARE by paying kickbacks to physicians and hospitals to induce increased use of MMS products. MMS manufactures and markets disposable medical devices used in interventional and diagnostic procedures, including cardiology, radiology, oncology, critical care and endoscopy. The anti-kickback statute prohibits...

General

30 Jul, 2020

Oklahoma City Hospital, Management Company, And Physician Group To Pay $72.3 Million To Settle Federal And State False Claims Act

The Justice Department’s enforcement programs are resuming – False Claims Act, FCPA and other programs will continue.  The rate of enforcement, however, is subject to change once again from the impact of the pandemic. As the pandemic continues to spread, DOJ focus on pandemic related fraud and other scams will divert resources from “traditional” priorities. DOJ’s commitment to False Claims Act prosecutions in the health...

General

12 Dec, 2019

Boston Heart Diagnostics Pays $26.67 Million to Settle False Claims Act Case

Boston Heart Diagnostics, a Massachusetts company, agree to pay $26.7 million to settle a False Claims Act case involving allegations of paying illegal kickbacks to physicians.  According to the settlement, Boston Heart charged Medicare and Medicaid patients for advanced lipid testing referred by providers who received kickbacks from independent marketers at the direction of Boston Heart.  Starting in 2015, Boston Heart provided advanced lipid testing...

General

24 Oct, 2018

Health Management Associates Pays Over $260 Million in Criminal and Civil Penalties for Pervasive False Billing and Kickback Charges

Healthcare Management Associates (HMA) settled criminal and civil charges with the Justice Department for illegal fraud and kickback schemes.  HMA billed federal government healthcare programs for inpatient services that should have been billed as outpatient or observation services, paid illegal remuneration to physicians in exchange for patient referrals, and inflated charges for emergency department facility fees.  HMA was acquired by Community Health Systems (CHS) in...

General

30 Aug, 2016

Healthcare Compliance: Juggling Risk Mitigation Strategies

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk assessment, healthcare organizations are often juggling among competing risks and responding to enforcement threats. The design and implementation of an effective healthcare compliance program is extremely difficult and requires dedication, resources,...

Uncategorized

2 Mar, 2016

Olympus: A Culture of Bribery and Kickbacks

When compliance officers read about a major Justice Department settlement action, we can all hear the collective sigh of relief – “Thank goodness, that did not happen here in my company.” The recent Olympus settlement is another in a long line of cases where any shred of corporate culture of integrity has been replaced with a culture of bribery and kickbacks, or other kids of...

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