Health Care

/Health Care

Client Alert – False Claims Settlement Costs DaVita Rx $63.7 Million

Texas-based DaVita Rx (DaVita) has agreed to pay a total of $63.7 million to resolve allegations made in a whistleblower lawsuit together with separate issues raised in a self-disclosure by DaVita. Filed by two former DaVita Rx employees, the whistleblower suit alleged that the company billed federal healthcare programs for prescription medications that were never [...]

Client Alert – Alabama “Pill Mill” Indictments Handed Down – Physician and Three Nurse Practitioners Arrested

A Montgomery, Alabama, physician and three nurse practitioners were arrested yesterday following their indictment by a federal grand jury for their role in the operation of a pill mill run from the offices of Family Practice, a Montgomery-based medical clinic. The arrests follow last week’s guilty plea of Family Practice’s owner, Dr. Gilberto Sanchez, to [...]

Client Alert – Patient Assistance Charity Loses Protection from Kickback Liability Office of Inspector General Revokes Advisory Opinion

In an unprecedented action, the U.S. Department of Health and Human Services Office of Inspector General (OIG) has revoked an Advisory Opinion that protected a patient assistance charity from kickback liability, noting that it had failed “to fully, completely, and accurately disclose all relevant and material facts to OIG...” and had also failed to comply [...]

Client Alert – DOD Office of Inspector General Finds that Department Could do More to Control Prescription Fraud and Abuse

From June 2016 through September 2017, the Department of Defense Office of Inspector General (OIG) conducted a performance audit of the Defense Health Agency (DHA), the agency responsible for the effective implementation of the Department of Defense (DoD) pharmacy benefit under TRICARE. The audit was initiated to determine if DHA had adequate controls in place [...]

Client Alert – Eli Lilly, Express Scripts Subsidiary United BioSource and Three Other Companies Named in False Claims Act / Anti-Kickback Whistleblower Suit

A recently unsealed lawsuit in the U.S. District Court for the Eastern District of Texas names Eli Lilly and Company Inc. (Lilly) and United BioSource Corporation (UBC), a subsidiary of pharmacy benefit management giant Express Scripts Inc., among others, as the perpetrators of a multifaceted illicit marketing scheme designed to defraud government health care programs [...]

Client Alert – Feds Garner Eleventh Guilty Plea in New Jersey State Health Benefits Fraud Investigation

We continue to follow the story of a compounded medication fraud scheme centered in New Jersey.  The conspiracy, described in detail in our prior alerts here and here has cost two New Jersey state health programs over $25 million. The latest development occurred earlier this week in a New Jersey federal court where an eleventh [...]

Client Alert – Medicare Fraud Strike Force Nabs Eight in $100 Million Compounding Scheme

Seven defendants have pleaded guilty to conspiracy to commit health care fraud and, while awaiting sentencing, have watched the government seize a number of expensive toys, including a 1936 Ford Deluxe, a 1964 Chevrolet Corvette convertible, a 1967 Chevrolet Camaro, a 1970 Chevrolet Monte Carlo and a 2008 Lamborghini convertible. Also recovered was a 50’ [...]

Client Alert – AmerisourceBergen Earnings Report Discloses $575 Million Set Aside For FCA Settlement

In late September 2017, drug wholesaler AmerisourceBergen Corp. (ASBG) pleaded guilty in federal court in Brooklyn to violations of the federal Food, Drug and Cosmetic Act in the sale of misbranded oncology drugs. The guilty plea included a settlement of $260 million—$208 million in fines and $52 million in criminal forfeiture. ASBG also signed on [...]

Client Alert – Nation’s Largest For-Profit Hospice Chain Settles False Claims Act Allegations for $75 Million

Chemed Corporation, along with several wholly-owned subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation, (collectively “Vitas”) have agreed to settle a government suit and three whistleblower actions, all of which allege that the defendants violated the False Claims Act (FCA) by submitting false claims for hospice services to Medicare.  The $75 million settlement [...]

Client Alert – Last of Sixteen Defendants in Compound Cream Fraud Sentenced in Federal Court

In the fall of 2016, 16 individuals, including several doctors, were charged with racketeering, money laundering, and mail and wire fraud, among other crimes, in a compounded medication scheme that netted the conspirators over $175 million over the course of two years. On October 30, 2017, the last of the conspirators was sentenced for his [...]