William Verrinder filed a False Claims Act against three of America’s biggest companies—Wal-Mart, Sears and Rite-Aid—claiming they charged Medicare for expired drugs. Since he’s a lawyer himself, he filed pro se. That way he...more
Sir Arthur Conan Doyle might have called it “The Case of the Doctors Who Work More than 24 Hours a Day.” Unfortunately for the physician group in question, Sir Arthur wasn’t the author; the federal court for the Northern...more
Last week a federal court in Florida granted a radiology practice’s motion for judgment in its favor in a False Claims Act case, despite these formidable obstacles: (1) the practice had billed Medicare for services performed...more
Some questions can’t be answered in a vacuum. That’s the situation when the question is whether an entity wants to be part of the state or separate from it. If the specific issue is whether its board meetings are open to...more
On Monday the United States Supreme Court declined to hear Danny Smart’s appeal of the Fifth Circuit’s rejection of his attempt to share in the proceeds of a $5 million settlement of a False Claims Act suit brought by another...more
Last Wednesday the Seventh Circuit affirmed the dismissal of a whistleblower suit brought by a pharmacist against his former employer, the Shopko pharmacy chain, for what he alleged was fraudulent billing of Medicaid by...more
We’re only one-third of the way through the month of November, but we already have a winner of November’s Generality-in-Pleading Award. The hands-down winner is Dr. Warren Troxler, whose False Claims Act whistleblower suit...more
Want to be a whistleblower but worried your own wrongdoing will prevent it? If so, Tuesday’s decision by a federal court in Texas should come as welcome news. In that long-running False Claims Act case, the court rejected a...more
Back in 2003 Karl Schumann filed a whistleblower suit alleging that as an executive with benefits company Medco, he learned that Bristol-Myers Squibb and AstraZeneca paid kickbacks to Medco to buy and recommend brand name...more
In August the Seventh Circuit expressed its view that so-called “worthless services” cases don’t state a claim under the False Claims Act. Last Friday the court reaffirmed its view by refusing to rehear the case en banc....more
On Tuesday a federal court in Illinois awarded fees of $200,000 to attorneys for a whistleblower in a False Claims Act action. Not impressed? Well, consider this: the whistleblower got a little less than $30,000. Figured...more
Antonio Saidiani filed a whistleblower suit alleging that NextCare urgent centers and CEO Dr. Shufeldt had collected tens of millions of dollars in false Medicare claims. Antonio was in a position to know because he was that...more
Brand name drugs cost a lot. So to make them more attractive, drug manufacturers issue coupons for discounts on the copayment portion of the price. They work the same as the dollar-off coupons offered by cereal manufacturers....more
Last Friday’s Eighth Circuit decision in Thayer v. Planned Parenthood of the Heartland favored the whistleblower in the ongoing controversy over specificity requirements in False Claims Act actions. The split had been even...more
Two nurses filed a whistleblower suit against the Illinois nursing home where they worked. Their theory was that the care provided at the home was so poor that it was worthless. So any bills to Medicare and Medicaid were...more
In U.S. ex rel. Corporate Compliance Assocs. v. N.Y. Society for the Relief of the Ruptured & Crippled the court ruled that the whistleblower failed to meet the False Claims Act’s requirement that allegations be described...more
Medicare and Medicaid providers lie awake at night worrying about disgruntled—or worse yet, fired—finance officers filing whistleblower suits. After all, Medicare and Medicaid regulations are notoriously complicated, and...more
You probably didn’t think Florida’s Halifax Health could make its situation any worse. After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case. That still...more
5/30/2014
/ Damages ,
Destruction of Evidence ,
False Claims Act (FCA) ,
Fraud ,
Halifax Hospital ,
Healthcare ,
Healthcare Fraud ,
Hospitals ,
Medical Records ,
Medicare ,
Penalties ,
Settlement