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False Claims Act Archives

Pennsylvania Hospital Settles FCA Case on Overbilling Government Healthcare Programs

The Lehigh Valley Health Network ("Health Network") has reached an agreement to pay nearly $700,000 to the federal government to settle a qui tam lawsuit alleging that it violated the False Claims Act by overbilling multiple federal healthcare programs. Hospitals and treatment centers within Health Network were allegedly misrepresenting the medical services provided to patients, and billing programs such as Medicare, Federal Employees Health Benefits, and Workers' Compensation in excess of reimbursement policy allowances.

Atrium Medical Corp. Settles False Claims Act Allegations for $11.5 Million

In March 2013, Esther Grace Sullivan, a sales representative and territory business manager at Atrium Medical Corp. ("Atrium" or the "Company"), alleged that the Company was paying doctors to use its iCast stents for unapproved uses, a violation of the False Claims Act ("FCA"). Medical stents are used to stop arteries from re-closing and Atrium's stents were approved to treat tracheobronchial obstructions, but doctors have used them for other vascular system purposes. The FCA claims against Atrium involved providing doctors dinners, giving them grants, and offering other kickbacks in order to incentivize them to use Atrium's medical stents. Although the government is typically involved in FCA cases, since these cases involve defrauding the government and cheating it out of large sums of money, the government was not interested in being part of the lawsuit. Nonetheless, the Plaintiff moved forward with her claims.

Home Care Co. Pays $21.5M to End FCA Suit

Medicare is a national social insurance program that provides health insurance to Americans who are aged 65 or older, younger people with disabilities, and people with end-stage renal disease and amyotrophic lateral sclerosis. As a social insurance program, it is largely funded by payroll taxes on employers and workers, and accounts for about 17% of the 2016 proposed Federal budget. The program contracts with regional insurance companies to process fee-for-service claims per year in order to provide health insurance options for eligible Medicare patients.

Worker Drops FCA Suit Against Shipbuilder

Both sides agreed to walk away from a whistleblower complaint on April 7, claiming that neither party had made payments or admitted fault. A set of workers had alleged that shipbuilder, Austal USA LLC ("Austal"), had defrauded the U.S. government by billing for higher salaries than it paid out.

Abbott Fends Off FCA Claim

The False Claims Act ("FCA" or "the Act") exists as an opportunity for citizens to bring the government's attention to fraudulent conduct that unduly costs the American taxpayer. While Abraham Lincoln originally signed the Act in 1863, the two most substantial components of the Act were implemented as amendments in 1986 and 2009. The two amendments lowered the standards of proof and increased the potential damages in these types of cases.

Department of Justice Subpoenas Alere in FCPA Probe

The U.S. Department of Justice issued a subpoena to Alere Inc. ("Alere" or the "Company") this March in connection with potential violations of the Foreign Corrupt Practices Act ("FCPA"). Alere operates primarily as a provider of point-of-service diagnostic devices and services for issues such as malaria and HIV. The launch of this investigation follows the Company's announcement that it is being acquired by Abbott Laboratories for $5.8 billion, which is expected to close by the end of the year.

U.S. Government Says D.C. Circuit Ruling Gives FCA Defendants Easy Out

Back in November, False Claims Act ("FCA") Defendants scored a huge victory in United States ex rel. Purcell v. MWI Corp. On February 8, the federal government asked the D.C. Circuit Court to reverse its judgment that held that Moving Waters Industries Corp. ("MWI)" was not liable for certifications it made to Nigeria because language in those certifications was ambiguous.

Novartis Settles $390M for Kickback Scheme

Novartis Pharmaceuticals Corporation ("Novartis") currently faces several False Claims Act ("FCA") charges for its alleged kickback schemes. Recently, Novartis has agreed to pay out $390 million to settle one of its major cases, which claimed it incentivized specialty pharmacies to increase sales of Exjade, an iron-reducing drug, and Myfortic, an immunosuppressant.

DOJ Intervenes in Inchcape FCA suit

The Department of Justice ("DOJ") entered into a False Claims Act ("FCA") suit against a defense contractor that allegedly caused false claims to be made to the U.S. Government. Inchcape Shipping Services Holdings Ltd. ("Inchcape" or the "Company") is accused of overcharging the U.S. Government for port services around the world.

False Claims Act Case Settles for $256 Million

In some regions around the country, a kickback consists of a group of friends winding down and "kicking back" at a casual gathering. However, in the professional and legal arena, a kickback is a form of bribery. The False Claims Act ("FCA") prevents kickbacks in the healthcare industry under the Anti-Kickback Statute, which forbids healthcare facilities from, inter alia, bribing doctors to refer Medicare patients to them. Those practices are illegal because they are prompting the government to spend public funds superfluously solely for the companies' own profit. Furthermore, the qui tam provisions in the FCA provide certain protections and incentives to whistleblowers who file FCA lawsuits against companies and individuals that defraud the government.