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Articles Tagged with health care fraud law firm

medicine$If you take medication regularly, why do you take it?  Why that specific medicine?  Hopefully, the answer is that you take it for a genuine medical need and, along with your doctor and pharmacist, you chose that specific medication because it is the best fit for your medical needs.  A lot of attention has been paid in recent years to how money intrudes on medicine, specifically people’s inability to afford the medicines they need.  However, money also intrudes in other ways as shown by the long story of Risperdal and the allegations of improper marketing of pharmaceuticals.  This is yet another area in which the False Claims Act (“FCA”) can be used to combat health care fraud and our pharmaceutical marketing fraud law firm is prepared to be part of this fight.

The Case of Johnson & Johnson and the $2.2 Billion Settlement

One of the longest Department of Justice (“DOJ”) press releases we’ve read on FCA claims dealt with one of the largest FCA settlements — Johnson & Johnson’s (“J&J”) agreement to pay $2.2 billion to settle a variety of claims involving off-label marketing and kickbacks.  The settlement includes both criminal and civil allegations.  The claims largely surround the drug Risperdal which, for most of the time involved, was approved only for the treatment of schizophrenia.

We frequently write about healthcare fraud and other forms of government contract fraud.  We cannot overemphasize the role that whistleblowers play in prosecuting these cases.  According to the Justice Department, nearly $3 billion of the $5.69 billion recovered through settlements and judgments in civil False Claims Act (“FCA”) litigation in Fiscal Year 2014 stemmed from qui tam lawsuits filed by private whistleblowers.  Who are these whistleblowers?  In some cases, they are high-ranking executives in companies that committed fraud.  However, whistleblowers can also be “rank and file” employees, the “everyday” workers who form the majority of any large operation, or even company outsiders.  Our law firm for government fraud whistleblowers works with people from all ranks of society who take step forward and join the fight against fraud.

Settlement In Suit Brought By Medical Technician

Last month, the Sacramento Bee reported that Quest Diagnostics agreed to pay $1.8 million to settle Medicare fraud claims.  According to the allegations, Quest submitted duplicate claims for Medicare reimbursement for the same test performed on a single day and a single patient.  A Quest spokesperson suggested IT issues caused rare cases of duplicate payments impacting a “miniscule percentage” of the company’s annual Medicare claims and said Quest is updating its billing systems to prevent a recurrence.

As a health care fraud law firm, we work with private whistleblowers nationwide to protect taxpayer money and ensure the health of millions of Americans.  Often, scammers who defraud the federal system also target state health care programs.  We work to fight this type of fraud too, recognizing that these systems are also vital to the health and well-being of countless individuals.  While we can handle health care fraud matters across the country, we have particularly strong ties to California and Florida.  In today’s post, we look at a problem plaguing California – Medi-Cal fraud involving drug treatment clinics.

Director Apologizes for Medi-Cal Fraud

Last September, The Center for Investigative Reporting (“CIR”) reported on legislative hearings in which Toby Douglas, the director of Medi-Cal, apologized for systemic problems involving the failure to effectively monitor taxpayer-funded drug rehabilitation programs.  In the course of those hearings, it became clear that the agency knew about widespread sham billing by “rogue clinics” as early as 2007.  In 2014, the agency temporarily suspended 73 clinics and 101 other counseling sites, locations that had bilked Medi-Cal out of more than $36 million in the previous fiscal year alone.  At the time of the report, there were at least 64 on-going fraud investigations looking into these scams.

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