Health Care Fraud Report Index-Summary

QUALITY OF CARE

– Accountable Care Organizations (ACOs)

– – Changes needed to qualify for ACO status, 833
– – Guidance sought on avoiding fraud issues, 835

– Arthritis injections administered improperly, charges settled (D. Conn.), 803
– Dental firm, low-income children, $24M settlement (D. Md.), 72
– False claims, substandard services as basis for relief, Insight, 226
– Hospitals

– – Infections, health care-associated, add substantially to hospital costs, study, 208
– – Long-term, Senate finance leaders seek data, 243
– – Waycross, Ga., qui tam suit, U.S. intervenes (S.D. Ga.), 337; doctor and hospital charged, 654

– Nursing homes

– – Patients' rights, suing for violations (U.S., rev sought), 32; (briefs filed), 118; (rev den), 167
– – Poor performance, CMS compliance, GAO report, 379
– – St. Louis, fraud (E.D. Mo.), 19
– – Surveys

– – – CMS accuracy, 14
– – – Federal and state, differences in findings, report, 449

– Psychiatric care conditions, NYC improvements (E.D.N.Y.), 18
– SNFs

– – Ark., patients in immediate jeopardy, penalty (8th Cir.), 22
– – Failure to minimize accident risk, civil fine (7th Cir.), 420
– – Failure to report changed condition, immediate jeopardy finding upheld (6th Cir.), 582
– – N.C., Medicare safety rules, penalties (4th Cir.), 117

QUI TAM SUITS

– Ambulance firms, NYC, settlement (E.D.N.Y.), 505
– Ambulatory surgery center, false claims pleading lacks particularity (E.D. Va.), 662
– Arbitration, motion to compel granted (N.D. Ohio), 748
– Cardiac diagnostic firm settles whistleblower suit (C.D. Cal.), 576
– Cataract surgery

– – False claims, patient vs. doctor and clinic (M.D. Fla.), 123
– – Unnecessary procedures alleged, partial dismissal (W.D. Wash.), 754

– Certification claims

– – Pleading failure, dismissal upheld (9th Cir.), 698; (U.S., rev sought), 848
– – Tenet Healthcare counsel charged (S.D. Fla.), 295

– Corporation as original source, Ven-A-Care pharmacy (D. Mass.), 114; Teva settles for $315M, 159; Teva settles federal and state claims, 629
– Dental care, substandard, $24M settlement (D. Md.), 72
– Dermatologists

– – NYC, falsely obtained certification, settlement (S.D.N.Y.), 507
– – Whistleblower/HIPAA concerns, amended case (E.D. Tenn.), 456

– Discovery

– – Delays, sanction (M.D. Pa.), 76
– – Ex parte patient interviews allowed (N.D. Ill.), 575

– DME, Lifetime Med. Supplies, suit dismissed (E.D. Ark.), 747
– Drugs

– – Antibiotic TOBI, Novartis to pay $72M false claim settlement, 410
– – Human growth hormone, suit alleging drug maker caused fraud dismissed (D. Mass.), 756
– – Jurisdiction, Raplon, original source (3d Cir.), 165
– – Levothroid and Celexa, false claims, settlement (D. Mass.), 741
– – Misbranded generics, two firms dismissed from suit (D. Md.), 583; third firm dismissed, 747
– – Off-label use

See Off-label use, this heading

– – OxyContin, marketing fraud, insufficient pleading (4th Cir.), 303; employment pact issue (U.S., rev sought), 740; (rev den), 837
– – Pharmacy firm Omnicare settles Medicaid overcharging claims (N.D. Ill.), 795
– – Procrit, kickbacks, original source disclosure (U.S., rev sought), 8; Solicitor Gen. view sought, 164; (rev den), 551

– Evidence, qui tam relators may use documents obtained by state enforcers (S.D. Tex.), 612
– Failure to file complaint under seal, dismissal upheld (6th Cir.), 840
– FQHC officer, pleading deficiency (M.D. Ga.), 75
– Health insurance, whistleblower suit filed against WellCare (M.D. Fla.), 576
– Home health care, miscoding alleged, some claims revived (7th Cir.), 457
– Hospitals

– – Anesthesiologists/Carlisle hospital pact, Stark and kickback claims go to trial (M.D. Pa.), 336
– – Auditor-caused false claims alleged, suit dismissed (S.D.N.Y.), 755
– – Bad faith pleading, hospital may seek sanctions (W.D.N.Y.), 216; sanctions imposed, 511
– – Nonphysicians, billing, settlement (E.D. Mich.), 28
– – Referrals, dismissal of suit reversed (9th Cir.), 697
– – Self-referrals, Rush Univ. hospital settles claims (N.D. Ill.), 249
– – Substandard services, U.S. intervenes in Ga. hospital suit (S.D. Ga.), 337; doctor and hospital charged, 654

– Limitations periods

– – Appeals, grant application (9th Cir.), 114; (U.S., rev den), 838
– – Brooklyn, N.Y. hospital, case untimely filed (S.D.N.Y.), 252
– – Certification claims, Tenet Healthcare counsel charged (S.D. Fla.), 382; case time-barred, 382

– Malpractice, Medicaid contractors need not seek reimbursement from negligent providers (8th Cir.), 659
– Medical devices

– – Cochlear implant maker settles whistleblower claims (D. Colo.), 505
– – Orthopedic implants, public disclosures of scheme, dismissal affirmed (1st Cir.), 752
– – Pacemaker, doctor kickbacks, second-filed suit (D. Colo.), 338
– – Pleading against manufacturer inadequate, suit dismissed (W.D. Mich.), 413

– Medicare overpayments not disclosed, CHRISTUS settles charges (C.D. Cal.), 838
– N.J., guidelines, 85
– Off-label use

– – Biliary stents, Medtronic charged (D. Miss.), 211
– – Cardioblate system, particularity lacking (S.D. Tex.), 841
– – Lipitor, Pfizer employee suit (E.D.N.Y.), 168; DOJ responds to Pfizer motion, 799
– – Marinol, whistleblower case dismissed (U.S., rev den), 552
– – Rapamune, whistleblowers file amended complaint (E.D. Pa.), 450; House panel launches probe, 502; DOJ moves to intervene, 794; motion approved, 837
– – Rituxan, bribery allegations (E.D. Pa.), 508; whistleblower denied access to grand jury transcripts, 841

– Outlook, 42
– Physical therapists vs. clinic, service of process, timeliness (D.N.J.), 125
– Postmarket studies and kickbacks, St. Jude Medical, U.S. seeks to intervene (D. Mass.), 654; shareholders seek protection from costs (D. Minn.), 847
– Preemption, FCA bars qui tam suits based on state disclosures (U.S., rev and rem), 282
– Price inflation, Medicare claims, hospital settles (D.N.J.), 26
– Research funds, falsely obtained (S.D.N.Y.), 29; suit to proceed, 454; psychiatrist and hospital, damages set, 664
– Speech pathologists, trial needed to resolve false claims issues (D. Idaho), 248
– Unnecessary procedures, amended complaint ordered (E.D. La.), 657
– Whistleblowers

– – Employment contracts, 162
– – Grassley (R-Iowa) asks 16 drug firms about their FCA programs, 568
– – Md., false claims act signed with limits on whistleblower suits, 346
– – Motivation described in article, 409
– – Potential, deterrence, Insight, 95

– Wrongful discharge

See RETALIATION

– Youth residential facility, fraudulent billing for psychiatric care (W.D. Va.), 216; parent firm not liable for subsidiaries' acts, 656