False Claims Act


VNSNY Agrees to $57 Million Settlement
June 29, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY, …
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False Claims Act, Medical Necessity and Government Regulation of Medicine
May 14, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
Rivkin Radler’s Geoffrey R. Kaiser authored an article for Law360 entitled “False Claims Act, Medical Necessity and Government Regulation of Medicine.” The full article can be found here. …
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OIG Posts FAQs on Enforcement During Pandemic
April 29, 2020 | Geoffrey R. Kaiser | Behavioral Health | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Telehealth
On April 24, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published responses to certain frequently asked questions and further explained its application of administrative enforcement authorities to arrangements directly connected to the COVID-19 pandemic. OIG stated that it is accepting inquiries regarding application of its administrative …
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Surgeon Sues Health System for ‘Forced Referrals’
April 8, 2020 | Rivkin Rounds Staff | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Litigation
An article in the April issue of Healthcare Risk Management, “Surgeon Sues Health System for ‘Forced Referrals’,” discussed a whistleblower lawsuit filed against a Florida health system. Rivkin Radler’s Geoffrey Kaiser was quoted in the article. Jeff pointed out that if a surgeon is an employee of a health system, requiring him to refer his …
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Medical Equipment Co. to Pay $37.5M to Settle Kickback Claims
January 17, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid
The U. S. Department of Justice (DOJ) announced on January 15 that ResMed Corp., a San Diego-based manufacturer of durable medical equipment, will pay $37.5 million to the federal government to settle five qui tam (whistleblower) cases under the False Claims Act (FCA) alleging that ResMed paid kickbacks to DME suppliers, sleep labs and other …
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DOJ Reports $3 Billion in 2019 False Claims Act Recoveries
January 14, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
The U.S. Department of Justice (DOJ) announced last week that in the fiscal year ended September 30, 2019, it obtained more than $3 billion in total recoveries from civil cases brought under the False Claims Act (FCA). The total, a slight increase from the $2.9 billion recovered in the prior fiscal year, included both settlements …
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The Broad Reach of the Medicare Fraud Strike Forces
January 3, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals | Telehealth
Rivkin Radler’s Evan Krinick authored an article for the New York Law Journal, “The Broad Reach of the Medicare Fraud Strike Forces.” The article discusses recent strike force actions in New York and New Jersey that targeted a variety of healthcare fraud schemes.   …
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Sutter Health to Pay $45 Million for Stark Law Violations
November 22, 2019 | Eric D. Fader | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
The U.S. Department of Justice (DOJ) announced on November 15 that Sutter Health, a northern California health system, agreed to pay a total of $45.6 million to settle allegations that it violated the Stark Law in submitting claims to Medicare for services. Sacramento Cardiovascular Surgeons Medical Group Inc. (Sac Cardio), whose physicians referred patients to Sutter, also …
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Life Spine Settles FCA Kickback Case for $6 Million
October 31, 2019 | Eric D. Fader | Affordable Care Act | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid
Spinal implant manufacturer Life Spine Inc. and two of its executives have settled their False Claims Act case by agreeing last week to pay the federal government $6 million. As discussed here, the company and executives had been accused of paying kickbacks to surgeons to use the company’s products. In addition to paying $5.5 million …
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Hospital to Pay $20 Million to Settle Whistleblower Case
October 29, 2019 | Eric D. Fader | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medical Devices and Wearables | Medicare and Medicaid
The U.S. Department of Justice (DOJ) announced on October 28 that Sanford Health, a hospital in Sioux Falls, South Dakota, will pay $20.25 million to settle a whistleblower lawsuit alleging violations of the False Claims Act and federal Anti-Kickback Statute. Two surgeons at the hospital filed the suit alleging that the hospital allowed another surgeon …
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