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False Claims Act Litigation

Florida Compounding Pharmacy Agrees To Pay At Least $775,000 To Resolve False Claims Act Allegations

By | Business Fraud, False Claims Act Litigation, Qui Tam Lawsuits, Qui Tam Litigation, whistleblower lawyers

The U.S. Department of Justice announced on February 14, 2019 that  Vital Life Institute LLC (formerly known as AgeVital Pharmacy LLC), located in Sarasota, Florida, and its two owners, have agreed to pay at least $775,000 to resolve claims that they violated the False Claims Act by engaging in an illegal kickback scheme to induce the referral of compounded drug prescriptions for TRICARE and Medicare beneficiaries. AgeVital and the owners also agreed to pay additional amounts in the event certain contingencies are triggered.

The government alleged that AgeVital, at the direction of its owners, paid kickbacks to a third-party marketing company to solicit prospective patients for compounded drug prescriptions regardless of patient need. The marketing company arranged for prescribers to sign those prescriptions, which were then referred to AgeVital to be filled. The kickbacks to the marketing entity allegedly consisted of a substantial share of the pharmacy’s TRICARE and Medicare reimbursements. The Anti-Kickback Statute prohibits, among other things, the knowing and willful payment of any remuneration to induce the referral of services or items that are paid for by a federal health care program.  Claims submitted to federal health care programs in violation of the Anti-Kickback Statute can subject the violator to liability under the False Claims Act.

The settlement resolves a lawsuit filed in federal court in Tampa, Florida, by a patient who allegedly received unwanted compounded medications from AgeVital that were billed to Medicare.  The lawsuit was filed under the qui tam or whistleblower provisions of the False Claims Act.  The Act permits private parties to bring a lawsuit on behalf of the United States for false claims and to share in any recovery.  The whistleblower will receive at least $139,500 of the settlement.

The lawsuit is captioned United States ex rel. Knopf v. AgeVital Pharmacy, LLC et al., Case No. 8:15-cv-2591-T-36JSS (M.D. Fla.).

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Email us at info@businesslitigationcontingencylawyers.com or telephone us toll-free in the United States at 800-756-2143 to find qui tam lawyers who may handle your False Claims Act matter on a contingency basis.

BusinessLitigationContingencyLawyers.com – The Practical Solution For Business Litigation

U.S. Justice Department Files Civil Complaint To Stop Tennessee Pharmacies’ Unlawful Dispensing Of Opioids

By | Business Fraud, False Claims Act Litigation

On February 8, 2019, the U.S. Department of Justice unsealed a civil complaint filed in the Middle District of Tennessee against two pharmacies, their owner, and three pharmacists, to stop them from dispensing controlled substance medications, including powerful opioids that have been linked to abuse and diversion.

The civil complaint alleges that the defendants were dispensing and billing Medicare for prescriptions in violation of the Controlled Substances Act and the False Claims Act. According to the United States’ complaint, the defendants’ unlawful dispensing of opioids has been tied to the deaths of at least two people and numerous others have been treated at hospitals for serious overdoses within a short time of obtaining controlled substances from the pharmacies.

The complaint alleges that the pharmacies and pharmacists filled numerous prescriptions for controlled substances outside the usual course of professional practice and in violation of the pharmacists’ corresponding responsibility to ensure that prescriptions were written for a legitimate medical purpose. Specifically, the complaint alleges that the defendants routinely dispensed controlled substances while ignoring numerous “red flags” or warning signs of diversion and abuse, such as unusually high dosages of oxycodone and other opioids, prescriptions for opioids and other controlled substances in dangerous combinations, and patients travelling extremely long distances to get and fill prescriptions. The complaint further asserts that the pharmacies falsely billed Medicare for illegally dispensed prescriptions.

A federal judge has already issued a temporary restraining order in the case, and the United States seeks civil monetary penalties and treble damages.

In announcing the unsealing of the complaint, one of the U.S. Attorneys assigned to the case stated, “The civil complaint unsealed today contains disturbing allegations of high-risk dispensing practices by the defendants. Given the national public health emergency resulting from the opioid crisis in our nation, the U.S. Attorney’s Office will use every resource at our disposal, including seeking injunctive relief and civil monetary penalties as we have here, to stop pharmacies and pharmacists from continuing to abuse their dispensing authority to fuel this epidemic.”

The Special Agent in Charge of DEA’s local Field Division stated, “The action supported today by the Drug Enforcement Administration should serve as a warning to those in the pharmacy industry who choose to put profit over customer safety. Pharmacists serve on the front lines of America’s opioid epidemic and they share responsibility with physicians to protect those whom they serve from the dangers associated with prescription medications. We will be vigilant in holding them accountable.”

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Email us at info@businesslitigationcontingencylawyers.com or telephone us toll-free in the United States at 800-756-2143 to find qui tam lawyers who may handle your False Claims Act matter on a contingency basis.

BusinessLitigationContingencyLawyers.com – The Practical Solution For Business Litigation

Pathology Lab Settles False Claims Act Allegations For $63.5M

By | Business Fraud, False Claims Act Litigation, Qui Tam Lawsuits, Qui Tam Litigation, whistleblower lawyers

The U.S. Department of Justice announced on January 30, 2019 that pathology laboratory company Inform Diagnostics has agreed to pay $63.5 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians. Inform Diagnostics, formerly known as Miraca Life Sciences Inc., is headquartered in Irving, Texas, and was a subsidiary of Miraca Holdings Inc., a Japanese company, during the relevant period. In 2017, majority ownership of the company changed and the company was renamed.

The settlement resolves allegations that Inform Diagnostics violated the Anti-Kickback Statute and the Stark Law by providing to referring physicians subsidies for electronic health records (EHR) systems and free or discounted technology consulting services. The Anti-Kickback Statute and the Stark Law restrict the financial relationships that health care providers, including laboratories, may have with doctors who refer patients to them. Although regulations adopted by the Department of Health and Human Services (HHS) in 2006 included provisions that allowed laboratories to provide EHR donations to physicians under certain conditions, the United States alleged that Inform Diagnostics violated those conditions. HHS withdrew those exemptions for laboratories in 2013.

The allegations stem from three lawsuits that were filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private citizens to bring suit on behalf of the United States for false claims and share in any recovery. The whistleblowers’ share of the settlement has not yet been determined.

In announcing the settlement, an Assistant Attorney General of the U.S. Department of Justice’s Civil Division stated, “The Department of Justice has longstanding concerns about improper financial relationships between health care providers and their referral sources because those relationships can alter a physician’s judgment about the patient’s true health care needs and drive up health care costs for everybody. In addition to yielding a substantial recovery for taxpayers, this settlement should deter similar conduct in the future and help make health care more affordable.”

The case was investigated by the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office for the Middle District of Tennessee, the U.S. Attorney’s Office for the Middle District of Florida, the Department of Health and Human Services Office of Inspector General, and the Federal Bureau of Investigation. The cases are captioned United States ex rel. Dorsa v. Miraca Life Sciences, Inc., Case No. 13-cv-1025 (M.D. Tenn.); United States ex rel. LPF, LLC v. Miraca Life Sciences, Inc., et al., 3:16-cv-1355 (M.D. Tenn.); and United States ex rel. Heaphy, et al. v. Miraca Life Sciences, Inc., 3:18-cv-1027 (M.D. Tenn.).

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Email us at info@businesslitigationcontingencylawyers.com or telephone us toll-free in the United States at 800-756-2143 to find qui tam lawyers who may handle your False Claims Act matter on a contingency basis.

BusinessLitigationContingencyLawyers.com – The Practical Solution For Business Litigation

U.S. Announces $269.2 Million Settlement With Walgreens In Two Civil Healthcare Fraud Lawsuits

By | Business Fraud, False Claims Act Litigation, Qui Tam Lawsuits, Qui Tam Litigation, whistleblower lawyers

The Department of Justice U.S. Attorney’s Office Southern District of New York (Manhattan U.S. Attorney) announced on January 22, 2019 that the United States filed and settled two healthcare fraud lawsuits against national pharmacy chain Walgreens Boots Alliance, Inc. (“Walgreens”) in which Walgreens must pay the United States and state governments a total of $269.2 million.

First Settlement – Insulin Pens

The U.S. alleged that Walgreens routinely submitted false days-of-supply data to federal healthcare programs when it sought federal reimbursement for insulin pens it dispensed to federal beneficiaries who did not need them. The U.S. alleged that Walgreens engaged in two practices that resulted in the fraudulent submissions: Walgreens configured its electronic pharmacy management system to prevent its pharmacists from dispensing less than a full box of five insulin pens, even when patients did not need that much insulin; and when a full box of insulin pens exceeded the federal healthcare program’s limit on the total days of supply (i.e., the total number of daily doses) that could be dispensed and reimbursed at that time, Walgreens allegedly evaded this restriction by falsely stating in its reimbursement claims that the total days of supply did not go over the limit. The U.S. contended that as a result, federal healthcare programs paid Walgreens millions of dollars for insulin that many beneficiaries did not actually need, and substantial quantities of valuable medication were wasted. The U.S. alleged that this conduct also opened the door to potential healthcare risks and abuse, such as the improper resale of insulin pens on the Internet.

The settlement requires Walgreens to pay approximately $168 million to the U.S., and Walgreens agreed separately to pay approximately $41.2 million to state governments. The settlement was approved on January 16, 2019 by a federal judge and was unsealed on January 22, 2019.

Second Settlement – Discount Drug Pricing

The U.S. alleged that Walgreens operated a program called the Prescription Savings Club (“PSC”) under which customers received discounts when they ordered drugs from Walgreens. Medicaid regulations required Walgreens to seek Medicaid reimbursement only at the lowest of certain drug price points, including the “usual and customary price” (“U&C price”). Medicaid rules of many states defined the U&C price as the price offered through discount programs like the PSC. Contrary to these requirements, Walgreens allegedly did not disclose to Medicaid the discount drug prices it offered customers through the PSC when it sought reimbursement from Medicaid. As a result, Medicaid programs paid Walgreens more in reimbursements than it would have paid had Walgreens disclosed the lower PSC prices.

The settlement requires Walgreens to pay a total of $60 million, of which approximately $32 million is to the United States and approximately $28 million will go to state governments. The second settlement was approved on January 15, 2019 by a federal judge and was also unsealed on January 22, 2019.

In both settlements, Walgreens admitted and accepted responsibility for conduct the U.S. alleged in its complaints under the False Claims Act. Both cases arose from lawsuits filed by whistleblowers under the False Claims Act.

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Email us at info@businesslitigationcontingencylawyers.com or telephone us toll-free in the United States at 800-756-2143 to find qui tam lawyers who may handle your False Claims Act matter on a contingency basis.

BusinessLitigationContingencyLawyers.com – The Practical Solution For Business Litigation

Over $2.8 Billion Recovered From False Claims Act Cases In Fiscal Year 2018

By | Business Fraud, False Claims Act Litigation, Qui Tam Lawsuits, Qui Tam Litigation, whistleblower lawyers

The U.S. Department of Justice announced on December 21, 2018 that the Department obtained more than $2.8 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending September 30, 2018.  Recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, now total more than $59 billion.

Of the $2.8 billion in settlements and judgments recovered by the Department of Justice this past fiscal year, $2.5 billion involved the health care industry, including drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.  This is the ninth consecutive year that the Department’s civil health care fraud settlements and judgments have exceeded $2 billion.  The recoveries included in the $2.5 billion reflect only federal losses but, in many of these cases, the Department was instrumental in recovering additional millions of dollars for state Medicaid programs.

In addition to combating health care fraud, the False Claims Act serves as the government’s primary civil remedy to redress false claims for federal funds and property involving a multitude of government operations and contracts.  These areas range from defense and national security to import tariffs and small business programs.

In 1986, Congress strengthened the Act by increasing incentives for whistleblowers to file lawsuits alleging false claims on behalf of the government.  These whistleblower, or qui tam, actions comprise a significant percentage of the False Claims Act cases that are filed.  If the government prevails in a qui tam action, the whistleblower, also known as the relator, receives up to 30 percent of the recovery.  Whistleblowers filed 645 qui tam suits in fiscal year 2018.

Of the $2.8 billion in settlements and judgments reported by the government in fiscal year 2018, over $2.1 billion arose from lawsuits filed under the qui tam provisions of the False Claims Act.  During the same period, the government paid out $301 million to the individuals who exposed fraud and false claims by filing these actions.

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Email us at info@businesslitigationcontingencylawyers.com or telephone us toll-free in the United States at 800-756-2143 to find qui tam lawyers who may handle your False Claims Act matter on a contingency basis.

BusinessLitigationContingencyLawyers.com – The Practical Solution For Business Litigation

U.S. Intervenes In West Virginia Hospital False Claims Act Lawsuit

By | Business Fraud, False Claims Act Litigation, Qui Tam Lawsuits, whistleblower lawyers

The U.S. Department of Justice announced on December 21, 2018 that the United States has partially intervened in a lawsuit under the False Claims Act against Wheeling Hospital Inc. (Wheeling), R & V Associates Ltd. (R & V), and Ronald Violi in the U.S. District Court for the Western District of Pennsylvania. The government intervened with respect to allegations that Wheeling, which is located in Wheeling, WV, violated the Stark Law and Anti-Kickback Statute, and that those violations were caused by R & V, Wheeling’s contracted management consultant, and Violi, Wheeling’s CEO.

The Stark Law prohibits a hospital from billing Medicare for services referred by physicians that have an improper financial relationship with the hospital. The Anti‑Kickback Statute, in relevant part, prohibits offering or paying anything of value to encourage the referral of items or services covered by federal healthcare programs. The United States alleges that Wheeling’s compensation to a number of employed and contracted physicians violated these statutory prohibitions because that compensation was based on the volume or value of the physicians’ referrals or was above fair market value.

The lawsuit was initially filed in December 2017 by Louis Longo, who was previously employed as Wheeling’s Executive Vice President, under the whistleblower provisions of the False Claims Act. Those provisions authorize private parties to sue on behalf of the United States for false claims and share in any recovery. The Act permits the United States to intervene and take over the lawsuit. Those who violate the Act are subject to treble damages and applicable penalties.

The case is captioned United States of America ex rel. Louis Longo v. Wheeling Hospital, Inc. et al., No. 17-cv-1654 (W.D. Pa.).

Source

If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as <em>qui tam</em> attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

Email us at info@businesslitigationcontingencylawyers.com or telephone us toll-free in the United States at 800-756-2143 to find qui tam lawyers who may handle your False Claims Act matter on a contingency basis.

BusinessLitigationContingencyLawyers.com – The Practical Solution For Business Litigation