Articles Tagged with california healthcare fraud attorney

andres-de-armas-103880-copy-300x200In early September, the U.S. Department of Justice (DOJ) announced pharmaceutical manufacturer Novo Nordisk Inc. has agreed to pay $58.65 million for failing to comply with a Food and Drug Administration (FDA) mandated Risk Evaluation and Mitigation Strategy (REMS) program. The REMS was for Novo Nordisk’s Type II diabetes medication Victoza, which created a risk of a rare form of cancer in humans known as Medullary Thyroid Carcinoma. Novo Nordisk was required to take steps to mitigate this potential risk, including providing information about MTC to physicians. By failing to mitigate the risk as prescribed in the REMS, the FDA determines the drug is misbranded under the law.

Novo Nordisk’s Alleged Misconduct

The DOJ claimed in a complaint that Novo Nordisk violated the Federal Food, Drug, and Cosmetic Act (FDCA) between 2010 and 2014 and violated the False Claims Act (FCA) between 2010 and 2014. According to the complaint, Novo Nordisk sales representatives gave physicians the false or misleading impressions regarding the Victoza REMS was not important. The representatives framed the information in such a way as to make the warning appear irrelevant.

daan-stevens-282446-copy-300x191The U.S. Department of Justice (DOJ) announced August 18 that the owner and operator of five home health agencies located in the Houston area, Godwin Oriakhi, 61, was sentenced to 480 months in prison for conspiring to defraud Medicare and the Texas’ Medicaid programs: Home and Community-Based Service (HCBS) and Primary Home Care (PHC), which are known as provider attendant services (PAS). The authorities found Oriakhi defrauded Medicare and the Medicaid programs for more than $17 million, making this the largest PAS fraud case in all of Texas’ history.

More on Oriakhi’s Fraud

Oriakhi pleaded guilty to two counts of conspiracy to commit health fraud and one count of conspiracy to launder monetary instruments in March 2017. This came after Oriakhi admitted that he and his daughter, a co-defendant in the case, and other members of his family obtained patients for his home health agencies through illegal kickbacks to patient recruiters, his office employees, and physicians. His five facilities receive hundreds of patient referrals this way.

aidan-bartos-313782-copy-300x200On August 10, the Department of Justice (DOJ) announced victory in another healthcare fraud case. A federal jury convicted registered nurse, Evelyn Mokwuah, 52, of criminal involvement in a $20-million Medicare fraud scheme. Mokwuah owned two home health companies based out of Houston, Beechwood Home Health and Criseven Health Management Corporation. She and these companies were convicted of making fraudulent claims to Medicare for home health services.

Healthcare Fraud Trial Ends Well for Government

There was a four-day trial regarding Mokwuah’s fraudulent activities. She was convicted of four counts of health care fraud and one count of conspiracy to commit health care fraud. Evidence at trial was based on claims made to Medicare by the two companies between 2008 and 2016. Fraudulent claims were made for home health services that were either not provided or were provided when not medically necessary.

hospitalOne of the many ways that patients are at the mercy of their health care providers and insurers is through pharmaceuticals and prescriptions. Doctors write specific prescriptions, sometimes based on pharmaceutical advertisements, that may require that patients receive name brand drugs. Insurers place limitations on the types of drugs that insureds can access. Another way that insurers and pharmaceutical companies have been limiting patient options is by engaging in health care fraud in order to increase profits at the expense of patient choice. Luckily, False Claims Act lawsuits have exposed pharmaceutical fraud, and actions have been taken against some major perpetrators.

Medco Fraud Settlement

According to the Corporate Crime Reporter, former AstraZeneca employees filed a qui tam lawsuit against AstraZeneca, a pharmaceutical manufacturer, and Medco, a company that manages pharmacy benefits. The lawsuit alleged that Medco and AstraZeneca entered into hidden financial agreements based on which Medco received lower prices on three AstraZeneca drugs in exchange for including one of AstraZeneca’s medications as the only one of its kind on some of Medco’s list of covered prescriptions.