4 Settlements for Justice Dept as Health Care Companies Seek to Avoid Coal for Christmas

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Close Up of Building - Settlements for Justice Department, representing government's veto power

End of the Year Settlements

It must be the last weekend before Christmas because health care companies are looking to resolve government investigations into their wrongdoing before we leap into the new year! In the last two days, we’ve now seen four multi-million dollar settlement announcements in False Claims Act cases.

A pharmaceutical company settled allegations that it billed federal healthcare programs for chewable fluoride tablets which contained less than half of the amount of fluoride ion contained on its label, causing children to receive less fluoride than recommended by the American Dental Association guidelines. The company stopped selling the tablets when the government started investigating and will now be $39 million to the federal government and various states under the federal and state False Claims Acts. The whistleblower will receive $4.71 million.

A cancer care service paid nearly $20 million to resolve allegations it billed Medicare and Tricare for unnecessary urine tests to detect genetic abnormalities consistent with bladder cancer. The government alleged that the laboratory tests for fluorescence in situ hybridization. The whistleblower, a medical assistant that formerly worked at the company, will receive $3.2 million from the recovery.

Another large group of hospitals agreed to pay a total of $28 million to resolve allegations that they performed kyphoplasty as an inpatient procedure in order to increase their billings rather than perform it as a less costly outpatient procedure. Kyphoplasty is a minimally-invasive procedure treating certain spinal fractures resulting from osteoporosis. The government has now reached settlements with over 130 hospitals and the medical device company responsible for the procedure. It previously paid $75 million to settle allegations it counseled hospital providers to perform the procedures on an inpatient basis.

A splint supplier has agreed to pay just over $10 million to resolve allegations of improperly billing Medicare for splint reimbursement when the government was already paying a bundled fee to the skilled nursing facility for their treatment. The defendants misrepresented the patients were in their homes rather than in a SNF.

The False Claims Act rewards whistleblowers who come forward with evidence of fraudulent billing of Medicare and Medicaid, as well as other government programs, with 15 to 30 percent of the government’s recovery. If you have evidence of a company engaged in wrongdoing similar to one of the above examples, please call our whistleblower attorneys at 1-800-590-4116 for a free, confidential legal consultation.

Congrats to all of the whistleblowers and their counsel in these cases!