Tagged: anti-kickback

BioReference Laboratories and Parent Company Agree to Pay $9.85 Million to Resolve False Claims Act Violations for Illegal Payments to Referring Physicians

When it comes to the healthcare sector, the Justice Department and the HHS-Office of Inspector General have no shortage of investigations and targets for prosecution.  The more resources made available to DOJ and HHS-OIG, the more money made for the federal government from medical care fraud.  It is a very simple equation.  It is like shooting fish in a barrel. BioReference and OPKO Health, Inc....

DOJ Continues Pace of Healthcare Fraud False Claims Act Prosecutions

False Claims Act prosecutions continue against healthcare executives, physicians and professionals.  Last year, DOJ recovered over $5.6 billion in FCA enforcement. DOJ expects total recoveries to increase in 2022.  Over 95 percent of False Claims Act prosecutions involved healthcare fraud and kickbacks.  Two Doctors and Eight Others Indicted for Healthcare Kickbacks In a recent prosecution in the Northern District of Texas, DOJ announced the indictment...

Episode 173 — Review of HHS-OIG Fraud Alert on Speaker Programs

In a far-reaching action, the Health and Human Services – Office of Inspector General (HHS-OIG) issued a Special Fraud Alert underscoring the “inherent fraud and abuse risks” associated with company-sponsored speaker programs.  In this Episode, Michael Volkov reviews the HHS-OIG Fraud Alert. The Episode is available Here.

Episode 168 — Review of Merit Medical False Claims Act Settlement

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. Dr. Charles J. Wolf, Merit’s former chief compliance officer, filed a whistleblower complaint against the firm in April 2016 following his resignation, in which he...

Three Pharmaceutical Companies Pay a Total of $122 Million to Settle Kickback Allegations Involving Co-Pay Assistance Foundations

In a significant False Claims Act enforcement action, DOJ announced settlements with three pharmaceutical companies – Jazz Pharmaceuticals, Lundbeck, and Alexion Pharmaceuticals – under which they agreed to pay $122 million to resolve allegations they violated the False Claims Act by paying Medicare of the Civilian Health and Medical Program (ChampVA) copayments for their own products through allegedly independent foundations that the companies used as...

Criminal Prosecutions of Individuals Outside the FCPA

When you look outside the FCPA arena and examine DOJ criminal prosecutions in healthcare, antitrust, tax, fraud, and other white-collar areas, there is no shortage of cases against individual violators. I am perplexed, to say the least, why DOJ cannot aggressively prosecute individuals for FCPA crimes in the same manner that prosecutors bring cases against doctors, executives and other individuals for a variety of criminal...

Tenet Healthcare Settles Fraud Case for $514 Million

If you work in compliance in the healthcare industry, you have a tough job. The number and variety of risks that healthcare providers face is daunting. The False Claims Act is a mighty weapon in the hands of federal prosecutors. Hospitals are under the enforcement microscope given the significant role they play in the delivery of healthcare. Tenet Healthcare Corporation, a national hospital chain, recently...

Drug Companies and Charitable Patient Foundations

Charitable organizations can easily become enmeshed in Justice Department enforcement issues. We have seen charities used in FCPA cases as a means to funnel bribes to government officials, spouses or family members. In the domestic world of drugs and anti-kickback laws, drug company relationships with patient foundations are now being examined for possible violation of anti-kickback laws. Government scrutiny of drug prices is occurring on...

Compliance Reminder — DOJ Announces Largest Healthcare Fraud Takedown

Jacqui Merrill, an Associate at The Volkov Law Group, rejoins us for a posting on DOJ’s largest healthcare fraud takedown.  Jacqui’s profile is here and she can be reached at [email protected] On Wednesday, June 22, 2016, the DOJ announced the largest nationwide heath care fraud takedown in history, which resulted in criminal and civil charges against 301 individuals for alleged participation in health care fraud...

DOJ Suffers Criminal Trial Setbacks: Warner Chillcott President Acquitted

Last week was a tough week for the Justice Department’s criminal prosecutors. Before everyone gets out their Yates Memorandum trending claims, it is important to recognize that DOJ’s loss in several high profile cases does not reflect some earth-shattering trend or recent Yates phenomena. DOJ last a series of criminal cases that were indicted or investigated before the Yates Memorandum had hit the ground in...