2007

Parties

Court

Date

Amount

Fraud/Topic

CIA

AFSCME v. Serono SA (class action settlement)

D. Mass.

1/31/07

$24 mill.

Fraudulent marketing & sale of HIV drug

NA

In re. Institute for Cancer Research

Bankr. S.D.N.Y.

1/12/07

$3.2 mill.

Misuse of grant funds

N

U.S. ex rel. Reilly v. Catskill Medical Center (APS)

S.D.N.Y.

3/28/07

$3.4 mill.

Defrauding Medicaid

Y

U.S. ex rel. Colon v. Affiliated Prof. Services Inc. (APS)

D. Mass.

1/12/07

$100,000

Medicare billing

N

U.S. ex rel. Colon v. Perry Hearn

D. Mass.

1/12/07

$150,000

Medicare billing

N

U.S. ex rel. Kaczmarczyk v. SCCI Health Services Corp.

S.D. Tex.

1/5/07

$7.5 mill.

Violated Stark self-referral law

N

U.S. ex rel. Marchese v. Cell Therapeutics (CTI)

W.D. Wash.

4/16/07

$10.5 mill.

Illegal marketing of Trisenox

N

U.S. ex rel. Moore v. East Tennessee Heart Consultants

E.D. Tenn.

1/4/07

$2.9 mill.

Retained Medicare overpayments

Y

U.S. v. Brighten at Broomall

E.D. Pa.

2/14/07

$45,000

inadequate care

C

U.S. v. Dr. Irina Benaur

E.D. Pa.

1/24/07

$210,000

Fraudulent claims

N

U.S. v. Pfizer Inc. (Pharmacia & Upjohn Co.)

D. Mass.

3/28/07

$34.7 mill.

Illegal marketing & promotion of Genotropin

N

U.S. and Mass. v. Tri-City Mental Health Center

D. Mass.

3/28/07

$556,687

False billing

N

U.S. v. Wellpoint Health Networks (RightChoice Managed Care)

E.D. Mo.

1/29/07

$975,000

Overcharged FEHBP

N

2006

Parties

Court

Date

Amount

Fraud/Topic

CIA

California v. Kaiser Foundation Health Plan, Inc.

8/9/06

$5 mill.

Violations of state law

N

Connecticut v. Essex Village & Meadowbrook Rest Home

2/13/06

$1.2 mill.

False claims

N

Florida v. Crouse

Fla.Cir. Ct.

2/14/06

$3 mill.

Sales of unauthorized health plan

N

Florida v. Tenet Healthcare Corp.

S.D. Fla.

2/21/06

$7 mill.

Inflated reimbursement claims

N

Hoorman v. SmithKline Beecham

Ill. Cir. Ct.

10/6/06

$63.8 mill.

Class action settlement re. promotion of Paxil

NA

New York v. Cardinal Health Inc.

NA

12/26/06

$11 mill.

Drug-trading practices

N

Sutter v. Horizon Blue Cross Blue Shield of NJ

N.J. Sup. Ct.

10/16/06

NA

Deceptive practices

N

Texas ex rel. Ven-a-Care of the Florida Keys

Tex. Dist. Ct.

6/12/06

$8.5 mill.

False reporting of drug prices to Medicaid

N

U.S. ex rel. Burns v. Northside Hospital

N.D. Ga.

10/20/06

$6.9 mill.

FCA and Stark law violations

N

U.S. ex rel. Clarke v. Diabetes Self Care

W.D. Va.

3/6/06

$9 mill.

Unapproved DME claims to Medicare

N

U.S. ex rel. Drescher v. Highmark

E.D. Pa.

6/19/06

$2 mill.

Underpayment of amounts owed for Medicare secondary payers

N

U.S. ex rel. Ghrist v. Orthoscript, James A. Nelson & Angela Isley

N.D. Ga.

10/13/06

$25,000

Medicare fraud

N

U.S. ex rel. Hall v. Pediatrix Med. Group

D. Md.

9/21/06

$25 mill.

Improper billing of health programs

N

U.S. ex rel. Kiern (Cole) v. Inove VNA Home Care

E.D. Va.

8/28/06

$9.6 mill.

False claims to Medicare & Medicaid

Y

U.S. ex rel. King v. Intrepid U.S.A.

D. Minn.

2/9/06

$8 mill.

Medicare billing

Y

U.S. ex rel. O'Brien(Hill) v. Morehouse Medical Assoc.

N.D. Ga.

10/3/06

$987,815

False Claims -code upgrading

N

U.S. ex rel. Orbeck v. Marion Regional Healthcare Sys.

D.S.C.

7/18/06

$3.75 mill.

Prohibited financial transactions with Doctors

Y

U.S. ex rel. Piacentile v. Merck & Co.

E.D. Pa.

10/23/06

$155 mill.

False claims to govt. health plans

N

U.S. ex rel. Pitelli v. Keystone Mercy Health Plan

E.D. Pa.

10/26/06

$5 mill.

Failure to return overpayments to Medicaid

N

U.S. ex rel. Quinelly v. Piedmont Hospital

N.D. Ga.

6/9/06

$3 mill.

Submitting false claims

Y

U.S. ex rel. Russell v. Odyssey Health Care

E.D. Wisc.

7/12/06

$13 mill.

Medicare false claims

Y

U.S. ex rel. Smith v. Lincare Holdings Inc. and Lincare Inc.

D. Mass.

6/8/06

$526,000

Overbilling Medicare

N

U.S. v. Stuart Aiken

D. MD.

5/5/06

$326,570

Medicare billing

N

U.S. v. Beebe Medical Center and DRs. Caruso and Parasher

D. Del.

3/16/06

$1 million

Illegal financial relationship between hospital and doctors

Y

U.S. v. Beverly Enterprises, Inc.

N.D.Calif.

8/18/06

$20 million

Fraudulent Medicare and Medicaid claims

N

U.S. v. Chiotellis

D. Mass.

5/17/06

$1.9 million

Medicare billing fraud

Y

U.S. v. Danbury Hospital

D. Ct.

10/25/06

$2.35 mill.

Overbilling Medicare for patient hospital stays

N

U.S. v. Debbi

S.D.N.Y.

3/1/06

$335,000

False Medicare claims for services in nursing homes

N

U.S. v. GlaxoSmithKline

D. Mass.

8/10/06

$70 mill.

Artificially inflated prices

N

U.S. v. Group II Medical Supports LLC

S.D.W. VA.

5/12/06

$1.6 mill.

False Medicare and Medicaid billing

N

U.S. v. InterMune Inc.

N.D. Cal.

10/26/06

$36.94 mill.

Illegal promotion of drug for off-label uses

Y

U.S. v. Lincare Inc.(ex rel. Martin)

5/15/06

$10 mill.

Violation of ant-Kickback and Stark laws

Y

U.S. v. Medco Health Solutions

E.D. Pa.

10/23/06

$8 mill.

False DME claims to Medicare

Y

U.S. v. Medtronic Inc.

W.D. Tenn.

7/18/06

$40 million

Kickbacks to Doctors

Y

U.S. v. Michel(Larkin Community Hospital)

S.D. Fla.

11/30/06

$15 million

False claims & referral kickbacks

N

U.S. v. Mobility Products Unlimited (MPU) - Fla.

M.D. Fla.

5/26/06

$2.77 million

Medicare Part B fraud

Y

U.S. v. Mount Sinai Med. Cntr. of Florida

S.D. Fla.

8/11/06

$3.5 million

Failure to report rebates and credits

Y

U.S. v. Omnicare (ex rel. Lisiitza & Kammerer)

N.D. Ill.

11/14/06

$49.5 mill.

Prescription drug substitution

Y

U.S. v. Rogan (court opinion and order)

N.D. Ill.

9/29/06

$64 million

Defrauding Medicare & Medicaid

NA

U.S. v. Schering-Plough Corp.

D. Mass.

8/29/06

$435 mill.

Illegal sales and marketing of drugs

Y

U.S. v. State of North Carolina

E.D. N.C.

8/18/06

$151.5 mill.

Improper disbursement of Medicaid funds

N

U.S. v. St. Barnabas Corp. (NJ)

E.D. Pa.

6/14/06

$265 mill.

Inflation of Medicare billing

Y

U.S. v. Tenet Healthcare Corp.

C.D. Cal.

6/28/06

$900 mill.

Medicare billing practices

Y

U.S. v. UHS of Delaware

E.D. Pa.

4/10/06

$1.5 mill.

Violation of ant-Kickback and Stark laws

N

U.S. v. University of Miami

S.D. Fla.

12/21/06

$2.3 mill.

Medicare billing

N

2005

Parties

Court

Date

Amount

Fraud/Topic

CIA

Academy of Medicine of Cincinnati v. Anthem BC/BS

Ky. Cir. Ct.

9/30/05

$160 mill.

Conspiracy to keep reimbursement rates artificially law

N

Florida v. King Pharmaceuticals, Inc.

E.D. Pa.

10/31/05

$4.2 mill.

Underpaid rebates Overcharged state and federal entities for drugs

N

In re Managed Care Litigation - Health Net Inc.

S.D. Fla.

5/3/05

$140 mill.

Violation of federal racketeering and state prompt-pay laws

N

In re Managed Care Litigation - Prudential Financial Inc.

S.D. Fla.

5/3/05

$22.2 mill.

Violation of federal racketeering and state prompt-pay laws

N

In re Managed Care Litigation - Wellpoint Inc.

S.D. Fla.

7/11/05

$198 mill.

Violation of federal racketeering and state prompt-pay laws

N

New York v. Americare Certified Special Services (Brooklyn, NY)

11/21/05

$7 mill.

Medicaid billing for adult home services

N

New York v. New York Oncology Hematology

NY Sup. Ct.

12/5/05

$1.2 mill.

Medicaid billing

N

New York v. Omnicare Inc.(10 subsidiaries)

4/28/05

$5.75 mill.

Medicaid billing

N

New York v. Staten Island Univ. Hospital

N.Y.Sup.Ct.

5/17/05

$76.5 mill.

Medicaid overbilling

N

Tenet Healthcare Cases II (class action settlement)

Cal. Super. Ct.

8/5/05

Undetermined

Overpricing of drugs and medical products and services

N

Texas ex rel. Ven-a-Care of the Florida Keys v. Roxane Labs

Tex. Dist. Ct.

11/18/05

$10 mill.

Fraudulent inflation of reported wholesale price of its drugs

N

U.S. ex rel. Bogart v. King Pharmaceuticals, Inc.

E.D. Pa.

10/31/05

$124 mill.

Underpaid rebates Overcharged state and federal entities for drugs

Y

U.S. ex rel. Brown v. AdvancePCS

E.D. Pa.

9/7/05

$137.5 mill.

Kickbacks

Y

U.S. ex rel. Buckman v. Rural Metro Corp. and Donlock, Ltd.

M.D. Pa.

6/21/05

$1.56 mill.

False claims for ambulance servcs.

N

U.S. ex rel. Falla v. Patel

D. Mass.

6/27/05

$400,000

Government health program fraud

Y

U.S. ex rel. Garner v. Anthem Insurance COs.

S.D. Ohio

8/08/05

$1.5 mill.

Overcharged FEHB

N

U.S. ex rel. Gober v. Univ. of Alabama

N.D.Ala.

4/14/05

$3.39 mill.

Medicare billing

C

U.S. ex rel. Gorumba v. Cancer Treatment Centers of America

W.D.Wash.

3/18/05

$478,000

Medicare/Tricare billing

Y

U.S. ex rel. Harris v. Dr. Bernad and Neurology Services Inc.

D.D.C.

4/13/05

$122,500

Medicare billing

N

U.S. ex rel. Hudnall and State of Texas v. ResCare

N.D. Tex.

6/14/05

$2.1 million

Medicaid fraud

N

U.S. ex rel. Long v. Mayo Foundation

D.Minn

5/23/05

$6.5 mill.

False Grant Expensing

N

U.S. ex rel. Pervez v. Beth Israel Med. Cntr.

S.D.N.Y.

11/30/05

$72 mill.

False statements re. Medicare Reimbursements

Y

U.S. ex rel. Reilly v. Catskill Reg. Med. Cntr.

S.D.N.Y.

1/7/05

$1.5 mill.

Patient referral

Y

U.S. ex rel. Reilly v. Catskill Reg. Med. Cntr.(Mt. Vernon Hosp.)

S.D.N.Y.

7/28/05

$2.65 mill.

Illegal Patient referral

Y

U.S. ex rel. Satchell v. Assessment and Treatment Alternatives (ATA)

E.D.Pa.

1/27/05

$325,000

Medicaid fraud

Y

U.S. v. Abington Mem. Hospital (Pa.)

E.D.Pa.

5/24/05

$4.2 million

False claims for clinical lab tests

Y

U.S. v. AdminaStar Federal (U.S. ex rel. Calabrese v. AdminaStar and U.S. ex rel. Moore and Scott v. AdminaStar)

W.D. Ky.

9/20/05

$6 million

Tampering and altering Medicare files and claims info.

N

U.S. v. AmeriChoice of Pennsylvania Inc.

E.D.Pa.

6/30/05

$1.6 million

Claims processing

Y

U.S. v. St. Barnabas Health Care System

D. NJ.

12/6/05

$3.8 million

Medicare overcharging

N

U.S. v. Cares R Us Home Health Care

E.D.Wisc.

3/28/05

$250,000

Medicaid billing

N

U.S. v. Central Montgomery Med. Cntr (CMMC)

E.D. Pa.

7/25/05

$200,000

Failure of care

N

U.S. v. EMSCO Billing (ex rel. Trombetta & Freeman)

N.D.Ill.

5/24/05

$700,000

Medicare/Medicaid overbilling

N

U.S. v. Erlanger Medical Center (Tenn.)

E.D.Tenn.

10/24/05

40 mill.

Stark law violations & Medicare anti-kickback violations