Health Care Tops Lists of False Claims Act Violations

(Chicago Tribune/TNS) -

Health-care fraud topped the list of federal crackdowns this year under the False Claims Act, accounting for more than half of $3.5 billion in settlements and judgments.

The federal government recovered $1.9 billion to settle claims against companies and people charged with providing unnecessary or inadequate care, paying kickbacks to health-care providers, or overcharging for goods and services paid for by Medicare, Medicaid and other federal health-care programs. The settlements were for the fiscal year that ended Sept. 30.

Hospitals were involved in nearly $330 million of settlements and judgments, led by a settlement by 457 hospitals in 43 states related to cardiac devices that were implanted in Medicare patients in violation of Medicare billing rules.

The nation’s second-largest nursing-home pharmacy, PharMerica Corp. of Louisville, Ky., paid $9.25 million to resolve allegations that it solicited and received kickbacks from Abbott Laboratories of North Chicago, Ill., in exchange for promoting the anti-seizure medicine Depakote to patients. In 2012, Abbott resolved related claims by agreeing to pay $1.5 billion that it promoted Depakote for unapproved uses in numerous nursing homes around the country.

Two of the largest recoveries were from Denver-based DaVita Healthcare Partners Inc., which operates a chain of dialysis clinics. DaVita paid $450 million to resolve allegations that it knowingly generated unnecessary waste in administering drugs to dialysis patients and then billed the government for costs that could have been avoided. DaVita paid an additional $350 million to resolve claims that it paid kickbacks to physicians for referrals.

The government calls the False Claims Act its primary civil remedy for fraud and false claims. In addition to health-care fraud, the federal government recovered money this year related to housing and mortgage fraud, government contracts, federal crop insurance, federal student aid and small-business loans.