December 14, 2018 - Posts

Whistleblower Roundup – December 14, 2018

A look back at the week’s news and developments affecting whistleblowers.


Drug Maker Actelion Agrees to Pay $360 Million for Illegal Kickback Scheme

Actelion Pharmaceuticals Inc. has agreed to pay $360 million to resolve claims that it illegally funded a “charitable” foundation in order to pay the copays of thousands of Medicare patients taking their arterial hypertension drugs. Actelion violated both the False Claims Act and Anti-Kickback Statute by using a charity foundation as an illegal conduit to pay the copay obligations of thousands of Medicare patients. To read more from The New York Times, click here.


Coordinated Health and its CEO Pay $12.5 Million to Resolve Fraudulent Billing Claims

Coordinated Health, and its founder/CEO Emil DiLorio, have agreed to pay $12.5 million to resolve allegations under the False Claims Act. Allegedly, Coordinated Health engaged in a scheme to artificially inflate the reimbursement claims for orthopedic surgeries. As a result, Medicare and Medicaid routinely overpaid Coordinate Health for its surgeries. To read more from Reuters, click here.


Western Medical Group Agrees To Pay $1.6 Million To Resolve False Claims Act Allegations

Western Medical Group, a durable medical equipment provider, has agreed to pay $1.6 million to settle False Claims Act allegations. The company allegedly violated Medicare’s prohibition against telephone solicitation of covered products to beneficiaries by engaging in a telemarketing scheme to sell knee and back braces to Medicare patients. The investigation began with two whistleblower suits filed by former Western Medical employees. To read the full DOJ press release, click here.


Target Corporation To Pay $3 Million Concerning Auto Refilling Medicaid Prescriptions

Target Corporations has agreed to pay $3 million to resolve False Claims Act allegations for illegally submitting claims to Massachusetts’ Medicaid program (MassHealth). MassHealth does not allow pharmacies to automatically refill prescriptions paid for by Medicaid without an explicit request from the beneficiary. However, Target pharmacies knowingly enrolled MassHealth beneficiaries in auto-refill programs. A whistleblower, under the qui tam provision of the False Claims Act, brought these allegations forward in a civil lawsuit. To read the full DOJ press release, click here.



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