Hospitals pay $20 million to settle allegations of false claims to Medicare, Medicaid and TRICARE and for unnecessary spinal surgeries

Sanford Health, Sanford Medical Center and the Sanford Clinic (collectively, Sanford)  have agreed to pay $20.25 million to resolve False Claims Act (FCA) allegations that they knowingly submitted false claims to federal health care programs, including Medicare, Medicaid and TRICARE, resulting from violations of the Anti-Kickback Statute and medically unnecessary spinal surgeries. The Anti-Kickback Statute […]

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Tenet Healthcare to pay $66 million to settle whistleblower suit asserting billing Medicare for docs who received kickbacks

Tenet Healthcare Corp. has agreed in principle to pay the federal government about $66 million to settle a whistleblower lawsuit alleging it billed public programs for medical services provided by physicians having improper financial relationships with a hospital partly owned by Tenet. Tenet disclosed the tentative settlement in its recent quarterly filing with the Securities and Exchange […]

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Reckitt Benckiser Group to pay $22.7 million to Kentucky in Medicaid fraud case for Suboxone administration without counseling

Reckitt Benckiser will pay $22.7 million in state and federal Medicaid dollars after reaching an agreement with a pharmaceutical distributor over its improper marketing and promotion of the drug Suboxone. The civil settlement resolves allegations that, from 2010 through 2014, Reckitt, directly or through its subsidiaries, knowingly: Promoted the sale and use of Suboxone to […]

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Genetic testing co. UTC Labs and principals to pay $42.6 million to settle kickback and Medicare fraud claims

UTC Laboratories, Inc. (RenRX) has agreed to pay $41.6 million, and its three principals, Tarun Jolly, M.D., Patrick Ridgeway, and Barry Griffith, have agreed to pay $1 million to resolve allegations that they violated the False Claims Act by paying kickbacks in exchange for laboratory referrals for pharmacogenetic testing and for furnishing and billing for […]

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Doctor Indicted For Submitting Medicare and Medicaid Claims for Services Performed By Other Physicians

Dr. Antonio Reyes-Vizcarrondo was indicted for one count of conspiracy to commit health care fraud and one count of health care fraud following allegations that he submitted false claims to both Medicare and Medicaid. According to the Department of Justice, Reyes-Vizcarrondo submitted a total of 8,159 claims between 2008 and 2015, resulting in profits of nearly […]

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Three Marketers Plead Guilty to Violating Federal Anti-Kickback Statutes After Recruiting Physicians to Write Unnecessary Prescriptions

Daniel Ferguson, John Frohrip, and Kevin Partin, pleaded guilty to violating federal anti-kickback statutes following allegations that they paid illegal kickbacks and recruited doctors to write prescriptions for expensive drugs as part of their health care fraud scheme. According to the Department of Justice, the defendants recruited physicians to write prescriptions for complex drugs that would […]

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“Goodie Bag” Doctor Charged in $3.2 Million Healthcare Fraud Scheme Involving Distribution of Oxycodone

Andrew M. Berkowitz, M.D., is facing an indictment of 19 counts of healthcare fraud and 23 counts of distributing oxycodone outside of medical treatment following allegations that he provided each of his patients with a “goodie bag” of prescription drugs after each visit, despite their individual ailments. It is also alleged that Berkowitz fraudulently submitted […]

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Licensed Pharmacist indicted for fraudulent billing of antipsychotic medication clozapine and sedative alprazolam to people who had already died. Costs to Medicare, Medicaid Millions

Nabil Fakih, a licensed pharmacist, Michigan Board of Pharmacy member, and owner of a Dearborn Heights drug store, was charged with healthcare and wire fraud and indicted by a grand jury. The Indictment accused Fakih of wrongfully taking millions of United States dollars from Medicare, Medicaid and Blue Cross Blue Shield (BCBS), dating back to […]

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Additional Reports Show That The Future of Medicare and Social Security Looks Bleak as the risk of Insolvency advances without attention to deficit

We recently published a blog on the impending crisis concerning funding of Medicare and Social Security benefits. The numbers of inquiries on this were substantial so I am writing additional information on the problem. One issue is that Congress appears reluctant to address the issue especially given the coming Presidential election and the obvious effect […]

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Drug companies pay $122 million to settle case charging kickbacks including bribery to patients under the guise of charitable organizations on co-pays

Jazz Pharma, Alexion, and Lundbeck were the subject of SOJ lawsuits asserting kickbacks and committing general violations of Medicare laws. The United States Department of Justice has decided to agree to a settlement of $122.6 million in total from these three alleged Medicare violators. The drug companies were accused of offering remuneration in hopes of encouraging patients […]

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