False Claims Act/Qui Tam

This blog is about qui tam, a  lawsuit brought under the False Claims Act by a private plaintiff on behalf of the Federal or State Government (rather than by the Government itself). The False Claims Act was originally enacted by Congress in 1863, as a response to widespread abuses by government contractors against the Union Army during the Civil War. The qui tam provisions are now used widely and this blog is intended to keep readers up to date with all qui tam related news and to provide commentary when warranted.  This blog also contains an array of laws and regulations concerning qui tam set out in an easy to read format.

Posts tagged as:

Medicaid

Eon Labs Pays U.S. $3.5 Million to Settle Medicaid False Claims Allegations in qui tam case brought by Nolan and Auerbach, P.A. Client

by Nolan and Auerbach on February 22, 2010

Eon Labs Inc. has agreed to pay the United States $3.5 million to resolve False Claims Act allegations relating to the company’s drug Nitroglycerin Sustained Release (SR) capsules, the United States Department of Justice (DOJ) announced Feb. 22, 2010. Eon Labs is a subsidiary of Sandoz Inc., which is in turn a subsidiary of Novartis AG.

In April 1999, the Food & Drug Administration (FDA) determined that the unapproved drug Nitroglycerin SR lacked substantial evidence of effectiveness and published a notice proposing to withdraw approval of the product.  The qui tam lawsuit alleged that, after the FDA notice, Nitroglycerin SR no longer was legally eligible for reimbursement by government health care programs such as Medicaid.

The lawsuit alleged that  Eon submitted false quarterly reports to the government that misrepresented Nitroglycerin SR’s regulatory status as a Covered Outpatient Drug under the Medicaid program.

The settlement resolves allegations against Eon in a multi-defendant whistleblower action, which remains sealed in part.

For the full release, go to: http://www.justice.gov/opa/pr/2010/February/10-civ-171.html.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA. at http://www.whistleblowerfirm.com.

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U.S. Intervenes in Whistleblower Suit against Community Health Systems and New Mexico Hospitals

by Nolan and Auerbach on March 8, 2009

The United States is intervening in a whistleblower suit that alleges that Community Health Systems Inc. (CHS) and three of its hospitals in New Mexico violated the False Claims Act (FCA) by presenting the government with false claims for federal matching Medicaid funds.

According to the U.S. Department of Justice, which made this announcement March 6, 2009, the suit was filed under the qui tam or whistleblower provisions of the FCA by Robert Baker, a former revenue manager in CHS’s corporate office.

The relator’s complaint alleges that, beginning in 2000, CHS and its hospitals improperly obtained federal funds through the New Mexico Sole Community Provider Fund (SCPF) and Sole Community Hospital Supplemental Payments (SCHSP) Medicaid programs.

To review the DOH press release, go to http://www.usdoj.gov/opa/pr/2009/March/09-civ-200.html. Or, for more information about the False Claims Act or qui tam whistleblower law, contact Nolan and Auerbach, PA.

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Dallas Hospital Reaches Settlement With the Government for Stark Violations

by Nolan and Auerbach on January 2, 2008

According to the U.S. Attorney Richard B. Roper of the Northern District of Texas, Harris Methodist HEB Hospital, a 284 bed acute-care facility, will pay $1.9 million to settle allegations that it violated the False Claims Act by improperly submitting claims for payment for orthopedic-related items and services.  These claims were identified as having taken place between March 15, 2004 and September 1, 2005.

According to the hospital in its own news release, the parent company of Harris Methodist HEB Hospital (Texas Health Resources) did a self report by telling the Office of Inspector General of Health and Human Services about it identification of a physician contract that did not comply with federal regulations. This triggered an investigation based on information provided by Harris Methodist HEB that Medicare and Texas Medicaid programs paid for orthopedic items and services referred to the hospital by a physician group that received free rent from the hospital, a violation of Stark self-referral law (also known as Physician Self-Referral Law).

The Stark law was created to forbid physicians from profiting from their own referrals.  This law acts to sanction improper physician referrals and to stop the potential for over-utilization. In this fashion, physicians and other health care professionals are able to exercise independent judgment for what is in the best interests of their patients as opposed to themselves.

To read the full story click here or on the following to read more about the False Claims Act and the Stark Laws .

If you believe you have information concerning a violation of the False Claims Act and want to read more about Nolan & Auerbach, P.A. you may contact us.

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Hospitals Are Giving Lessons on Blowing the Whistle on Fraud

by Nolan and Auerbach on December 27, 2007

A federal law that takes effect in January 2007 requires the country’s hospitals and nursing homes to educate their employees and officers on how to detect and report fraud. This requirement applies to companies that earn at least $5 million a year in Medicaid business. Under the False Claims Act, whistleblowers have received millions of dollars for disclosing large-scale fraud.

To read more, click here.

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