Cases and News
A whistleblower in an off-label marketing case against Boehringer Ingelheim Pharmaceuticals Inc. will receive more than $17 million as a reward. The reward is his share of a $95 million settlement with the government. Whistleblowers get a share of such settlements as a reward for reporting fraud under the False Claims Act.
Robert Heiden, a former sales representative for Boehringer, blew the whistle on the company’s illegal off-label marketing of three different drugs. The three drugs were Aggrenox, Combivent, and Micardis.
The government alleged that Boehreinger marketed these drugs for uses that were not approved by the Food and Drug Administration. Such unapproved uses are not covered by Medicare and Medicaid. Yet these federal health care programs were billed millions.
Boehreinger is also accused of paying kickbacks to doctors for prescribing Aggrenox, Atrovent, Combivent and Micardis.
As a result of today’s $95 million settlement, the federal government will obtain $78,455,048, and state Medicaid programs will obtain $16,544,952.
We’ve talked about Medicaid and Medicare fraud by way of “ghost patients.” Medical providers bill Medicare or Medicaid for patients who do not exist or who didn’t receive the billed health care. Now we’re moving on to “phantom clinics”.
A man plead guilty on Friday to billing Medicare a whopping $100 million for health care clinics that did not exist. Not only were the patients ghosts, but so were the doctors. And there were at least 118 phantom clinics!
If you have non-public information about Medicare fraud or other health care fraud, a Medicare whistleblower 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 or contact us.
After the guilty plea on Friday, October 26, 2012, the United States Attorneys Office for the Southern District of New York released a statement:
Preet Bharara, the United States Attorney for the Southern District of New York, announced today that DAVIT MIRZOYAN pled guilty today in Manhattan Federal Court to racketeering and other crimes in connection with his involvement in an Armenian-American criminal organization involved in a wide range of criminal activity, including a massive Medicare fraud. MIRZOYAN pled guilty before United States Magistrate Judge Henry B. Pitman.
Medicaid fraud scheme cost Medicaid millions of dollars
The elaborate Medicaid fraud scheme used “straw companies” to give kickbacks to sober houses. In return, the sober houses ordered unnecessary drug screening urine tests from Calloway Laboratories. The tests were neither ordered by a doctor nor medically necessary. Medicaid was billed for the tests – costing millions of dollars. Calloway Laboratories settled the charges in March for $20 Million.
If you have non-public information about Medicaid fraud or other health care fraud, a whistleblower attorney can help you determine whether you have a case. We can help evaluate whether you may be eligible for a whistleblower reward and guide you through the steps that need to be taken. Call 1-877-255-2676 today or contact us.
Medicare fraud whistleblowers will get a share of the $5.25 million settlement reached between the United States Department of Justice and a major pharmacy chain. RxAmerica, a subsidiary of CVS Caremark, settled claims that it misrepresented the cost of prescription drugs to seniors under Medicare part D.
Under the False Claims Act, a whistleblower receives a percentage of any monies recovered by the government. The amount a whistleblower could receive ranges from 15 to 30 percent of the total monetary recovery by the government.
If you have non-public information about Medicare fraud or other health care fraud, a whistleblower attorney can help you determine whether you have a case. We can help evaluate whether you may be eligible for a whistleblower reward and guide you through the steps that need to be taken. Call 1-877-255-2676 today or contact us.
Medicare fraud whistleblowers harmed by deceptive drug pricing
A common form of Medicaid and Medicare fraud is the use of what is called ghost patients. Health care providers submit claims to the government for health care services, medical devices, medical tests, pharmaceuticals, or procedures they never provide. Either the patients do not exist at all, or the patients exist but did not receive the health care.
If you have non-public information about ghost patient Medicaid fraud or other health care fraud, a whistleblower attorney can help you determine whether you have a case. We can help evaluate whether you may be eligible for a whistleblower reward and guide you through the steps that need to be taken. Call 1-877-255-2676 today or contact us.
Medicaid fraud whistleblower stops ghost patient scheme in Vegas
A man has pled guilty to charging Medicaid for expensive power wheelchairs while actually providing cheap, basic wheelchairs to recipients. Charging the government for more expensive medical equipment than actually provided is a common form of Medicaid Fraud called up-coding. The man, Uche Ben Odunzeh, also billed Medicaid for medical supplies he never even provided. Odunzeh, the owner of Empire Medical Services, submitted false claims to the government amounting to more than $275,000.
If you have non-public information about medical equipment Medicaid fraud or other health care fraud, a whistleblower attorney can help you determine whether you have a case and can guide you through the steps that need to be taken. Call 1-877-255-2676 today or contact us.
As detailed by the U.S. Attorney’s Office for the District of Columbia,
From on or about January 8, 2008, through on or about March 18, 2011, Emerald Medical submitted 100 claims to the District of Columbia’s Medicaid program for power wheelchairs, totaling $591,653. The D.C. (more…)
For off label marketing of the drug Depakote, a federal district judge last week ordered Abbott Laboratories to pay a $500 Million criminal fine, to forfeit $198.5 Million, and to pay $1.5 Million to the Virginia Medicaid Fraud Control Unit.
In May, Abbott Laboratories pled guilty to off-label marketing of Depakote for dementia and schizophrenia, uses not approved by the FDA. It also settled allegations that it marketed Depakote for psychiatric illnesses in children, including conduct disorders, attention deficit disorder and autism, and other psychiatric illnesses in adults, including depression, anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, alcohol and drug withdrawal, agreeing to pay $1.6 Billion.
Not only is Medicare fraud bankrupting the country, but it also endangers patients health. NYTimes tells the story of a man who received the wrong motorized chair – a shoddier, more dangerous chair than the one he had ordered – due to fraud. The Times explains the financial and health care costs:
Medicare abuse and fraud like this costs taxpayers tens of billions of dollars every year. The Centers for Medicare and Medicaid Services, or C.M.S., estimated that in 2010, the two programs together made more than $65 billion in improper federal payments. An April 2012 study by a RAND Corporation analyst and former C.M.S. administrator estimated that fraud and abuse cost Medicare and Medicaid as much as $98 billion in 2011.
A new study found a 62% increase in the number of children ages 3 to 18 who are enrolled in Medicaid taking antipsychotic drugs in the last ten years. The number of children taking such antipsychotics was 354,000 in 2007. Science Daily reports:
Increased antipsychotic use was observed across a wide range of mental health diagnoses, and was particularly high for children with ADHD or conduct disorder, although the FDA has not approved the drugs to treat these conditions in children. In total, 65% of children prescribed antipsychotics in 2007 were using the drugs “off-label,” or without FDA safety and efficacy data to support their use to treat young patients… (more…)
The Affordable Care Act, widely called “Obamacare,” provides new tools and funding for combatting Medicare fraud and Medicaid fraud. The purpose is to reduce the costs of fraud to the government and taxpayers. NPR explains:
Medicare and Medicaid pay out some $750 billion each year to more than 1.5 million doctors, hospitals and medical suppliers. By many estimates, about $65 billion a year is lost to fraud…. Criminals use real patient IDs to bill for wheelchairs that were never delivered or exams never performed. Dishonest doctors — a small percentage of physicians, to be sure — charge for care they never deliver or perform unnecessary operations. In one scam, criminals bill Medicare and a private insurer for the same patient.