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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 [...]

Client Alert – Deliberations Begin in Meningitis Outbreak Case

October 24, 2017 - In late June of this year, we discussed the sentencing of Barry Cadden, the owner and head pharmacist at the New England Compounding Center (NECC), for his role in the 2012/2013 meningitis outbreak that sickened hundreds and led to the deaths of 76 people. Cadden had been found guilty by a [...]

Client Alert – Guilty Pleas Continue to Amass in New Jersey State Health Benefits Fraud Investigation

October 12, 2017 - In late summer we issued a client alert describing a healthcare fraud scheme that had hit two New Jersey state health benefits programs for over $25 million by submitting fraudulent prescriptions for compounded medications. At the time of the initial alert, five conspirators had submitted guilty pleas to an assortment of [...]

Client Alert – Insys Therapeutics Runs Afoul of Attorneys General in Two States

October 10, 2017 - Arizona-based pharmaceutical company Insys Therapeutics Inc. (Insys) has found itself under investigation in both Massachusetts and New Jersey over the aggressive marketing of its opioid-fentanyl drug Subsys. Subsys has been approved by the FDA for use with breakthrough pain in cancer patients who have developed tolerance to other opioid-based drugs. The [...]