anti-kickback statute Archives - Medical Malpractice Lawyers

Federal Appellate Court Distinguishes Certain Drug Rebates From Unlawful Kickbacks

April 7, 2025

Regeneron Pharmaceuticals, Inc. manufactures Eylea. Eylea is one of just a few drugs approved by the Food and Drug Administration (FDA) for treating an ophthalmological condition called neovascular age-related macular degeneration, also known as wet AMD. Eylea is a “buy and bill” drug un[...]

Federal Appellate Court Rules District Court Misapplied Coconspirator Exclusion To Hearsay Rule In Healthcare Fraud Case

December 2, 2024

The Anti-Kickback Statute (“AKS”) is a federal law prohibiting people from referring or accepting the referral of patients covered by a federal healthcare program in exchange for a payment. 42 U.S.C. § 1320a–7b. This statute was allegedly violated by John Holland, William Moore, and E[...]

DaVita Pays Over $34M To Resolve Illegal Kickbacks Allegations

September 21, 2024

The U.S. Attorney’s Office of the District of Colorado announced on July 18, 2024 that DaVita Inc., which is one of the largest providers of kidney care services in the U.S. and which served approximately 250,200 patients at 3,042 outpatient dialysis centers (2,675 centers were located in the[...]

Federal Appellate Court Finds Pfizer’s Proposed Copay Assistance Program For Expensive Heart Drug Would Violate Anti-Kickback Statute

January 4, 2023

Pfizer’s Proposed Copay Assistance Program Violates Anti-Kickback Statute: Pfizer, Inc. produces and sells a drug called tafamidis that treats a rare, progressive heart condition known as transthyretin amyloid cardiomyopathy. Without treatment, patients have a median life expectancy of two to [...]

False Claims Act: Kickbacks In The Health Care Industry

March 22, 2022

Kickbacks in the healthcare industry are pernicious because of their potential to subvert medical decision-making and to increase healthcare costs. In addition to pursuing improper payments by drug manufacturers, the department resolved other schemes involving the willful solicitation or payment of [...]

Pathology Lab Settles False Claims Act Allegations For $63.5M

February 12, 2019

The U.S. Department of Justice announced on January 30, 2019 that pathology laboratory company Inform Diagnostics has agreed to pay $63.5 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians. Inform Diagnostics,[...]

Pharmaceutical Company Agrees To Pay $360M To Settle Copays Kickback Scheme

December 21, 2018

The U.S. Department of Justice announced on December 6, 2018 that Actelion Pharmaceuticals US, Inc. (“Actelion”) has agreed to pay $360 million to resolve claims that it illegally used a nonprofit foundation as a conduit to pay the copays of thousands of Medicare patients taking Actelion[...]

OIG Advisory Opinion Warns Drug Company Its Proposal To Provide Drug For Free May Be Illegal

December 8, 2018

The Office of the Inspector General of the United States Department of Health and Human Services (“OIG”) issued an advisory opinion posted on November 16, 2018 that concluded that a drug company’s proposal to provide free product to hospitals for their use exclusively to treat inpa[...]

Health Care Fraud And Abuse Laws In The U.S. (AFTER The Patient Protection And Affordable Care Act Of 2010)

May 18, 2011

In a continuing effort to fight health care fraud and abuse, Congress enacted (and the President signed on March 23, 2010) comprehensive health reform legislation, including the Patient Protection and Affordable Care Act (PPACA). PPACA Fraud And Abuse Provisions PPACA amends the administrative sa[...]

Health Care Fraud And Abuse Laws In The U.S. (BEFORE The Patient Protection And Affordable Care Act Of 2010)

May 17, 2011

It is estimated that health care fraud and abuse costs the government billions of dollars each year. Inasmuch as Medicare and Medicaid are the largest single consumer of health care in the entire world and represent over 20% of all U.S. federal government spending each year, the potential cost of he[...]

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