Health Care Fraud Report Index-Summary

ABA

See AMERICAN BAR ASSOCIATION (ABA)

ABORTION

– N.Y. Medicaid family planning claims unallowable, IG finds overpayments due to ineligible services, 768

ABUSE

– Drugs and alcohol

See SUBSTANCE ABUSE

– Elderly

See ELDER ABUSE

– Personal care facility operator, motion to vacate 18-year prison sentence for neglect and abuse of patients denied (M.D. Pa.), 471

ACCESS TO CARE

– Alaska agency and HHS Civil Rights Off. sign equal transportation access agreement to benefit disabled nursing home residents, 354
– Health care reform

See HEALTH CARE REFORM, FEDERAL

ACCREDITATION AND CERTIFICATION

– ASCs, effective date of participation based on date Form 855B is complete (Departmental App. Bd., Civil Remedies Div.), 677
– Clinical laboratories, CLIA certification

See CLINICAL LABORATORIES

– False certifications for home health aides, training center charged (N.Y. Crim. Ct.), 209
– Federally qualified health centers, satellite locations properly denied status (Dep't Appeals Bd.), 159
– Former general counsel of Tenet Healthcare allegedly violated FCA by submitting false certifications to Medicare, trial rescheduled (S.D. Fla.), 550
– FQHCs

– – CMS acceptance of application as complete basis for effective date, sustained (Departmental App. Bd., Civil Remedies Div.), 677
– – Effective date of participation upheld (Departmental App. Bd., Civil Remedies Div.), 677

– HHAs, certification denial due to patient deficiencies affirmed (Departmental App. Bd., Civil Remedies Div.), 315
– Hospitals

– – Date provider meets all federal requirements is effective date, determination upheld (Departmental App. Bd., Civil Remedies Div.), 638
– – Joint Commission accreditation not enough, intermediary must approve Form 855A for Medicare participation eligibility (Departmental App. Bd., Civil Remedies Div.), 638
– – Participation date linked to approval of Form 855A (Departmental App. Bd., Civil Remedies Div.), 315

– Long-term care, effective date of Medicare participation certification upheld (Dep't Appeals Bd., Appellate Div.), 156
– NCQA

See NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA)

– Psychiatric care facilities, provider agreement effective on date survey complete without deficiencies (Departmental App. Bd., Civil Remedies Div.), 315
– URAC

See UTILIZATION REVIEW ACCREDITATION COMMISSION (URAC)

– Wife of rehabilitation company owner liable for signing and certifying cost reports (E.D. Mich.), 636

ADEA

See AGE DISCRIMINATION IN EMPLOYMENT ACT (ADEA)

ADVERSE EVENTS

– Hospital-acquired infections

See HOSPITALS

– Reporting, key issues explored, IG and state reports, 10
– Safety of hospitalized Medicare patients, concerns justified, IG study, 11

ADVERTISING

– Chiropractors' association may advertise and provide referrals without anti-kickback law penalties, advisory opinion, 768
– Compliance plan not enough to avoid enforcement according to government attorneys, BNA Special Report, 788
– Off-label use promotions

See OFF-LABEL USE

ADVISORY OPINIONS, HHS IG

– Ambulance services

– – Exclusive contract agreements between ambulance companies and local governments allowed, 714
– – Hospital's proposal to subsidize cooperative no basis for sanctions, 664
– – Joint venture arrangement to serve county allowed, advisory opinion, 800
– – Villages' arrangement for insurance-only billing for backup transportation not ground for penalties, 347

– Blood pressure screenings free to all walk-in visitors to hospital allowed, 626
– Call coverage, on-call payments for physicians who treat uninsured patients do not violate anti-kickback law, BNA Special Report, 446
– Chiropractors' association may advertise and provide referrals without penalties, advisory opinion, 768
– Group practice arrangement presents no kickback concerns, 10
– Joint venture between hospital and orthopedic surgeons group to own ASC poses minimal risk of fraud, advisory opinion, 627
– Medigap insurers contracting with hospitals to create preferred provider networks no basis for sanctions, 627
– Patient assistance programs

– – Nonprofit group can help needy patients pay cost-sharing amounts for advanced diagnostic testing for HIV and colon cancer without risking penalties, 423
– – Part D copayment subsidy for needy patients by state board would not merit penalties, advisory opinion, 663
– – Pharmaceutical company may provide certain products to large DSH hospitals without penalties, 628

– SNFs, complimentary local transportation for friends and families of residents not subject to penalties, 229
– Tax revenues may cover county residents' emergency services cost sharing requirement, 9

AGE DISCRIMINATION IN EMPLOYMENT ACT (ADEA)

– Nurses allege termination due to bias and retaliation for reporting unsafe conditions (D. Colo.), 597

AHA

See AMERICAN HOSPITAL ASSOCIATION (AHA)

AHLA

See AMERICAN HEALTH LAWYERS ASSOCIATION (AHLA)

AIDS AND HIV

– Attorney given 3-year prison term for illegal distribution of HIV drug (D.N.H.), 436
– Fla. infusion clinics

– – Clinic owner sentenced to nearly four years and restitution (S.D. Fla.), 275
– – Dementia alleged, physician competent to stand trial (S.D. Fla.), 206
– – Employee convicted in $12M Medicare billing scheme (S.D. Fla.), 673
– – Five-state scheme alleged, MA insurers billed $22M for treatments (S.D. Fla.), 391
– – Guilty plea to Medicare billing fraud, In Brief, 25; co-owners enter guilty pleas (S.D. Fla.), 77; jury convicts doctors and medical assistants (S.D. Fla.), 239; physician and two assistants receive multi-year prison terms, 637
– – Indictment unsealed, 3 operators accused of Medicare fraud involving kickbacks and manipulated blood samples (S.D. Fla.), 312; three defendants plead guilty, 632
– – Miami physicians indicted for bogus treatments (S.D. Fla.), 151; doctors and clinic employees plead guilty, 238; co-owner/physician and chemist plead guilty, 274; chemist and others sentenced to prison, 470; physician sentenced to 8 years in prison plus $9M restitution, 551
– – Pharmaceutical wholesaler, owner pleads guilty to Medicare billing scheme (S.D. Fla.), 109
– – Physicians convicted of billing for rarely-used, expensive medications (S.D. Fla.), 675
– – Shell-company scheme, jury finds clinic owners guilty (S.D. Fla.), 808

– Patient assistance program, nonprofit group can help needy patients pay cost-sharing amounts for advanced diagnostic testing without risking penalties, advisory opinion, 423
– Stolen prescription pads, Fla. man pleads guilty to forging physician prescriptions for high-cost cancer and HIV prescriptions and reselling drugs (N.D. Ga.), 809
– Subdosing due to drug dilution, physician pleads guilty (C.D. Cal.), 214

ALABAMA

– Hospice care, Birmingham firm settles Medicare fraud claims (N.D. Ala.), 75
– Kyphoplasty, hospitals agree to pay to settle FCA allegations (W.D.N.Y.), In Brief, 777
– Medicaid

– – AWP suits

– – – AstraZeneca, GlasxoSmithKline and Novartis win on appeal, verdict reversed (Ala.), 811
– – – Sandoz ordered to pay $78.4M (Ala. Cir. Ct.), 209
– – – Six more companies settle (Ala. Cir. Ct.), 438
– – – State and 5 drug makers settle suit (Ala. Cir. Ct.), 26

– – Generic drug cases against pharmacies filed by private lawyers in name of state dismissed by attorney general, 812

ALASKA

– Medicaid, owner of nursing service pleads guilty to theft and sentenced to prison and restitution (Alaska Super. Ct.), 686
– Nursing homes, state agency and HHS Civil Rights Off. sign equal transportation access agreement to benefit disabled residents, 354

ALFs

See ASSISTED LIVING FACILITIES (ALFs)

AMA

See AMERICAN MEDICAL ASSOCIATION (AMA)

AMBULANCE SERVICES

– Diverted in transit, EMTALA claim proceeds for uninsured ectopic pregnancy patient (U.S., rev den), 79
– Exclusive contract agreements between ambulance companies and local governments allowed, advisory opinions, 714
– Hospital's proposal to subsidize cooperative no basis for sanctions, advisory opinion, 664
– Joint venture arrangement to serve county allowed, advisory opinion, 800
– Medicaid billings vulnerable to fraud despite state oversight efforts, IG report, 461
– Nonemergency ESRD patients

– – False representations about patients transported to dialysis treatments, Tex. couple convicted (E.D. Tex.), 735
– – Firm owners sentenced to prison, restitution, and forfeiture (S.D. Tex.), 396
– – Indictment of owner and manager for filing false claims announced (N.D. Tex.), 476
– – Prison term of 97 months upheld for owner convicted of Medicare and Tex. Medicaid fraud (5th Cir.), 152

– Overpayments for transporting Part A beneficiaries to SNFs, IG report, 714
– Tax revenues may cover county residents' emergency services cost sharing requirement, advisory opinion, 9
– Villages' arrangement for insurance-only billing for backup transportation not ground for penalties, advisory opinion, 347

AMBULATORY CARE

– Effective date of participation for ASC based on date Form 855B is complete (Departmental App. Bd., Civil Remedies Div.), 677
– Joint venture between hospital and orthopedic surgeons group to own ASC poses minimal risk of fraud, advisory opinion, 627
– Self-referrals, bill regulating physicians passed by state senate, 26; N.J. lawmakers pass bill to create safe harbors for ASCs referrals, 113; governor signs new law putting restrictions on licensing and self-referrals, 280
– State licensing requirements not met, ASC status denial upheld (Dep't Appeals Bd., Appellate Div.), 156

AMERICAN BAR ASSOCIATION (ABA)

– BNA conference reports

See CONFERENCE REPORTS

– Conferences

See CONFERENCES AND MEETINGS

AMERICAN HEALTH LAWYERS ASSOCIATION (AHLA)

– Conferences

See CONFERENCES AND MEETINGS

– Stark Law restructuring and improvements recommended by white paper, 625

AMERICAN HOSPITAL ASSOCIATION (AHA)

– Meetings

See CONFERENCES AND MEETINGS

– Reform initiatives with greater access to affordable care favored, 353

AMERICAN MEDICAL ASSOCIATION (AMA)

– Out-of-network fees

– – CIGNA and Aetna databases used for reimbursement, medical societies also file class actions alleging knowing underpayment (D.N.J.), 168
– – Wellpoint sued by AMA and several state medical groups (C.D. Cal.), 283

– Prescription data restriction program meets Mass. gift rules, 601

AMERICAN RECOVERY AND REINVESTMENT ACT (ARRA)

– CMS accurately adjusted temporary Medicaid matching fund increases, IG report, 424
– Expansion of federal fraud laws to cover stimulus package funds

See LEGISLATION, FEDERAL, HR 1748, S 386

– Health care sector experience with compliance, a model for entities receiving economic stimulus funds, BNA Analysis & Perspective, 216
– HHS Inspector Gen., annual work plan for FY2010 includes mandated reviews, 770
– HIPAA

– – Contract and policy changes needed, lawyers say, 304
– – Health IT funding, BNA audioconference, 215
– – HHS Civil Rights Office to enforce security rule, 630

– Oversight role for HHS IG, 369

AMERICANS WITH DISABILITIES ACT (ADA)

– Alaska agency and HHS Civil Rights Off. sign equal transportation access agreement to benefit disabled nursing home residents, 354

ANALYSIS AND PERSPECTIVE

– Deferred prosecution agreements, further guidance governing corporate monitors needed, 288
– DME industry faces increased oversight and enforcement, 327
– FERA: a giant leap forward for False Claims Act enforcement, 567
– Health care fraud enforcement: Congress invests in fraud recovery efforts to help reform and strengthens False Claims Act, 609
– Health care sector experience with compliance, a model for entities receiving covered funds under ARRA, 216
– Medicare Recovery Audit Contractor Program demonstration project, key issues and lessons learned, 173
– OIG's new changes to the self-disclosure protocol, 523
– Private-public partnership to fight fraud should be more integral to reform, 695
– Recession's effect on health care fraud: the challenge of maintaining effective compliance in a down market, 752
– Reform bills would change compliance efforts from voluntary to mandatory, 692
– Voluntary disclosure, Chicago hospital settles after reporting potential FCA violations related to sale, 44

ANESTHESIOLOGY SERVICES

– Dentist, Medicare provider status improperly denied where applicant was licensed by state as anesthesiologist (Dep't Appeals Bd.), 162; upheld (Departmental App. Bd., App. Div.), 397
– Kickbacks, qui tam suit proceeds over group arrangement with hospital where Stark Law exception was not met (3d Cir.), 67

ANTI-KICKBACK LAWS

– Ambulance services

– – Exclusive contract agreements between ambulance companies and local governments allowed, advisory opinions, 714
– – Hospital's proposal to subsidize cooperative no basis for sanctions, advisory opinion, 664
– – Joint venture arrangement to serve county allowed, advisory opinion, 800
– – Villages' arrangement for insurance-only billing for backup transportation not ground for penalties, advisory opinion, 347

– Blood pressure screenings free to all walk-in visitors to hospital allowed, advisory opinion, 626
– Celexa and Lexapro allegedly marketed for pediatric patients, U.S. intervenes in whistleblower suits, 2 cases (D. Mass.), 205; cases dismissed after drugmaker agrees to settle suits with government and qui tam plaintiffs, 807
– Chiropractors' association may advertise and provide referrals without penalties, advisory opinion, 768
– Clinical laboratory kickbacks to doctors for referrals, operators sentenced to 15-month prison terms (D.N.J.), 554
– Criminal conspiracy complaints against joint implant makers dismissed due to business practice reforms, 4 cases (D.N.J.), 267
– Embezzlement, medical center employee and physician recruiting service owner sentenced to prison (N.D. Tex.), 359
– Employment of mental health practitioner who was paid “market value” for building does not violate law, advisory opinion, 305
– ESRD, nutritional supplement program expansion not basis for penalties, advisory opinion, 538
– Foreign Corrupt Practices Act

See FOREIGN CORRUPT PRACTICES ACT (FCPA)

– Gainsharing, hospital's agreement to share cardiac catheterization savings will not lead to penalties, advisory opinion, 539
– Healthways Inc. agrees to pay to settle qui tam claims (M.D. Tenn.), 234
– Home health care

– – Beneficiary numbers obtained by kickbacks and bribes, Fla. operators and agencies indicted (S.D. Fla.), 506
– – Scheme to defraud Medicare, former agency owners plead guilty (E.D. Mich.), 676

– Hospitals

– – Anesthesiology group arrangement, qui tam action proceeds where Stark Law exception was not met (3d Cir.), 67
– – Outpatient testing access and cardiology group revenues link, qui tam suit proceeds (S.D. Ohio), 74; motion for interlocutory appeal denied, 202; motion to dismiss denied, 394
– – State and federal intervention in FCA whistleblower suit involving St. Louis detoxification services management firm and N.Y. facilities (E.D.N.Y.), 15
– – Tulare (Cal.) Local Healthcare District settles FCA suit brought by former chief financial officer (C.D. Cal.), 633

– Johnson & Johnson reveals it and subsidiary Ortho-Clinical Diagnostics received subpoenas related to physician payments, 386
– Joint venture between hospital and orthopedic surgeons group to own ASC poses minimal risk of fraud, advisory opinion, 627
– LTC, nursing chain agrees to pay to resolve allegations (N.D. Miss.), 806
– Medical devices, Stryker's motion to quash kickbacks probe subpoena dismissed on jurisdictional grounds (D.N.J.), 148
– Medigap insurers contracting with hospitals to create preferred provider networks no basis for sanctions, advisory opinion, 627
– Medline Indus. Inc., former employee's claims donations made by charitable foundation were kickbacks not sufficiently specific, suit dismissed (N.D. Ill.), 431
– Pacemaker manufacturer allegedly engaged in “elaborate scheme” to compensate physicians for use, federal officials considering whether to intervene (S.D. Fla.), 204
– Patient assistance programs

– – Nonprofit group can help needy patients pay cost-sharing amounts for advanced diagnostic testing for HIV and colon cancer without risking penalties, advisory opinion, 423
– – Part D copayment subsidy for needy patients by state board would not merit penalties, advisory opinion, 663
– – Pharmaceutical company may provide certain products to large DSH hospitals without penalties, advisory opinion, 628

– Pharmaceutical consultant convicted of receiving kickbacks, exclusion affirmed (Departmental App. Bd., Civil Remedies Div.), 638
– Physical therapy clinic operator's sentence to prison and restitution for violating anti-kickback law upheld (5th Cir.), 272
– Physicians

– – Call coverage, on-call payments for physicians who treat uninsured patients allowed, advisory opinion, BNA Special Report, 446
– – Group practice arrangement presents no kickback concerns, advisory opinion, 10
– – Medical devices, NeuroMetrix pays millions to settle, 141
– – Psychiatric facility, former CEO and physician convicted of participating in conspiracy (N.D. Ill.), 552
– – Radiology centers, state attorney general settles with 14 centers, 112

– Physicians, N.Y. doctor sentenced to 21 months in prison for pharmacy kickback scheme (S.D.N.Y.), 736
– Safe harbors

See SAFE HARBORS

– Self-disclosure protocol

– – Being refined to focus on kickbacks, IG open letter to industry, 258
– – Recent settlements announced, 666
– – Significant modifications, BNA Analysis & Perspective, 523

– Sham DME provider scheme

– – Harborside Healthcare agrees to pay to resolve allegations (N.D. Miss.), 806
– – McKesson subsidiary and others, government allegations sufficient to partially deny motion to dismiss suit (N.D. Miss.), 808

– SNFs, complimentary local transportation for friends and families of residents not subject to penalties, advisory opinion, 229
– Spinal surgery devices, amended qui tam complaint allowed in suit against supplier (E.D. Ark.), 70
– Substance abuse, state and federal intervention in FCA whistleblower suit involving St. Louis detoxification services management firm and N.Y. hospitals (E.D.N.Y.), 15
– Univ. of Medicine and Dentistry of New Jersey

– – Cardiologists settle kickbacks for referrals allegations, 766; medical school agrees to pay to settle kickback charges, 766
– – Medicaid fraud allegations settlement (D.N.J.), 469

– Wheelchairs, 5-year prison term for supplier sentenced in Medicare billing fraud scheme (N.D. Tex.), 155

ANTITRUST

– Average wholesale price inflation of prostrate cancer treatment, $12.9M judgment against AstraZeneca affirmed (1st Cir.), 773
– Average wholesale price publications, revised settlement of suit against First DataBank Inc. and Medi-Span approved (D. Mass.), 236; chain drugstore group will appeal settlement, 356; trade group for community pharmacists seeks stay of final approval, 389; court gives final approval to settlement, 633; pharmacy industry attempt to overturn settlement fails (1st Cir.), 720
– FTC Red Flags Rule, BNA audioconference, 320
– GPOs, financial relationships data requested by Senate panel, 665
– Immucor Inc. subject of Justice Dep't probe of blood reagents industry, 386
– Johnson & Johnson reveals it and subsidiary Ortho-Clinical Diagnostics received subpoenas related to investigation, 386
– Orthopedic devices, claims against major manufacturers dismissed (W.D. Pa.), 268

APPEALS

– Denial of payment for new SNF admissions upheld, hearing request not timely (Departmental App. Bd., Civil Remedies Div.), 638
– Independent diagnostic testing facility, rejection of enrollment application not final adverse decision, request for review denied (Departmental App. Bd., Civil Remedies Div.), 638
– Interlocutory, motion in FCA qui tam suit would lead to unnecessary delay (S.D. Ohio), 202; motion to dismiss denied, 394
– Medicare Recovery Audit Contractor Program, pilot program appeals exceeded expectations, report, 7
– Patient lifts reclassified as DME, LCD complaint dismissed (Departmental App. Bd., Civil Remedies Div.), 315
– Proposal to terminate provider agreement withdrawn, hospital has no right to ALJ hearing (Departmental App. Bd., App. Div.), 737
– Qui tam actions, 30-day filing notice applies when U.S. does not intervene in FCA suit (U.S., judg aff), 464
– Recoupment of Medicare overpayments would be barred during requested redetermination, In Brief, 710
– State registry of individuals charged with abuse, hearing request to expunge name denied because IG did not exclude petitioner (Departmental App. Bd., Civil Remedies Div.), 315

ARIZONA

– Nevada-based doctor and assistant charged in illegal prescription drug investigation (Ariz. Super. Ct.), 605

ARKANSAS

– Kickbacks solicited from neurosurgery equipment supplier, amended Medicare and Medicaid violations qui tam complaint allowed (E.D. Ark.), 70

ARMED SERVICES

– EMTALA, no claim where Naval Hosp. patient screening was adequate (E.D. Va.), 81
– TRICARE

See TRICARE

ARRA

See AMERICAN RECOVERY AND REINVESTMENT ACT (ARRA)

ASCs (AMBULATORY SURGICAL CENTERS)

See AMBULATORY CARE

ASSISTED LIVING FACILITIES (ALFs)

– Caregiver convicted of forging checks on personal bank accounts of residents, exclusion affirmed (Departmental App. Bd., Civil Remedies Div.), 315

ATTORNEY-CLIENT PRIVILEGE

– Burden of proving plaintiff was original source in FCA case not met by asserting privilege to bar court from learning how her attorney first learned of billing practices (7th Cir.), 550

ATTORNEYS

– Ala., Medicaid generic drug cases against pharmacies filed by private lawyers in name of state dismissed by attorney general, 812
– Attorney-client privilege

See ATTORNEY-CLIENT PRIVILEGE

– Client sanctioned, lawyers are not responsible for whistleblower's misconduct (Mich. Ct. App.), 688
– Criminal prosecution

– – Confidential information allegedly used to solicit clients, N.Y. lawyer and public hospital employees arrested for data bribery scam, 782
– – Illegal distribution of HIV drug, lawyer given 3-year prison term (D.N.H.), 436

– Former general counsel of Tenet Healthcare

– – False certifications to Medicare alleged, FCA trial rescheduled (S.D. Fla.), 550
– – Ordered to pay $120,000 for inflated outlier revenues in SEC filings (C.D. Cal.), 550

– Ineffective assistance of counsel

– – Physician's prison sentence for fraud upheld as court rejects argument (C.D. Cal.), 151
– – Sworn statement she was satisfied with performance defeats claim (E.D. Va.), 510
– – U.S. ordered to show why court should not vacate conviction of nursing facility owner (N.D. Cal.), 266

– Sanctions against HMO and its lawyers in underpayment class action vacated (3d Cir.), 726

ATTORNEYS' FEES

– Inappropriate conduct by CMS counsel, SNF penalty reduced and fees awarded (Departmental App. Bd., Civil Remedies Div.), 162; CMP reinstated and fee award reversed (Departmental App. Bd., App. Div.), 737
– Qui tam action against DME company not frivolous, motion for fees denied (M.D. Fla.), 393

AUDITS

– “Comprehensive” and “targeted,” CMS official discusses types, 382
– DSH payments, additional requirements under final CMS rule, 12; association urges extension of deadline, 385
– Electronic medical records, challenge of ensuring integrity, 819
– HealthSouth, Ernst & Young settlement of securities class action approved (N.D. Ala.), 268
– IG

See generally INSPECTOR GENERAL (IG), HHS

– Medicare Recovery Audit Contractor Program

See RECOVERY AUDIT CONTRACTORS (RACs)

– Mich. attorney general and lawmakers urge creation of independent inspector general's office for Medicaid, 557
– N.Y. Medicaid enrollees also in other states' plans, comptroller finds $28.4M in payments, 210
– Obstruction, St. Louis podiatrist pleads guilty (E.D. Mo.), 276; prison sentence, home confinement, and fine, 515
– Recovery audit contractors (RACs)

See RECOVERY AUDIT CONTRACTORS (RACs)

– Utah Medicaid audit reveals inefficiencies hamper recovery of overpayments, 685

AUTOMOBILE INSURANCE

– Allstate settles nationwide class action related to medical billing review system's allegedly incorrect calculations for auto and homeowner claims (Ill. Cir. Ct.), 689
– Chiropractic and physical therapy services, Allstate's complaint charging submission of fraudulent invoices dismissed (D. Conn.), 35
– Medical billing company owner pleads guilty to participating in fraud scheme (D.N.J.), 562
– Staged accidents

– – Chiropractors sentenced to prison, 2 cases (S.D. Fla.), 690
– – Fla. man pleads guilty to scheme that billed private insurers for purported injuries in staged accidents (S.D. Fla.), 362; prison sentence of 14 years and $3M forfeiture, 608
– – Medical clinic, management company, and their owners ordered to pay Allstate $1.5M (S.D. Fla.), 745
– – New York

– – – Ins. Dept. highlights staged accidents among 2008 recoveries, 210
– – – Physician convicted of running no-fault insurance scam (N.Y. Sup. Ct.), 215
– – – RICO suit against medical services companies and DME suppliers may proceed (E.D.N.Y.), 786

– – State Farm Auto Ins.

– – – Jury award of $15.4M by jury in RICO suit against health care providers (E.D. Pa.), 283
– – – Mich. no-fault law, suit alleging fraudulent billings by rehabilitation clinic may proceed (E.D. Mich.), 483
– – – RICO suit against medical services companies and DME suppliers may proceed (E.D.N.Y.), 786
– – – Secondary payers, insurer did not avoid duty to reimburse Medicare under MSP statute, suit dismissed (D. Idaho), 674

AVERAGE WHOLESALE PRICE (AWP)

– Ala. Medicaid

– – Sandoz ordered to pay $78.4M (Ala. Cir. Ct.), 209
– – Six more companies settle (Ala. Cir. Ct.), 438
– – State and 5 drug makers settle (Ala. Cir. Ct.), 26

– Ill. Medicaid, settlement with Amgen and Immunex Corp. announced (Ill. Cir. Ct.), 558
– Johnson & Johnson Remicade and Procrit claims dismissal, trial court failed to adequately explain rationale, reversed and remanded (1st Cir.), 772
– Ky. Medicaid

– – Amgen agrees to pay to settle price inflation charges (Ky. Cir. Ct.), 244
– – Jury verdict of $16M against Sandoz (Ky. Cir. Ct.), 517

– Prostrate cancer treatment, $12.9M judgment against AstraZeneca affirmed (1st Cir.), 773
– Publications, revised settlement of suit against First DataBank Inc. and Medi-Span approved (D. Mass.), 236; chain drugstore group will appeal settlement, 356; trade group for community pharmacists seeks stay of final approval, 389; court gives final approval to settlement, 633; pharmacy industry attempt to overturn settlement fails (1st Cir.), 720
– Utah Medicaid, state recovers $1M from drugmaker Dey, 743
– Wis. Medicaid, Amgen and Immunex settle reporting charges (Wis. Cir. Ct.), 28

AWP

See AVERAGE WHOLESALE PRICE (AWP)