Medical device manufacturers may seek to track the use and effectiveness of its products in many ways. However, the Department of Justice says that Covidien went too far by providing kickbacks for institutions that provided registry data. Authorities say that the manufacturer launched a registry to collect data regarding its mechanical thrombectomy device, Solitaire.
As one of the nation's largest retailers, Target has more than 10 stores scattered across the Milwaukee metro area. The department store chain recently agreed to pay almost $3 million to resolve a whistleblower lawsuit that claimed the company violated Medicaid prescription rules prohibiting automatic refills.
Commentators believe that many health care companies and medical providers exaggerate the severity of medical conditions of patients who receive Medicare benefits -- including participants of Medicare Advantage Plans - to increase company profits. Health care fraud depletes resources, and taxpayer money, effectively harming taxpayers and patients alike. Federal law allows individuals with knowledge of fraudulent practices to bring forth lawsuits on behalf of the government to recover taxpayer money that is obtained through fraudulent practices related to government programs or contracts.
The federal government has vast resources, but detecting fraud in programs and contracts is no easy task in the normal course of business. The False Claims Act (which was initially enacted during the President Lincoln years) allows private individuals to file a lawsuit on behalf of the government to expose fraud and recover unlawfully obtained taxpayer money. Whistleblowers receive a percentage of any verdict or settlement that arises from the lawsuit.
Surrounded by mountains and forest, Kalispell, Montana, is the gateway to one of the nation’s natural wonders: Glacier National Park. The beautiful scenery is a backdrop to an ugly scandal focused on the 138-bed hospital that takes its name from the town. The medical center has been roiled by charges that physicians there took illegal kickbacks and defrauded the federal government.
On its website, Bayada Home Health Care urges its employees to “do the right thing.” Three former employees believe they’ve done just that by filing a whistleblower lawsuit that accuses Bayada of fraudulent Medicare billing.
Creating unfair incentives to bring in business in the health industry may be the basis for a claim under the False Claims Act. Improper contracts may come in a variety of forms. Kickback schemes and similar inducements to increase revenues from Medicare or Medicaid reimbursements are often the focus of health care fraud lawsuits. Private individuals may initiate a lawsuit on behalf of the government to expose fraud in government contracts.
Six years ago, a Department of the Interior employee reported to his supervisors that the federal department had violated the National Environmental Policy Act in order to make it easier for Arctic Ocean oil exploration. When Jeffrey Missal's supervisors showed little interest, he reported the infraction to the department's Inspector General.
A hospital system on the West Coast has agreed to settle a False Claims Act lawsuit that alleged the healthcare company drove up its profits by admitting patients without medical necessity. The Department of Justice says the Prime Healthcare, some affiliated entities and the founder of the healthcare system have agreed to pay $65 million to settle the whistleblower lawsuit. A former Director of Performance Improvement at one of the hospitals in the system brought the original lawsuit on behalf of the government. She is expected to receive $17,225,000 million for bringing forth evidence and filing the initial claim.
A regional hospital system based in the upper Midwest has agreed to settle a whistleblower lawsuit for $84.5 million. The allegations arose before the healthcare organization was formed -- new management took over after the merger that created the new organization. However, as a successor business, the regional hospital system has agreed to make things right.