Health Care

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Client Alert – New York Man Admits to $45 Million Health Care Fraud

Steven M. Butcher pleaded guilty last week in a New Jersey federal court to conspiracy to commit health care fraud and violate the Anti-Kickback Statute. Butcher, a former pharmaceutical sales rep, formed MedMax, LLC, a marketing company for compounded medications, and used the company as a vehicle to perpetrate a fraudulent scheme to bilk private [...]

Client Alert – Judge Rules that $1 Billion False Claims Act Suit against UnitedHealth can Proceed

Earlier this week, a federal court judge in California shot down UnitedHealth Group Inc.’s (UnitedHealth) attempt to dismiss a whistleblower’s suit claiming that UnitedHealth had wrongly retained more than $1 billion from the Medicare program after submitting invalid diagnostic data for patients enrolled in Medicare Advantage Plans from 2011 through 2014. The Department of Justice [...]

FisherBroyles Welcomes New Partner Radha V. Bachman

FisherBroyles, LLP is pleased to announce that Radha V. Bachman has joined the firm as a partner in the Florida office. Bachman represents health care clients across the spectrum in corporate, transactional and regulatory matters. Her clients include hospitals and health systems, physicians, ambulatory surgery centers and senior living facilities. Bachman serves on the Florida [...]

Client Alert – Nationwide Dialysis Provider Settles Patient Privacy Breach Allegations for $3.5 Million

Late last week, Fresenius Medical Care (FMC), a dialysis provider with nationwide coverage that also operates a number of urgent care centers and labs, settled with the Department of Health and Human Services Office of Civil Rights (OCR) over a number of alleged patient privacy breaches that occurred in 2012. In addition to a payment [...]

Client Alert – Massachusetts’ New U.S. Attorney Vows to Continue Pressure on Drug Makers and Patient Assistance Programs

Readers may recall our alert from November 2017, “Patient Assistance Charity Loses Protection from Kickback Liability - Office of Inspector General Revokes Advisory Opinion” in which we relayed the story of Caring Voice Coalition (CVC), a patient assistance program formed to help patients afford expensive prescription drugs by funding health insurance copayments. CVC, like many [...]

Client Alert – Aetna Settles for $17 Million following Accidental Disclosure of Customers’ HIV Status

Health insurance giant Aetna is learning an expensive lesson following its mishandling of private health information in the summer of 2017. Aetna has agreed to pay over $17 million to resolve privacy breach claims with approximately 12,000 of its customers after it accidentally revealed their HIV status through the windows of envelopes.  In an ironic [...]

Pharmaceutical Sales Rep Gets 65-Month Sentence in Fraud Scheme

Kirtis Green, a sales representative for Tennessee company Top Tier Medical, earned a 65 – month prison stint for his role in a $5 million health care fraud that saw several private health insurance companies, together with TriCare, duped into paying for medically unnecessary compounded creams. The charges against Green included Wire, Mail, and Health [...]

Client Alert – 2017 False Claims Act Enforcement Recovers $3.7 Billion

No Signs of a Slow Down in 2018 The 2017 fiscal year-end results are in and the U.S. Department of Justice (DOJ) has announced the recovery of $3.7 billion in settlements and judgments from civil cases involving fraud and false claims against the government. In a summary of 2017 enforcement activity, the DOJ year-end report [...]

Federal Prosecutors Given Green Light to Enforce Marijuana Laws following Long Hiatus under Obama Administration

The de facto federal safe harbor for the nation’s burgeoning marijuana industry may be coming to an end with the release yesterday of a memorandum from U.S. Attorney General Jeff Sessions notifying the nation’s 93 U.S. attorneys that prior Department of Justice guidance specific to marijuana enforcement had been rescinded.[i] The prior guidance documents, often [...]

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 [...]