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Articles Posted in Healthcare fraud

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Whistleblower awarded $1M as Drug-Testing Firm Pays $5.9M to Settle Kickback Allegations

A former billing manager brought the misconduct to the attention of the Justice Department by filing a False Claims Act lawsuit. Medical-testing firm Genotox Laboratories of Austin, Texas has agreed to pay $5.9 million to resolve allegations it violated the Anti-Kickback Statute and False Claims Act by paying volume-based commissions…

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Johnson & Johnson Subsidiary Pays $9.75M to Settle Qui Tam Whistleblower Lawsuit over Alleged Kickbacks

A medical device sales representative who filed the False Claims Act lawsuit received a $1.37 million whistleblower award. Johnson & Johnson (NYSE: JNJ) orthopedics and neurosurgery medical device unit DePuy Synthes has agreed to pay $9.75 million to resolve allegations it violated the False Claims Act by providing illegal kickbacks to…

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Ophthalmologist Pays $1.85M to Settle Allegations She Violated the False Claims Act by Fraudulently Billing Medicare for Unperformed, Medically Unnecessary Procedures

The fraud was discovered by a medical office manager who filed a whistleblower lawsuit under the qui tam provisions of the False Claims Act. A Georgia ophthalmologist has agreed to pay $1.85 million to settle allegations she violated the False Claims Act by fraudulently billing Medicare for medically unnecessary cataract…

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Cardiac Monitoring Firms Pay $45M to Settle Whistleblower Allegations they Violated the False Claims Act by Submitting Ineligible Claims to Federal Healthcare Programs

The fraud was exposed by two former company executives who filed a qui tam lawsuit under the False Claims Act. They will share a whistleblower award of $8.3 million. Pennsylvania-based cardiac monitoring company BioTelemetry, Inc. (Nasdaq: BEAT) and its subsidiary CardioNet LLC have agreed to pay nearly $45 million to resolve…

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Electronic Health Records Firm ModMed Pays $45M to Settle Whistleblower Allegations it Violated the False Claims Act by Paying and Receiving Kickbacks in Connection with “Donated” EHR Software

The fraud was exposed by a former ModMed executive who filed a qui tam lawsuit under the False Claims Act. He will receive a $9 million whistleblower award. Florida-based electronic health records firm Modernizing Medicine has paid $45 Million to resolve allegations it violated the False Claims Act by paying…

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Justice Dept. Alleges Health Insurer Cigna Violated the False Claims Act by Artificially Inflating the “Risk Scores” of its Medicare Advantage Members to Boost its Capitation Payments

The lawsuit is part of an effort by the U.S. Justice Department to investigate and litigate fraudulent diagnosis-coding practices by Medicare Advantage (Part C) insurers  The U.S. Department of Justice has announced that it has sued health insurance company Cigna Corporation (NYSE: CI), alleging that it violated the False Claims…

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Florida Medical Group Pays $130K to Settle Allegations it Violated the False Claims Act by Accepting Kickbacks from Pharma Distributor Cardinal Health

The settlement follows Cardinal Health’s payment of $13M to resolve related False Claims Act allegations earlier this year A Florida medical group has paid $130,000 to resolve allegations it violated the Anti-Kickback Statute (AKS) and False Claims Act by knowingly taking illegal kickbacks from pharmaceutical distributor Cardinal Health (NYSE: CAH).…

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Philips Respironics Pays $26M to Settle False Claims Act Lawsuits over Alleged Kickbacks to DME Suppliers; Whistleblower Awarded $4.3M

Manufacturer of home respiratory equipment allegedly coaxed DME suppliers to recommend and buy more of its products by furnishing them with two types of kickbacks—HMS prescription data and loan guarantees Philips Respironics, a subsidiary of the Netherlands-based Koninklijke Philips N.V. (NYSE: PHG) and a leading manufacturer of home respiratory equipment,…

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Biogen Settles False Claims Act Kickback Lawsuit for $900M; Qui Tam Relator Receives Record $250M Whistleblower Award

Biogen allegedly spent millions illegally inducing doctors to prescribe its multiple sclerosis drugs The Boston-based pharmaceutical company Biogen Inc. (NasdaqGS: BIIB) has agreed to pay $900 million to resolve a qui tam whistleblower’s claims that it paid neurologists “massive” kickbacks to coax them to prescribe its drugs for the treatment…

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Pharmaceutical Giant Bayer Pays $40M to Settle False Claims Act Whistleblower Lawsuits Over Three Drugs

Qui tam whistleblower alleged that Bayer fraudulently paid kickbacks, conducted off-label marketing, and hid safety risks Bayer, the U.S. division of the German drug giant Bayer AG (OTC: BAYRY), has agreed to pay a total of $40 million to settle a pair of False Claims Act whistleblower lawsuits alleging that…