Cases and News

Medicare Fraud Fought With New Tools

Posted by on Aug 22, 2012 in Medicaid Fraud, Medicare Fraud | 0 comments

Medicare Fraud

Medicare fraud being fought with new tools

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.

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GlaxoSmithKline to Pay $3 Billion in Pharmaceutical Whistleblower Case

Posted by on Jul 3, 2012 in Off-label drug marketing, Pharmaceutical Fraud, Whistleblower reward | 0 comments

GlaxoSmithKline pharmaceutical whistleblower

Pharmaceutical company GlaxoSmithKline has agreed to pay $3 billion in fines to the government in a pharmaceutical whistleblower case.  This is the largest pharmaceutical fraud settlement to date, and brings whistleblower lawsuit settlements to a total of $10 billion for 2012.  Whistleblowers get a share of these settlements as a reward for reporting fraud under the False Claims Act.

The pharmaceutical whistleblowers were four GSK employees, including a vice president and a senior marketing development manager.  The pharmaceutical fraud involved GSK’s conduct regarding Paxil, Avandia, Wellbutrin, and other drugs it manufactures.  To get doctors to prescribe the drugs, GSK paid for luxuries like tropical vacations and spa treatments.

According to prosecutors, GSK also promoted the use of Paxil in children, and helped publish a misleading (more…)

Whistleblower Reward of Nearly $21M for Health Plan Employee

Posted by on Apr 5, 2012 in Medicaid Fraud, Medicare Fraud, Pharmaceutical Fraud, Whistleblower reward | 0 comments

 

WellCare Health Plans employee blew the whistle on the managed care plan’s scheme to double bill Medicare and Medicaid for patient services.  The whistleblower was a senior financial analyst with WellCare, which provides managed care plans for 2.6 million people on Medicare and Medicaid.   The Tampa Bay Times explains the whistleblower reward:

 

Whistle-blowers who bring a lawsuit under the False Claims Act are entitled to receive a percentage of the recovery. Hellein’s award of $20.75 million represents his share of the $40 million in restitution received by the United States plus the federal portion of the $137.5 million civil settlement.

Source:  Tampa Bay Times

Do you have information about Medicare fraud, Medicaid fraud, or Pharmaceutical 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.