Healthcare and Pharma Cases

OtisMed Corp. and its former chief executive officer, Charlie Chi, have agreed to pay more than $80 million to resolve criminal and civil liability for knowingly submitting fraudulent claims to Medicare regarding the sale of a medical device. This was in violation of both the False Claims Act and the Federal Food, Drug, and Cosmetic Act.

The civil settlement resolves claims filed under the whistleblower provisions of the False Claims Act, which allows private citizens to file suit on behalf of the United States government and to share in the government’s financial recovery.

The whistleblower case against OtisMed was brought by Richard Adrian, a former sales executive with Stryker Corp., the Michigan-based parent company of OtisMed. Adrian, who worked at Stryker for 15 years, got $7 million for his efforts.

Since 2009, the U.S. Department of Justice has recovered $23 billion under the False Claims Act, with $15 billion of that being from fraud perpetrated against federal health care programs....

Donald Gallick and Tracy Lovvron will soon collect over $2 million for their roles in blowing the whistle on fraudulent practices and corruption at Extendicare Health Services, Inc. nursing home facilities.

The plaintiffs filed separate whistleblower lawsuits against Extendicare per the False Claims Act, a federal law that allows private individuals to sue on behalf of the government to recover fraudulently obtained funds. Lovvron will receive over $1.8 million as a reward for exposing fraud, and Gallick will collect over $250,000.

Intentional, Systematic Attempts to Defraud Money from Medicare

Extendicare employed Tracy Lovvorn from 2008 to 2009, during which time she claimed that she discovered a substandard pattern of care. She said Extendicare facilities in Delaware and Pennsylvania prescribed unnecessary therapies to claim extra reimbursements from Medicare. Patients didn’t need the help, but the company provided it anyway to take advantage of Medicare reimbursement policies....

Community Health Systems Inc., the largest operator of acute care hospitals in the United States, agreed to pay $98 million in a settlement announced today by the U.S. Department of Justice.

Seven False Claims Act Whistleblower Lawsuits

The settlement allowed the healthcare giant to resolve seven lawsuits filed by nine whistleblowers under the U.S. False Claims Act that alleged Community Health Systems had intentionally billed federal healthcare programs (Medicare and Medicaid) incorrectly at 119 different hospitals between 2005 and 2010, resulting in additional profits for Community Health Systems Inc. and higher costs to the government....

Various states are readying to collect their portions of a $124 million Federal False Claims Act settlement with Omnicare, Inc. Whistleblower Donald Gale, who brought the initial claim against the nation’s largest nursing home pharmaceuticals provider under the False Claims Act, was awarded 14 percent of the total settlement amount.

Omnicare Pharmacist Gale Filed Federal False Claims Act Whistleblower Lawsuit

Accusations were initially raised in 2010 by qui tam claimant Donald Gale, general manager of an Ohio Omnicare pharmacy. Gale filed a lawsuit on his own behalf and on behalf of the United States using the Federal False Claims Act....

Amedisys home health care companies will pay $150 million to settle claims of seven whistleblower lawsuits for healthcare fraud filed under the False Claims Act in federal courts alleging fraudulent home healthcare billings to Medicare and improper financial relationships with physician groups.

Whistleblowers Included April Brown, Natalie Raven, and Others

Amedisys whistleblowers listed on the seven False Claims Act complaint captions as relators included April Brown, CAF Partners, Umberhandt, Ognen, Lewis, and Natalie Raven. The lawsuits were filed under the False Claims Act terms allowing citizens to file whistleblower suits on behalf of the U.S. and share in any money recovered....

When Jennifer Denk, a Wisconsin pharmacist employee of PharMerica, learned that Schedule II narcotics were being dispensed under her professional license without a valid prescription, she told her managers what was happening. PharMerica, a national provider of pharmaceutical services, management allegedly ignored her. She notified the U.S. Drug Enforcement Agency in May, 2009. Agents raided the company’s Pewaukee, WI facility and Denk was fired.

Jennifer Buth Whistle Blower Lawsuit Taken Over by Dept. of Justice

In 2009 Denk, now Jennifer Buth, filed a whistle blower lawsuit, which was recently made public or “unsealed”, when the U.S. Department of Justice took over prosecution of the civil case. According to the complaint, PharMerica dispensed the drugs oxycodone and fentanyl in non-emergency circumstances without a physician’s prescription in violation of the Controlled Substances Act and defrauded Medicare when the company collected reimbursements for the drugs illegally dispensed....

Pharmaceutical whistleblower cases don’t always center around off-label marketing and illegal kickbacks anymore. In the largest individual whistleblower award case to date, former SmithKline quality assurance manager, Cheryl Eckard, won a record $96 million for reporting ’s FDA current good manufacturing practices (CGMP) violations, the Department of Justice announced Tuesday.
SB Pharmco Puerto Rico Inc., a subsidiary, pleaded guilty to manufacturing and distributing...