Cases and News
Defendant in Medicare fraud case bought 20 cars, documents show Jackson Clarion Ledger Newly released court records claim the owner of a Mississippi hospice ran a multimillion Medicare fraud and used some of the money to buy 20 cars since December…
See on www.clarionledger.com
Arkansas Business: Mt. Home doctor may have crafted state’s largest Medicare … – Arkansas Times (blog)
Arkansas Business: Mt. Home doctor may have crafted state’s largest Medicare …
See on www.arktimes.com
Three East Texans indicted for Medicare Fraud
(CNN/CBS) – Home buyers may have enjoyed record low mortgage rates over the past year, but they were paying a pretty penny when it came time to close the deal.
Ambulance fraud, at a high cost to the government.
See on www.cbs19.tv
US sues PharMerica over drug dispensing, Medicare fraud Chicago Tribune (blog) According to the complaint, PharMerica between 2007 and 2009 dispensed controlled drugs several thousand times without first getting valid written prescriptions from…
See on www.chicagotribune.com
WXYZ Cancer doctor gave needless chemo in $35M fraud, prosecutors say Today.com Video: Investigators say a doctor in Michigan has been telling people they have cancer, even when they didn’t, and then giving them chemotherapy as part of an alleged…
See on www.today.com
For off-label marketing of the drug Protonix and other fraudulent conduct, Pfizer has agreed to pay $55 million in its settlement with the United States Department of Justice. Protonix is an acid reflex drug produced by Wyeth, which is owned by Pfizer.
“Wyeth tried to cheat the system by obtaining a limited FDA approval for Protonix, fully intending to promote this drug for additional, unapproved uses,” stated U.S. Attorney Carmen Ortiz.
The Food and Drug Administration only approved Protonix for a particular kind of gastro-esophageal reflux disease (GERD) that can only be diagnosed via endoscopy. But, according to the DOJ, Wyeth trained its marketers to promote Protonix for every kind of GERD. By opening up the drug for far more common uses, Wyeth could greatly increase profits.
Reporting Medicare fraud paid off for hospital administrator Randi Ferrare, who will get a $1.8 million Medicare fraud reward. The reward is her share of the $10.1 million government settlement with Morton Plan Health System.
Ferrare brought a Medicare Whistleblower suit under the Federal False Claims Act, alleging that the Florida hospital system over-billed Medicare. Hospitals affiliated with Morton Plant Health Care billed certain cardiac procedures as inpatient care, when it should have been billed on a lower cost outpatient basis.
The rates Medicare pays for inpatient care are much higher than for outpatient and observational care. When patients are observed to see if they should be admitted as inpatient, the proper billing codes are at the observational rate. According to the government, Morton Plant improperly billed such observational care as inpatient care. The over $10 million settlement approximates the amount Medicare overpaid between July 2006 and July 2008.
“Overbilling the government for routine procedures wastes valuable resources that could be used to care for other patients,” said Stuart F. Delery, Principal Deputy Assistant Attorney General for the Justice Department’s Civil Division. “At a time when we are trying to reduce public spending, it is especially important to ensure that hospitals do not overcharge the government by improperly inflating their billing.”
Ferrare’s Medicare whistleblower complaint was filed only against the Morton Plant hospital network. However, the government investigation expanded to include two other affiliated hospitals, St. Anthony’s and St. Joseph’s.
In settling the allegations, the hospital systems admits to no wrongdoing. It faults complexities in Medicare billing and coding for the alleged discrepancies. It also points to medical developments during the time period that allowed more procedures to be done on an outpatient basis.
If you have non-public information about improper billing or other heath care fraud, a Medicare whistleblower attorney can assist you in reporting Medicare fraud. We can help evaluate whether you may be eligible for a Medicare fraud reward and guide you through the steps that need to be taken. Call 1-877-255-2676 today to report Medicare fraud or contact us.
He was a part of a conspiracy to bill Medicare for unnecessary neurological tests at three Michigan clinics. Some of the unnecessary tests included sending an electrical current through the arms and legs of the patients.
Explains the U.S. Department of Justice:
Evidence at trial showed that the patients were not referred to the clinics by their primary care physicians, or for any other legitimate purpose, but rather were recruited with prescriptions for controlled substances, cash payments, and fast food. The three clinics then billed the Medicare program for various diagnostic tests that were medically unnecessary.
United States Attorney Barbara L. McQuade stated, “This doctor exposed patients to electrical currents for neurological testing solely to generate money for himself at the expense of the Medicare program. We hope that cases like this one will deter other doctors from using patients as commodities for personal gain.”
If you have non-public information about Medicare fraud or other medical fraud, a Medicare fraud attorney can help you determine whether you have a case. We can help evaluate whether you may be eligible for a Medicare fraud reward and guide you through the steps that need to be taken. Call 1-877-255-2676 today to report Medicare fraud or contact us.
A Medicare whistleblower pharmacy in Florida is leading the way in reporting Medicare fraud. After numerous successful False Claims Act cases, Ven-a-care pharmacy is making millions in Medicare fraud rewards.
Reporting Medicare Fraud in Florida
A special report from Florida Trend details how the small pharmacy has become one of the most successful Medicare whistleblowers in the country. Ven-a-care is responsible for exposing billions in over-charges to Medicare and Medicaid for prescription drugs.
Explains the report:
In August 2011, Attorney General Pam Bondi filed a three-paragraph statement announcing a $26.6-million settlement with Par Pharmaceutical Cos. At the bottom of that statement was a reference to a small Florida pharmacy called Ven-A-Care of the Florida Keys.
The company filed the initial whistleblower’s lawsuit that accused Par Pharmaceuticals of inflating prices of its drugs and overcharging Medicaid. As its reward, Ven-A-Care will receive at least $23 million from the $156 million multi-state settlement….
According to a report by Public Citizen, a consumer watchdog group, Ven-A-Care accounts for half of the $6 billion in settlements generated by whistleblowers over a 20-month period ending in July 2012.
The National Law Journal has estimated that the four pharmacy owners have received $340 million in Medicare fraud rewards for their efforts. (more…)